Mental health disorders are New Zealand’s third leading cause of health loss with conditions such as anxiety, depression, post-traumatic stress disorder (PTSD), and attention deficit disorders (ADD) affecting a large portion of people1-4. One in six people or 16.6% of the population (650,000 adults) will experience a common mental disorder at some time in their lives that will drastically impact on the health and well-being4. Socio-economically deprived New Zealanders, women, and Māori all have higher rates of mental health-related issues4. Studies have shown that the biggest barrier to people seeking help is fear of how they will be perceived within society5. Understanding mental health can help alleviate some of the fears surrounding it and also assist to better understand how we can manage it.

When stress becomes too much for some or just when you feel overwhelmed anxiety is a mental health disorder where people feel;
-Excessive worrying or apprehension about several of events or activities
-Difficulty managing the worrying
Three or more: 
-Restlessness or being “on edge”
-Easily fatigued
-Body tension
-Sleeping problems
-Can also be associated with panic attacks and other severe symptoms


Depression can come and go, for some it can be a single episode, or othersongoing recurring episodes3. It is characterized with a depressedmood or loss in pleasure:

  • Feeling down almost every day for two weeks or more
  • Notably loss of enjoyment in almost all activities during this time
  • Significant unintentional weight changes
  • Other people notice that you are slowing down in movement or thinking
  • Almost constant fatigue
  • Recurrent thoughts of self-harm

Post-Traumatic Stress Disorder (PTSD)

This mental health concern is due to the unfortunate experience of a traumaticevent. Symptoms vary from person to person and may not manifest immediately.This disorder is characterised by:

  • Experiencing a stressor that threatens or experiences serious injury ordeath
  • Persistently re-experiencing traumatic event through nightmares,flashbacks, intrusive thoughts
  • Avoidance of triggering emotions, memories, and reminders
  • Exhibiting two types of negative alterations in cognition and mood
  • May have alterations in arousal and activity
  • Lasts more than one month
  • Creates distress or emotional impairment
  • Not due to other illnesses or medications

Attention-Deficit/Hyperactivity Disorder (ADHD)

Adults suffering from ADHD frequently experience five or more indications ofinattention and hyperactivity that impairs daily life7. Thesymptoms of ADHD include:

  • Inattention
  • Carelessness: making mistakes and lacking attention detail
  • Difficulty concentrating
  • Does not listen to direct communications
  • Lack of follow-through
  • Poor organisation
  • Avoids or dislikes tasks with sustained mental effort
  • Loses necessary items
  • Easily distracted
  • Generally forgetful
  • Hyperactivity/impulsion
  • Fidgets
  • Leaves conversations randomly
  • Restless
  • Has trouble with calm activities
  • Always on the go
  • Talks excessively
  • Bursts out comments
  • Difficulty waiting
  • Interrupts or intrudes on others

For those looking for natural alternatives to improve mental health many mayseek complementary or alternative medicines to treat theirsymptoms9. In Central and South American culture, the cacao beanhas always been used a sacred brain food to maintain mental balance andhappiness. Now new scientific studies are beginning to explain why cacao issuch a powerful plant to help our mental health.

How Cacao works to improve our mental health

1. With brain protecting flavonoids like epicatechin

Cacao is rich in special antioxidants that protect our brain function10,11,12. It contains molecules called flavonoids, that improve memory, cognition, and learning13. Studies of people consuming flavonoids over a 10- year period showed that they preserved their cognitive performance14,15. Cacao flavonoids are rapidly absorbed in the brain and can increase cerebral blood flow reaching peak concentrations within 2-3h after eating16-19. The most prevalent flavonol found in cacao, called epicatechin20, has been independently shown to be beneficial for vascular function and blood flow21. Studies have shown that perceived fear and anxiety can negatively alter cerebral blood flow(CBF)22. So having higher levels of flavanols from cacao in your blood can help reduce anxiety, fear and improve cognition23,24. In larger clinical trials several studies showed that after 5 days or more of consuming cacao people experienced cognitive improvement in many tests,  although overall behavioural changes were not noted18,25-32.

2. Through the action of methylxanthines (MXT) like theobromine

The other dominant component of cacao is the family of molecules classified under methylxanthines (MTX), and their metabolic products, which act on key receptors in the brain. The MTX components in cacao include theobromine, caffeine and procyanidins11,35. Cacao only contains low levels of the stimulant caffeine11, but much higher proportions oftheobromine, that produces a similar but lesser effect in comparison36,37. So cacao can be a little stimulatory but not as much as foods with high levels of caffeine like coffee. Theobromine is the most bioavailable compound in cacao, as measured in human plasma11.It also penetrates the brain crossing the selective blood-brain barrier for direct effects14. Theobromine improves working memory, acute memory formation and memory use40. The proposed mechanism is that theobromine is an adenosine receptor antagonist, a kind of inhibitor12, but differs from the comparative molecule caffeine12. In fact, theobromine in cacao actually off sets caffeine-related anxiety and sleep disruption10. This suggests theobromine may preferentially bind to different brain regions or types of neurons to specifically enhance memory, offering many more benefits than simple caffeine.

3. By supporting our ‘bliss molecule’ - Anandamide

Cacao also contains trace levels of human amines that may collectively alter mood through promoting the production of our natural bliss molecule called Anadamide. Anadamide is a human cannabinoid that regulates many stress-related functions in our nervous system. Anadamide acts to bring harmony, balance and bliss back to our natural brain function in partnership with neurotransmitters like serotonin. It is still unclear however if cacao directly or indirectly influences Anandamide. One study that has since been refuted claimed that cacao contains anandamide, which when ingested resulted in direct activation of cannabinoid receptors in the brain41. This was strongly refuted by other researchers42, however there has since been proposed a secondary hypothesis that the molecule phenylethylamine (PEA) that exists within cacao actually acts to prevent the re-uptake of cannabinoid acting molecules like Anadamide, thereby enhancing the cannabinoid receptor activation indirectly42. This follow-up response declared that the trace amounts of these amines would not be sufficient to induce a mind-altering experience. However, acute administration of cacao showed anti-anxiety responses in a rat stress-test, and long-term ingestion of cacao increased the amount of serotonin in several brain regions43.Serotonin reduces anxiety, amongst other mood-stabilising effects. The trace element PEA, found in cacao is structurally similar to serotonin and dopamine and enhances these uplifting neurotransmitters through secondary mechanisms44,45. So directly or indirectly cacao may offe rincreased levels of bliss and happiness to our brain when consumed regularly.

4. Through natural antidepressant effects

Antidepressant effects of cacao have been demonstrated in laboratory studies where rats consuming it performed better in stressful situations33.In a similar human study using cacao flavonol tablets to disguise the pronounced taste, acute consumption improved cognitive function and improved self-reported mental fatigue34. Further studies investigating cacao supplementation for anxiety showed acute administration provided anti-anxiety responses, with long-term ingestion increasing the amount of serotonin in several brain regions43. These studies suggest a positive role in cacao consumption for depression and anxiety, by alleviating the symptoms experienced by those struggling.

The clinical research has provided sound evidence to support the use of cacao in the ongoing management of mental health disorders. The molecules it contains have been shown to offer brain protection, improvements in memory, enhancement in mental function as well as anti-depressant and anti-anxiety effects. These properties could be of assistance to those struggling with their mental health. The only complications with the use for such issues is alack of standardising of active ingredients. Currently there is no known standard for required levels of flavanols, methylxanthines, PEA or other important molecules and not all cacao is equal in terms of its therapeutic quality. Levels of such compounds can vary greatly depending on where and how the cacao has been grown and processed. However, daily consumption of a good quality premium cacao may offer some people benefit for the ongoing management of mental health disorders.

To learn more about cacao and become a cacao expert.

Liquid error (templates/article.gem-556419612852-template line 16): Error in tag 'section' - 'blog-health' is not a valid section type


(1) Trautmann, S., Rehm, J., & Wittchen, H. U. (2016). The economic costs of mental disorders. EMBO reports, 17(9), 1245-1249.

(2) Wittchen, H.U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C.L.F.P.J. and Fratiglioni, L., 2011. The size and burden of mental disorders and other disorders of the brain in Europe 2010. European neuropsychopharmacology, 21(9), 655-679.

(3) Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve‐month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International journal of methods in psychiatric research, 21(3), 169-184.

(4) Mental Health and Illness. (n.d.). Retrieved from

(5) Andrade, L.H., Alonso, J., Mneimneh, Z., Wells, J.E., Al-Hamzawi, A., Borges, G., Bromet, E., Bruffaerts, R., De Girolamo, G., De Graaf, R. and Florescu, S., 2014. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological medicine, 44(6), pp.1303-1317.

(6) Schiffman, S. S., Gill, J. M., & Diaz, C. (1985). Methyl xanthines enhance taste: Evidence for modulation of taste by adenosine receptor. Pharmacology Biochemistry and Behavior22(2), 195-203.

(7) American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.

(8) Gureje, O., Nortje, G., Makanjuola, V., Oladeji, B. D., Seedat, S., & Jenkins, R. (2015). The role of global traditional and complementary systems of medicine in the treatment of mental health disorders. The Lancet Psychiatry, 2(2), 168-177.

(9) Nehlig, A. (2013). The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. British journal of clinical pharmacology75(3), 716-727.

(10) Kim, J., Kim, J., Shim, J., Lee, C. Y., Lee, K. W., & Lee, H. J. (2014). Cocoa phytochemicals: recent advances in molecular mechanisms on health. Critical reviews in food science and nutrition54(11), 1458-1472.

(11) Franco, R., Oñatibia-Astibia, A., & Martínez-Pinilla, E. (2013). Health benefits of methylxanthines in cacao and chocolate. Nutrients5(10), 4159-4173.

(12) Vauzour, D., Vafeiadou, K., Rodriguez-Mateos, A., Rendeiro, C., & Spencer, J. P. (2008). The neuroprotective potential of flavonoids: a multiplicity of effects. Genes & nutrition3(3), 115.

(13) Letenneur, L., Proust-Lima, C., Le Gouge, A., Dartigues, J. F., & Barberger-Gateau, P. (2007). Flavonoid intake and cognitive decline over a 10-year period. American journal of epidemiology165(12), 1364-1371.

(14) Verstraeten, S. V., Keen, C. L., Schmitz, H. H., Fraga, C. G., & Oteiza, P. I. (2003). Flavan-3-ols and procyanidins protect liposomes against lipid oxidation and disruption of the bilayer structure. Free Radical Biology and Medicine34(1), 84-92.

(15) Liu, X., Smith, B. J., Chen, C., Callegari, E., Becker, S. L., Chen, X., ... & Hosea, N. (2005). Use of a physiologically based pharmacokinetic model to study the time to reach brain equilibrium: an experimental analysis of the role of blood-brain barrier permeability, plasma protein binding, and brain tissue binding. Journal of Pharmacology and Experimental Therapeutics313(3), 1254-1262.

(16) El Mohsen, M. M. A., Kuhnle, G., Rechner, A. R., Schroeter, H., Rose, S., Jenner, P., & Rice-Evans, C. A. (2002). Uptake and metabolism of epicatechin and its access to the brain after oral ingestion. Free Radical Biology and Medicine33(12), 1693-1702.

(17) Francis, S. T., Head, K., Morris, P. G., & Macdonald, I. A. (2006). The effect of flavanol-rich cocoa on the fMRI response to a cognitive task in healthy young people. Journal of cardiovascular pharmacology47, S215-S220.

(18) Xie, L., Kang, H., Xu, Q., Chen, M.J., Liao, Y., Thiyagarajan, M., O’Donnell, J., Christensen, D.J., Nicholson, C., Iliff, J.J. and Takano, T., 2013. Sleep drives metabolite clearance from the adult brain. science342(6156), pp.373-377.

(19) Pérez-Jiménez, J., Neveu, V., Vos, F., & Scalbert, A. (2010). Identification of the 100 richest dietary sources of polyphenols: an application of the Phenol-Explorer database. European journal of clinical nutrition64(S3), S112.

(20) Schroeter, H., Heiss, C., Balzer, J., Kleinbongard, P., Keen, C. L., Hollenberg, N. K., ... & Kelm, M. (2006). (–)-Epicatechin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans. Proceedings of the National Academy of Sciences103(4), 1024-1029.

21) Hasler, G., Fromm, S., Alvarez, R. P., Luckenbaugh, D. A., Drevets, W. C., & Grillon, C. (2007). Cerebral blood flow in immediate and sustained anxiety. Journal of Neuroscience27(23), 6313-6319.

(22) Chapman, S. B., Aslan, S., Spence, J. S., Hart Jr, J. J., Bartz, E. K., Didehbani, N., ... & Lu, H. (2013). Neural mechanisms of brain plasticity with complex cognitive training in healthy seniors. Cerebral cortex25(2), 396-405.

(23) Mozolic, J. L., Hayaska, S., & Laurienti, P. J. (2010). A cognitive training intervention increases resting cerebral blood flow in healthy older adults. Frontiers in human neuroscience4, 16.

(24) Socci, V., Tempesta, D., Desideri, G., De Gennaro, L., & Ferrara, M. (2017). Enhancing human cognition with cocoa flavonoids. Frontiers in nutrition4, 19.

(25) Crews WD, Harrison DW, Wright JW. A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults. Am J Clin Nutr (2008) 87:872–80.

(26) Camfield DA, Scholey A, Pipingas A, Silberstein R, Kras M, Nolidin K, et al. Steady state visually evoked potential (SSVEP) topography changes associated with cocoa flavanol consumption. Physiol Behav (2012) 105:948–57. doi:10.1016/j.physbeh.2011.11.013

(27) Desideri G, Kwik-Uribe C, Grassi D, Necozione S, Ghiadoni L, Mastroiacovo D, et al. Benefits in cognitive function, blood pressure, and insulin resistance through cocoa flavanol consumption in elderly subjects with mild cognitive impairment: the Cocoa, Cognition, and Aging (CoCoA) Study. Hypertension (2012) 60:794–801. doi:10.1161/HYPERTENSIONAHA.112.193060

(28) Sorond FA, Hurwitz S, Salat DH, Greve DN, Fisher ND. Neurovascular coupling, cerebral white matter integrity, and response to cocoa in older people. Neurology (2013) 81:904–9. doi:10.1212/WNL.0b013e3182a351aa

(29) Brickman AM, Khan UA, Provenzano FA, Yeung LK, Suzuki W, Schroeter H, et al. Enhancing dentate gyrus function with dietary flavanols improves cognition in older adults. Nat Neurosci (2014) 17:1798–803. doi:10.1038/nn.3850

(30) Mastroiacovo D, Kwik-Uribe C, Grassi D, Necozione S, Raffaele A, Pistacchio L, et al. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial. Am J Clin Nutr (2015) 101:538–48. doi:10.3945/ajcn.114.092189

(31) Neshatdoust S, Saunders C, Castle SM, Vauzour D, Williams C, Butler L, et al. High-flavonoid intake induces cognitive improvements linked to changes in serum brain-derived neurotrophic factor: two randomised, controlled trials. Nutr Healthy Aging (2016) 24:81–93. doi:10.3233/NHA-1615

(32) Messaoudi, M., Bisson, J. F., Nejdi, A., Rozan, P., & Javelot, H. (2008). Antidepressant-like effects of a cocoa polyphenolic extract in Wistar–Unilever rats. Nutritional neuroscience11(6), 269-276.

(33) Massee, L. A., Ried, K., Pase, M., Travica, N., Yoganathan, J., Scholey, A., ... & Pipingas, A. (2015). The acute and sub-chronic effects of cocoa flavanols on mood, cognitive and cardiovascular health in young healthy adults: a randomized, controlled trial. Frontiers in pharmacology6, 93.

(34) Hammerstone, J. F., Lazarus, S. A., Mitchell, A. E., Rucker, R., & Schmitz, H. H. (1999). Identification of procyanidins in cocoa (Theobroma cacao) and chocolate using high-performance liquid chromatography/mass spectrometry. Journal of Agricultural and Food Chemistry47(2), 490-496.

(35) Craig, W. J., & Nguyen, T. T. (1984). Caffeine and theobromine levels in cocoa and carob products. Journal of Food Science49(1), 302-303.

(36) Belščak, A., Komes, D., Horžić, D., Ganić, K. K., & Karlović, D. (2009). Comparative study of commercially available cocoa products in terms of their bioactive composition. Food Research International42(5-6), 707-716.

(37) Wollgast, J., & Anklam, E. (2000). Review on polyphenols in Theobroma cacao: changes in composition during the manufacture of chocolate and methodology for identification and quantification. Food Research International33(6), 423-447.

(38) Oracz, J., Nebesny, E., & Żyżelewicz, D. (2015). Changes in the flavan-3-ols, anthocyanins, and flavanols composition of cocoa beans of different Theobroma cacao L. groups affected by roasting conditions. European Food Research and Technology241(5), 663-681.

(39) Islam, R., Matsuzaki, K., Sumiyoshi, E., Hossain, M.E., Hashimoto, M., Katakura, M., Sugimoto, N. and Shido, O., 2019. Theobromine Improves Working Memory by Activating the CaMKII/CREB/BDNF Pathway in Rats. Nutrients11(4), p.888.

(40) Di Tomaso, E., Beltramo, M., & Piomelli, D. (1996). Brain cannabinoids in chocolate. Nature382(6593), 677.

(41) Di Marzo, V., Sepe, N., De Petrocellis, L., Berger, A., Crozier, G., Fride, E., & Mechoulam, R. (1998). Trick or treat from food endocannabinoids?. Nature396(6712), 636.

(42) Yamada, T., Yamada, Y., Okano, Y., Terashima, T., & Yokogoshi, H. (2009). Anxiolytic effects of short-and long-term administration of cacao mass on rat elevated T-maze test. The Journal of nutritional biochemistry20(12), 948-955.

(43) Irsfeld, M., Spadafore, M., & Prüß, B. M. (2013). β-phenylethylamine, a small molecule with a large impact. Webmedcentral4(9).

(44) Melzig, M. F., Putscher, I., Henklein, P., & Haber, H. (2000). In vitro pharmacological activity of the tetrahydroisoquinoline salsolinol present in products from Theobroma cacao L. like cocoa and chocolate. Journal of ethnopharmacology73(1-2), 153-159.

You have successfully subscribed!
This email has been registered