Caffeine and Anxiety: Is There a Connection?

I was talking to a woman the other day who was convinced caffeine causes her anxiety … not just makes it worse. Even though this was her opinion, I was convinced it was true for her.

She had given up caffeinated drinks one at a time. She started with energy drinks, then energy water, then coffee, and finally tea. “How am I supposed to make it through the day without some sort of caffeine?” she asked. This got me thinking about how caffeine affects people—more specifically, a person with anxiety.

People often see coffee, tea, and soft drinks simply as beverages rather than a drug that can exacerbate anxiety and panic. According to the National Coffee Association’s survey for 2012, 83% of Americans reported that they drank coffee, and consumption rose nearly 6% in the previous year alone. At the same time, panic and other anxiety issues have become the most common mental conditions in the United States. So are these two things tied together?

Why do we use caffeine? Coffee is commonly used to get us going in the morning. Most of us have a pleasurable response to drinking caffeine. Now we have energy drinks and other caffeine-laden products to rev up our mornings or get us through our days. Caffeine makes us more alert and productive. We push our bodies beyond their limits and use caffeine to assist us.

So how does caffeine work in our bodies? We ingest it and it enters the bloodstream and the brain rather swiftly. In the brain, it begins to affect chemicals that are responsible for regulation of sleep while speeding up activity in the brain, giving us that rush. Blood pressure increases, pupils dilate, and our mood begins to change. Sounds a lot like what a person having a panic reaction might feel. So how can you tell the difference?

Caffeine can affect us differently, especially individuals who are prone to anxiety or panic or have a family history of anxiety issues. The level of stress in your life and your diet can impact both your consumption of caffeine and the response that you have.

Caffeine effects both mood and pain levels. According to a 2010 study, the impact of caffeine is determined by the individual’s anxiety sensitivity. Anxiety sensitivity plays a role in pain perception. Individuals who are low in anxiety sensitivity benefit from moderate doses of caffeine in that caffeine increases their positive mood and decreases sensitivity to pain. High anxiety sensitivity is related to an increased perception of adverse pain experiences, especially in women. The results suggest that the pain-relieving effects of caffeine depend on the individual’s anxiety sensitivity and fear of bodily sensations.

Cognitive behavioral therapy can help individuals with anxiety figure out how anxiety manifests and how caffeine is affecting their reactions. Individuals with anxiety already have a default to see things in a negative light or as threatening, even when the incident is not. Caffeine speeds this response and affects anxious reactions. Treatment begins by training the individual to chart and monitor his or her reactions with varying amounts of caffeine. This will give the individual information on how caffeine affects him or her and will help in the development of effective strategies to manage anxiety or panic.

The person will not feel great while progressing through the treatment, but the goal is to understand how he or she reacts—and that the person’s fear is greater than the actual effect. Once the person begins to see that he or she can handle these anxious reactions, the person reacts less intensely to fears.

References:

1. National Coffee Association. National Coffee Drinking Trends (NCDT), 2013. http://www.ncausa.org/i4a/pages/index.cfm?pageid=731. Retrieved 30 June 2013.
2. http://www.adaa.org/about-adaa/press-room/facts-statistics. Retrieved 30 June 2013.
3. Yang, Amy, Palmer, Abraham A., Wit, Harriet (2010). Genetics of Caffeine consumption and response to caffeine. Psychopharmacology211:245 257

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