Can Caffeine Induce Anxiety Attacks
by Patient Advocate
The short answer is a definite yes. In looking over some of the more popular member generated content here on Anxiety Connection, I stumbled upon a post written by member Linda back in 2007 where she makes an amazing discovery about the source of her anxiety attacks. In her post entitled, “No Coffee, No Anxiety” Linda explains how she would have chronic anxiety and panic attacks during a stressful period in her life. Despite the fact that the stressors went away, she continued to have problems with anxiety. Then she found the one thing that really helped. Here is an excerpt of Linda’s story:
“I stopped drinking coffee because I noticed that it was making me feel a bit nauseated on a regular basis. I didn’t remove caffeine completely — I started drinking tea instead. It was about two weeks without coffee when I realized that the anxious feeling was gone. Completely. The ONLY change I made in my life at the time was cutting out the coffee. That was more than two years ago and the anxiety has never returned, even in stressful situations. It may sound crazy, but I’m a firm believer that coffee was the cause of my anxiety.”
For example here are the criteria outlined in the DSM-IV-TR for Caffeine intoxication:
-Recent consumption of caffeine, usually in excess of 250 mg
-Demonstration of 5 or more of the following signs during or shortly after caffeine use:
Restlessness o Nervousness
Periods of inexhaustibility
Caffeine Increases Stress Hormones
Most people who deal with anxiety would agree that they have too much stress in their lives and caffeine adds to the burden.
Caffeine affects the body much like stress by increasing heart rate, blood pressure, and levels of stress hormones.
” Some psychiatrists recommend that routine psychiatric assessments should include examining caffeine consumption since removing caffeine can be more beneficial than prescribing anti-anxiety drugs.
Other Issues That Could Link Caffeine And Anxiety
It is possible that one of the reasons that a link is considered present is because anxiety is a subjective experience. Most people can feel caffeine when it gets into their system. Those that feel it and are asked about their anxiety levels may simply be attributing their extra energy to anxiety retroactively. Anxiety is a subjective experience, and generally subjective experiences make for inconsistent anecdotal evidence.
Furthermore, it’s possible that studies about the effects of caffeine do not take into account tolerance. It’s possible that those that have not had caffeine in the past react strongly to the drug moreso than those that are tolerant. This could also create a feeling of energy that is attributed to anxiety, but is generally nothing more than caffeine related energy.
Finally, we mentioned earlier that what you add to your caffeinated beverages could affect anxiety as well. Refined sugars can be harmful to the body, so sodas and heavily sugared caffeinated drinks may not be ideal.
All of these could potentially link caffeine and anxiety, as well as coffee and anxiety, but none of them are evidence that coffee causes generalized anxiety only that there are reasons that others may subjectively report anxiety while on caffeine.
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Caffeine Robs You Of Essential Brain Nutrients
Caffeine causes nutrients to be excreted from your body, some of which are particularly important for your brain health and mood.
One of the nutrients that gets depleted is magnesium, a mineral that has profound effects on your mental wellness.
Magnesium plays a critical role in a number of brain-related disorders including:
Anxiety is a common sign of B vitamin deficiency.
Taking extra B vitamins can address imbalances of the brain chemicals GABA, serotonin, dopamine, and epinephrine that contribute to anxiety.
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Its Not Hard To Develop Caffeine
Caffeine is a common ingredient that we put into our bodies. We know we drink it. Sometimes we dont know were eating it.
If you are consuming anything with the word energy in the description, it probably contains caffeine. Energy jerky has caffeine. Chocolate is a source of caffeine, as is coffee ice cream. Some gum is caffeinated. Check the labels on over-the-counter pain relievers, because many contain caffeine. Watch for names and descriptions with words like jolt, buzz, blast, blitz, perky, spark, oomph, vitality, zing, and any other catchy word that makes you feel jittery just by reading it.
With so many overt and insidious sources of caffeine, it is easy to take in too much. Generally, anything more than 250 mg of caffeine per day is generally considered excessive, but every person is different. Some may be able to tolerate a bit more, others can feel negative effects with much less. Caffeine-induced anxiety has more to do with the symptoms you feel than the milligrams you consume.
Caffeine-induced anxiety disorder is a legitimate diagnosis. The prevalence, though, is low. The DSM-5 estimates that in any 12-month period, less than 0.002% of the population is diagnosed with the disorder.
The low number can be deceiving. While its true that a diagnosis of this anxiety disorder is rare, its also true that the number of people experiencing anxiety caused by caffeine is significantly higher. Caffeine can, and often does, cause, trigger or worsen anxiety.
Can Alcohol Cause Anxiety Or Make It Worse
Alcohol use can cause new onset anxiety and worsen pre-existing anxiety symptoms. Many individuals will use alcohol as an unhealthy coping tool to reduce symptoms of anxiety.
Alcohol may be a temporary, unhealthy way to relieve anxiety and forget about your underlying stressors, however using alcohol does not erase these underlying triggers. Whether your anxiety is related to past trauma, financial stress, or untreated depression alcohol is merely a temporary Band-Aid and the longer one depends on alcohol to help treat their anxiety, the more at risk they are for developing an alcohol use disorder. Additionally, symptoms of anxiety will still be lurking around the corner as the underlying triggers have not been properly addressed and treated.
Chronic alcohol use affects your ability to respond to stress in healthy and effective ways, which can lead to anxiety. This may be due to alcohols effect on the amygdala, the area of your brain that regulates negative emotions. Brain imaging studies have found abnormalities in amygdala functioning in individuals with alcohol use disorder.3
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Alcohol Abuse And Panic Attacks
While abusing alcohol can cause a person to do things that they normally wouldnt do , it is typically the withdrawal from alcohol that causes anxiety and panic attacks in some users. Additionally, some people who already suffer from anxiety attempt to use alcohol to manage it, making the symptoms much worse when they stop drinking.
Panic Attack Signs And Symptoms
The signs and symptoms of a panic attack develop abruptly and usually reach their peak within 10 minutes. They rarely last more than an hour, with most ending within 20 to 30 minutes. Panic attacks can happen anywhere and at any time. You may have one while youre in a store shopping, walking down the street, driving in your car, or even sitting on the couch at home.
Panic attack symptoms include:
- Shortness of breath or hyperventilation
- Heart palpitations or racing heart
- Chest pain or discomfort
- Feeling unreal or detached from your surroundings
- Feeling dizzy, light-headed, or faint
- Numbness or tingling sensations
- Fear of dying, losing control, or going crazy
Is it a heart attack or a panic attack?
Most of the symptoms of a panic attack are physical, and many times these symptoms are so severe that you may think youre having a heart attack. In fact, many people suffering from panic attacks make repeated trips to the doctor or the emergency room in an attempt to get treatment for what they believe is a life-threatening medical problem. While its important to rule out possible medical causes of symptoms such as chest pain, elevated heart rate, or difficulty breathing, its often panic that is overlooked as a potential causenot the other way around.
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Mobilization Of Intracellular Calcium
At very high concentrations of about 12 mM, caffeine lowers the excitability threshold in muscle cells, leading to prolonged contraction. The introduction of such high doses of caffeine allows calcium to enter the muscle cell through the plasma membrane and sarcoplasmic reticulum more readily. Influx of calcium through the membranes in muscle cells requires at least 250 M of caffeine. Normally, other toxic effects of caffeine begin to occur in concentrations over 200 M, however average consumption averages lead to concentrations less than 100 M. This means that calcium influx and mobilization are most likely not the cause of caffeine’s effect on the central nervous system, and are therefore not the cause of caffeine-induced anxiety disorder.
Caffeine And Social Anxiety
Another study, led by the same doctor, wanted to further explore the effect of caffeine on patients with other psychiatric disorders. This time, they conducted a nearly identical experiment on patients with panic disorder , generalized social anxiety disorder , performance social anxiety disorder , and healthy controls.
Similar to the previous study, panic attack symptoms were more common in subjects with a history of panic attacks. 60.7% of panic disorder patients, 52.6% of performance social anxiety disorder patients, and 16% of generalized social anxiety disorder patients had a panic attack after the caffeine test. There were no panic attacks among healthy controls or after placebo intake.
All groups were sensitive to caffeine and experienced some level of increased anxiety after consumption. Panic disorder and performance social anxiety disorder subjects reported the most panic attack symptoms, Generalized social anxiety disorder and controls reported a different set of symptoms.
Mechanism Of Caffeine Action
Caffeine acts in multiple ways within the brain and the rest of the body. However, due to the concentration of caffeine required, antagonism of adenosine receptors is the primary mode of action. The following mechanisms are ways in which caffeine may act within the body, but depending on necessary caffeine concentration and other factors may not be responsible for the clinical effects of the substance.
Caffeine Restricts Blood Flow To The Brain
When you are anxious, blood flow to the brain is already reduced and caffeine can reduce it further.
Caffeine restricts blood flow to the brain by as much as 27%.
Blood flow is the delivery system for getting nutrients of all kinds to your brain including oxygen, water, glucose, vitamins, and minerals.
An interesting aside is that many people take brain supplements and nootropics like ginkgo, citicoline, curcumin, and vinpocetine which work, in part, by increasing blood flow to the brain not realizing that the caffeine they drink essentially neutralizes this benefit!
What Does Research Say About The Link
A recent study published by the Frontiers in Public Health Journal shows that people could be taking more caffeine than is safe due to the high levels of caffeine in energy drinks. Apart from upsetting your sleep pattern, it can upset your mood, and these two are symptoms of depression and stress.
Other research studies have implied while energy drinks may increase the risk of mental health outcomes that are undesirable, it was impossible to prove for sure the direct cause and effect.
Research also suggested that emotions can be impacted by the number of energy drinks consumed. For instance, 250 mg of caffeine made a subject feel elated, and 500 mg increased the subjects irritability, so it could be said that caffeine affects a persons mood.
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Can Caffeine Make Anxiety Worse
According to Wolkin, research indicates that caffeine can aggravate and maintain an anxiety disorder. The impact of coffee can be so pervasive and play such a clear role in exacerbating someones anxiety that she asks all new patients about their caffeine consumption.
If she later notices that coffee is intensifying, or helping to maintain, some of the anxiety a person is experiencing, she recommends weaning off slowly in conjunction with their therapeutic work.
Caffeine use can also become a vicious cycle for those with underlying anxiety, according to Jenicka Engler, Psy.D., a psychologist and clinical scientist in Massachusetts. For example, someone with anxiety may be dealing with fatigue due to trouble sleeping, so theyll turn to coffee to perk up throughout the day. But, in turn, glugging down too much caffeine makes them feel even more anxious and prevents them from falling asleep at night. And then the cycle repeats.
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Whats The Link Between Coffee Caffeine Anxiety And Panic Attacks
Posted May 3, 2018
Chris Choi was grabbing his Veranda Roast grande at an L Street NW Starbucks in downtown Washington on Monday morning, his first of the day. Its very trendy to drink coffee, said Chris, 23, Youll never be judged going out and getting coffee. You find more people into that.
So why am I banging on about the link between caffeine consumption and anxiety symptoms? First, because our contemporary coffee culture may be genuinely contributing to modern feelings of pervasive existential dread reported by writers such as Scott Stossel in his book My Age of Anxietyand blogging journalists whove noted the puzzling growth of anxiety in the modern age. The sheer volume of coffee consumption may not be as great as it has been in the past , but its a modern-day culturally popular beverage delivered by trendy coffee shops and convenient coffee capsule machines that were told every home should have . Whats different in the modern era is that the current generation is much more aware of anxiety symptoms than were coffee drinkers twenty or thirty years ago. So we may be acutely aware today of our caffeine-induced anxiety symptoms but not necessarily aware that these symptoms may in part be attributed to our coffee consumption.
Understanding Alcohol Use & Abuse
Alcohol is one of the most commonly used substances in the U.S. In 2019, 85.6% of people reported drinking alcohol at some point in their lives, 25.8% of people aged 18 and older reported binge drinking in the past month, and 14.5 million people aged 12 and older had an alcohol use disorder , the clinical term for alcoholism or alcohol addiction, according to the National Institute on Alcohol Abuse and Alcoholism .1
Alcohol abuse means that you use alcohol in unhealthy ways that impact your life. It involves drinking more than the Centers for Disease Controls Dietary Guidelines for alcohol, which states that people who choose to drink should do so in moderation. This means 2 drinks or fewer for a man and 1 drink or fewer for a woman per day. A standard drink is the equivalent of 12 ounces of 5% beer, 8 ounces of 7% malt liquor, 5 ounces of 12% wine, or 1.5 ounces of 80 proof distilled spirits or hard liquor . Excessive alcohol use includes binge drinking, heavy drinking, and drinking while pregnant.2
Not everyone who engages in excessive drinking has an AUD, but excessive or unhealthy use of alcohol can lead to the development of addiction.
A large proportion of people who abuse alcohol also have co-occurring anxiety disorders. Having either an alcohol use disorder or an anxiety disorder can substantially elevate your risk of developing the other.3
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Detoxing Is No Laughing Matter
Caffeine withdrawal is a very unpleasant experience, to say the least.
The symptoms of withdrawal usually last a few days to two weeks for light caffeine consumers but can last 2 months or more for those that had been consuming around 1,000 mg or more daily. However, even for the most addicted, the worst symptoms subside after about a weeks time.
Even after the withdrawal period is over, many still feel never quite as good as they did when they were drinking caffeine all of the time. Some believe that caffeine permanently alters ones brain chemistry. This is most likely due to the changes that occur with dopamine levels in the brain because of the daily caffeine use.
Does Anxiety Cause Anemia
An interesting question though is whether or not anxiety can actually cause anemia. Its unlikely that anxiety can lead to dangerous levels of anemia, but it may be possible for anxiety to contribute to the development of mild anemia.
Studies have rarely looked at the effects of anxiety on vitamin metabolism. But there are reasons to believe that stress does have an effect. For example, as many as 25% of the country is already magnesium deficient. During times of severe stress, the body actually uses up magnesium in the body. Thus those with anxiety may already have low magnesium, and then be using up what they do have when theyre experiencing anxiety attacks. Its possible this leads to the development of mild anemia.
Hyperventilation also uses up magnesium. Since many people with anxiety hyperventilate, a large number may be contributing to a magnesium deficiency and ultimately anemia.
Anxiety can also affect the immune system, which may have an effect on anemia. It can also cause poor eating habits these too may cause you to become more anemic.
These are all unexplored, but absolutely possible links between anxiety and anemia.
F41.0 Panic disorder Definition. The essential feature is recurrent attacks of severe anxiety , which are not restricted to any particular situation or set of circumstances and are therefore unpredictable.
Likewise, is panic disorder and anxiety the same thing?
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