Can Caffeine Cause Anxiety?

A cup of coffee or tea is how many of us start our days, but research is exploring how this daily habit affects our anxiety levels. In this SingleCare article, Mindpath Health’s Brian Zachariah, MD, talks about what those nervous jitters really are.

Coffee is one of the most popular beverages in the world; many people rely on the caffeine in that first cup of joe to manage energy levels throughout their day. Caffeine is consumed by over 80% of adults in the U.S. and has been shown to enhance alertness and reaction time but can there be too much of a good thing? Is there a link between coffee and anxiety?

“Though caffeine intake has been shown to be associated with some psychiatric symptoms like anxiety and nervousness, there is no evidence yet to suggest that caffeine itself is causing them,” says Rajnish Jaiswal, MD.

Caffeine does not directly cause anxiety, but it can make anxiety symptoms worse, especially when consumed in excess. So, how much coffee is too much? The U.S. Food and Drug Administration (FDA) recommends a daily limit of 400 mg of caffeine for healthy adults which is equal to about four, 8-ounce cups of brewed coffee or 10 cans of cola.

Some symptoms of overusing caffeine include:

• Dizziness
• Rapid heartbeat
• Nervousness/restlessness
• Headache
• Insomnia

Drinking more than the recommended daily amount of coffee for an extended period of time may also lead to caffeine withdrawal symptoms (such as headaches, fatigue, and irritability) when a person tries to cut back on caffeine intake.

For most people, moderate caffeine intake is safe, and coffee even boasts some health benefits when enjoyed in moderation, but studies show that excessive caffeine consumption can lead to symptoms that overlap with those of many psychiatric disorders and that it may exacerbate anxiety—especially for those with anxiety disorders and/or sleep disorders.

Does caffeine make anxiety worse?

Anxiety disorder is a mental health disorder in which a person experiences overwhelming feelings of worry and fear, interfering with daily life and activities. There are several types of anxiety disorders including generalized anxiety disorder and panic disorder. Those with anxiety disorders may want to decrease their daily caffeine intake.

“Caffeine is known for its mild stimulant effects and excessive amounts can lead to jitteriness, anxiety, irritability, and insomnia,” says Brian Zachariah, MD, a psychiatrist with Mindpath Health. “In fact, it’s listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under causes for substance-induced anxiety disorders (caffeine-induced anxiety disorder).”

Caffeine-induced anxiety disorder is a condition recognized by the American Psychiatric Association where the symptoms of anxiety are directly caused by the excessive consumption of caffeine and are interfering with a person’s daily functioning.

Additionally, drinking large amounts of coffee may cause interactions with some medications and dietary supplements.

“Caffeine does interact with several classes of medications (antiarrhythmics, antipsychotics, bronchodilators) and of concern with fluvoxamine, which is an SSRI medication often used for anxiety disorders,” Dr. Zachariah says. “Also, the effects of caffeine can mimic worsening anxiety, wherein providers may increase the dose of the anxiolytic medication without realizing the actual culprit.”

Many people may not think to mention their daily caffeine intake with their healthcare provider, but it’s important—especially for those who are drinking many caffeinated beverages daily.

How long does caffeine-induced anxiety symptoms last?

“Caffeine’s effects can vary due to individual variation, but it usually starts to peak in effect in about 15 minutes and wears off in about two and a half to five hours,” Dr. Zachariah says. Dr. Jaiswal agrees: “There is a wide range of when and how long caffeine lasts in people as many factors like age, gender, genetics, lifestyles can influence it.”

Caffeine may not completely leave your system for 10 hours and can interfere with sleep. The American Academy of Sleep Medicine recommends avoiding caffeine in the late afternoon or evening.

How to prevent and overcome caffeine-induced anxiety

To prevent unwanted caffeine side effects that mimic anxiety symptoms, consume caffeine in moderation and be aware of how many caffeinated products you may ingest daily.

In all, drinking coffee in moderation is safe for most people. While coffee does not cause anxiety, consuming excessive amounts of caffeine can make anxiety symptoms worse, especially for those with baseline anxiety disorders.

Read the full SingleCare article with sources.