Caffeine and mental health

TYPE OF PSYCHOLOGY: Psychopathology; psychotherapy

Caffeine is a mild stimulant drug found in common foods, beverages, and over-the-counter medications. While its use is generally nonproblematic and part of many people’s daily routines, overuse or misuse can lead to physical and mental health problems.

Introduction

Caffeine is a legal drug that in its natural form has a bitter taste. Chemically, it is a xanthine-type drug, which is alkaloid in nature, meaning that it is nitrogen based. It is a mild diuretic, or substance that encourages urination, and a mild stimulant. Stimulants are a broad group of substances that can excite the body’s central and peripheral nervous system and the cardiovascular system. Because of these properties, stimulants can have therapeutic and otherwise desirable effects. In fact, stimulants and their derivatives have been used to treat conditions such as drowsiness, narcolepsy, asthma, attention-deficit hyperactivity disorder (ADHD), autism, and obesity.

Caffeine is commonly found in coffee, tea, and other beverages, such as soft drinks and energy drinks. It is also present in chocolate, cocoa, over-the-counter medications for avoiding drowsiness, and even some headache remedies. The general effect of caffeine is mild relative to other ; nonetheless, caffeine is considered a psychoactive substance. Its most basic effect is to trigger increased alertness; other, positive effects such as enhanced cognitive performance and increased selective attention remain the subject of debate. The most common form of administration of the drug is oral ingestion. Because caffeine products are mild stimulants, legal, and available worldwide, they are part of daily rituals in many countries. People gather to drink caffeinated beverages, enjoying them as part of social rituals. Therefore, as with other drugs, some psychosocial benefits are associated with caffeine.

Disorders Related to Caffeine Use

As with any drug, pros and cons of usage exist; potential problems can occur if caffeine is not used properly. In fact, from a physical health perspective, regular overuse of caffeine can result in mild to serious gastrointestinal problems such as gastroesophageal reflux disease (GERD). Untreated, such conditions can result in ulcers and erosion of the esophageal tract. Problems such as GERD have been associated with cancer. Therefore, in terms of the link between caffeine and GERD, caffeine intake may be a controllable factor relevant to cancer prevention. Regular use of caffeine can also lead to tolerance, the need to use more of a drug to achieve a previous effect or the use of the same amount resulting in a lessened effect. Frequently when this happens, individuals may also be subject to caffeine withdrawal symptoms, such as headaches, if they stop using the drug. Such effects contrast markedly to the more severe withdrawal syndromes—confusion, , and fatigue—experienced by individuals dependent on stimulants such as amphetamine.

In addition to physical problems, caffeine is associated with at least three types of mental health problems in which it is a causative factor. These conditions are known as "caffeine-related disorders." One of these problems is caffeine intoxication, which is characterized by a pattern of symptoms: When individuals consume more than two or three cups of coffee, they may show symptoms such as a flushed face, physical agitation, muscle twitches, excitement, restlessness, nervousness, insomnia, diuresis, gastrointestinal problems, and a feeling of inexhaustibility. When an individual shows many of these symptoms, experiences distress or impairment, and the problems are not because of other problems, clinicians diagnose caffeine intoxication. Again, review of these symptoms underscores that caffeine is mild relative to other stimulants, such as amphetamines, which can cause paranoia, panic, psychosis, rapid pulse rates, hallucinations, , violence, suicidal or homicidal tendencies, bruxism (teeth grinding), arrhythmias, heart damage, and even seizures.

A few other disorders are known as "caffeine-induced disorders," a subset of substance-induced disorders, which are problems caused by taking a drug. Caffeine-induced sleep disorder occurs when the use of caffeine significantly disturbs an individual’s sleep. Caffeine-induced anxiety disorder occurs when caffeine use causes a person to experience distressing anxiety, a mood state characterized by extreme fear, worry, and uneasiness that may be cognitive, emotional, or physical. In a few case studies, extremely high doses of caffeine have reportedly induced psychosis, with the affected person exhibiting symptoms such as paranoid delusions and bizarre behavior. With caffeine-induced disorders, clinicians must rule out other causes, such as a primary sleep disorder, anxiety disorder, or other existing psychiatric conditions. One method of doing this is to observe if the person continues to have symptoms after they have abstained from caffeine. If symptoms persist, a caffeine-related diagnosis is dismissed. If the symptoms do not persist, the problem is deemed related to the use of caffeine.

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