Caffeine-induced anxiety disorder is real—here's how to know if you have it.

By Anthea Levi
December 11, 2018

You already know that too much caffeine can bring on the jitters. Sip a second espresso after dinner, and you’re bound to feel a bit on edge. But could that 3 p.m. soy latte actually be messing with your mental health? If you struggle with anxiety, the answer may be yes.

“Overall, caffeine is often bad news for people with anxiety,” says Susan Bowling, PsyD, a psychologist at the Women’s Health Center at the Wooster Branch of Cleveland Clinic. That’s because the powerful stimulant naturally found in coffee beans jump-starts anxiety by speeding up bodily functions.

“The natural effects of caffeine stimulate a host of sensations, such as your heart beating faster, your body heating up, your breathing rate increasing—all things that mimic anxiety,” Bowling told Health. “Psychologically, it’s difficult for your mind to recognize that this is not anxiety because it feels the same.” Restlessness, nervousness, headaches, sweating, insomnia, and ringing in the ears are other common signs of caffeine-triggered anxiety.

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According to Bowling, some studies show that consuming more than 200 mg of caffeine (about the amount in just two cups of coffee) can increase the likelihood of anxiety and panic attacks in people sensitive to it. It is so powerful that "caffeine-induced anxiety disorder" is a subclass in the DSM-5 diagnostic manual, she adds.

Yet caffeine, which is the most commonly consumed psychoactive substance in the world, doesn’t affect us all the same way. The reason? “In part, it is the way your body is wired,” says Bowling. “Some people can handle a little caffeine and others are very sensitive to it. It’s based primarily on your genetics." People who are sensitive to the effects of caffeine may simply metabolize it more quickly than others, for example.

If you’re prone to post-coffee anxious feelings, regular caffeine consumption can set you up in a vicious cycle. “[Perhaps] one has an anxiety attack, can't sleep at night due to the caffeine-induced anxiety, feels very low energy in the morning, then drinks coffee to wake up...and then starts the cycle over again,” says Bowling.

Could your morning joe be behind your anxiety? There are ways to tell. Bowling suggests doing a mini-observational study on yourself to find out.

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“Keep a journal of the impact of caffeine for a week,” says Bowling. Aside from counting every cappuccino and latte you sip, track other sneaky sources of caffeine you might consume, such as decaf coffee (yep, even decaf has a little caffeine), cola, chocolate, OTC pain medication, energy drinks, and infused mints or snacks. The next week, eliminate all caffeine while keeping the rest of your diet and activities the same. “For people who have anxiety, they often notice an improvement in their anxiety levels,” she says.

What if you don’t struggle with anxiety—should you still cut back on caffeinated coffee or tea for the sake of your mental health? Not necessary, says Lauren Slayton, RDN, nutritionist and founder of the private practice Foodtrainers in New York City. "It’s a question of dosage," explains Slayton. "Coffee absolutely picks you up, and it improves cognition and athletic performance. [But] too much of most things backfires.”

While there’s no one size fits all approach to caffeine consumption, experts suggest sipping coffee in moderation to reap the beverage’s purported health benefits, which include a lower risk of cardiovascular disease and type 2 diabetes. ”We recommend one or two cups of coffee per day max, with no crappy sweeteners or creamers,” says Slayton.

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