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Many of us drink beverages that contain caffeine to help us be more alert or give us a boost that we feel we need to get through the day or specific tasks. I know I can’t ( or believe I can’t) even open my mouth to speak coherently in the morning unless I’ve had my coffee.
In the afternoon a coke helps to rejuvenate me enough to be alert and helpful to my clients. Unfortunately, although caffeine has positive effects, there also is a relationship between caffeine and panic attacks and other anxiety disorders.
This is not true for everyone. Each person responds to caffeine in a unique way. Some people can drink large quantities and be seemingly unaffected. Others have a small bit early in the day and are nervous, jittery and unable to sleep in the evening. The amount of time it takes caffeine to leave each person’s system can vary dramatically as well. This depends on a variety of factors such as the enzyme level in a person’s liver and the kinds of medications they are taking. A strong cup of coffee often contains the most caffeine, followed by tea and soft drinks. Certain ice creams and chocolate snacks also contain caffeine. Ben and Jerry’s, for example. Each one of these products when ingested may be contributing to the caffeine and panic attack connection for you.
Most people who drink caffeine have had the experience of the jitters it can cause when you’ve had too much. When I was in college cramming for finals I can remember having this experience while chugging diet coke all night long. In large or small does, people with anxiety can be triggered by caffeine in this way.
People who have anxiety and panic, in particular, are more susceptible to the effects of caffeine. You may have an anxiety disorder and be unaware of the way caffeine is exacerbating or interacting with it.
Studies suggest that certain people are particularly prone to panic attacks when they drink caffeine. Usually these are people who already have panic disorder diagnosis or experience panic attacks. A 2008 study explored the genes that code for two proteins, called adenosine receptors, which are known to interact with caffeine. They found four variations of this gene and also found that two of these variants were associated with panic disorder, and among these that caffeine and panic attacks were causally related ( Childs, E., Hohoff, C., Deckert, J. et al 2008)
Caffeine is known to produce panic attacks in people with panic and agorophobia and some cases social anxiety, but not otherwise healthy controls.
In a 1986 study, it was found that Caffeine consumption exacerbated anxiety in 54% of panic disorder patients and triggered panic attacks in 17% (Brier 1986) another study demonstrated a dose of caffeine could mimic behavioral symptoms in people with panic attacks (as high as 71 percent) but not in those without the diagnosis of panic disorder (Charney 1985).
It is generally understood that panic attacks can be triggered by a misinterpretation of a physiological response. It’s easy to see how caffeine’s affect on the central nervous system could mistakenly trigger a fear response that triggers the panic attack. This has been the case with some people I work with, although others do not report any association between their use of caffeine and panic attacks.
Caffeine toxicity can also produce an array of symptoms that can look similar to many categories of anxiety disorders, and in some cases, even psychosis! Some people in the medical profession believe that people are often misdiagnosed and medicated unnecessarily when they are actually suffering from the effects of caffeine.
In small doses many people report very positive effects on their mood after ingesting caffeine. It appears that in larger doses there are problems that can occur. For example one study on children and Mountain Dew showed an association between large amounts of caffeine and depression. Caffeine can cause a crash in some people that can mimic depression.
If you suffer from panic disorder, it would be important to pay attention to the association between caffeine and your panic attacks. Keeping a chart where you note what occurs after drinking your morning coffee or soda can help you to see if your symptoms of panic are actually symptoms of caffeine stimulation.
Below are some questions for you in exploring the connection between caffeine and panic attacks that may be helpful. If you find that you have check marks, then your caffeine and panic attacks may be related. In this case, it may be time to think about cutting out, or at least cutting down on caffeine!
Breier A, Charney DS, Heninger GR. Agoraphobia With Panic Attacks: Development, Diagnostic Stability, and Course of Illness. Arch Gen Psychiatry. 1986;43(11):1029–1036. doi:10.1001/archpsyc.1986.01800110015003
Charney DS, Heninger GR, Jatlow PI. Increased Anxiogenic Effects of Caffeine in Panic Disorders. Arch Gen Psychiatry. 1985;42(3):233–243. doi:10.1001/archpsyc.1985.01790260027003
Childs, E., Hohoff, C., Deckert, J. et al. Association between ADORA2A and DRD2 Polymorphisms and Caffeine-Induced Anxiety. Neuropsychopharmacol 33, 2791–2800 (2008). https://doi.org/10.1038/npp.2008.17
Torres, F. (April 2009). Caffeine induced psychiatric disorders. Journal of Continuing Education Topics & Issues , 74-79.
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