Caffeine and Anxiety Disorders – Not always the best of friends
Well, who doesn’t like a good cup of coffee. I sure as heck do! What a great way to start the day! You have that first cup, you feel that pick-me-up, and you’re ready to go. You shake off the morning grogginess, and you feel great! At least that’s what your brain is telling you.
Caffeine is the most widely used psychoactive substance in the world. I’m from Seattle, the coffee capital of the world, (even though you can’t grow coffee beans here) and the birthplace of Starbucks. They’ve pumped the brakes a little as the world changes with the pandemic, but basically you can find a Starbucks anywhere in the world. Just turn around. But shoot, I tell you. I remember when it was just a cup of coffee. To each their own, but I do get a little annoyed when I get in line behind someone who wants a double-pump, almond, half-steamed, skim-milk, peppermint Karenchino. It’s just mud! We drink it for the caffeine!
I don’t keep it a secret, and I’m not ashamed of it, but I have an anxiety disorder. How society judges the mentally ill is for another post. My disorder has been largely held in check for a long time now, and I’m functioning very well, despite the recent loss of my father. But let’s take a look at how caffeine and anxiety work together, or, more properly put, don’t work together.
Most folks get their caffeine from coffee, a brewed drink prepared from roasted coffee beans, the seeds of berries from certain Coffea species. This makes caffeine an alkaloid, a naturally occurring organic compound, usually derived from plants. When coffee berries turn from green to bright red in color – indicating ripeness – they are picked, processed, and dried. Dried coffee seeds (referred to as “beans”) are roasted to varying degrees, depending on the desired flavor. Roasted beans are ground and then brewed with near-boiling water to produce the beverage that we all love.
I’m speaking generally of caffeine, but there are plenty of other ways to get the substance in your body: tea, soft drinks, chocolate, and, if you’re feeling like trashing yourself, No-Doz.
How caffeine works, and why it makes you feel good
Your brain does a lot of neat tricks, and it accomplishes them in clever ways. When your neurons, or brain cells, are firing, they are doing exactly that; sending jolts of electricity to one part of the body or the other, telling it what to go do with itself. To aid in this, your brain uses what are called neurotransmitters, nifty little chemicals. There are quite a few different types, and each of them plays either a few roles or many, depending on the need. There is one neurotransmitter in particular called adenosine, a natural central nervous system depressant, which keeps you mellow and composed. Caffeine blocks the actions of adenosine. So you wake up! At the same time, this blockage of adenosine results in the brain releasing other neurotransmitters, namely dopamine, which makes you feel great, and glutamate, which helps ramp up the body. But of course, the caffeine wears off after a while, your neurotransmitters try to return to normal, and you get tired. So time for more mud!
But wait, there’s more! Caffeine also inhibits the release of a neurotransmitter called GABA. GABA’s role is to calm the mind and decrease feelings of fear, stress and anxiety. So when you have a lot of caffeine in your system, GABA cannot do it’s job.
Anxiety disorder is an umbrella term for several conditions characterized by worry and fear. It is the most common mental illness in the United States; over 40 million people have some form of it. In these challenging times, the disorder has become more prevalent.
At the risk of WAY oversimplifying things, the physiology behind an anxiety disorder is as follows. (Yes, these is a physiologic mechanism behind it; so the next time someone tells you to just calm down and deal with life, tell them to take a good look in the mirror, worry about themselves, and don’t offer unsolicited advice. Or feel free to use stronger language, if you like.) There is a part of your brain called the amygdala. Like most parts of the brain, it plays several different roles. One of the hats that it wears is playing a primary role in fear and anxiety. Studies have shown that people with increased activity in their amygdala are at a much higher rate for depression and anxiety. In the case of an anxiety disorder, the amygdala will overreact to the illusion of fear, if you will, and signal another part of your brain called the hypothalamus. This then will activate your sympathetic nervous system, responsible for the phenomenon known as fight or flight. In doing so, this floods your body with chemicals called cortisol and adrenaline. This action increases blood pressure and pulse, increases muscle tension, and the acceleration of the breathing process. These are well-known symptoms of anxiety. In the meantime, the same mechanism floods your brain with a neurotransmitter call noreprinephine, which mobilizes the brain for action and alertness, at the cost of rational thinking. This is also a well-known symptom of anxiety.
One of the main neurotransmitters that calms the amygdala is GABA. Many psychiatric medications are used to treat anxiety, but some of the most common are a class of drugs called benzodiazepines (Klonopin, Xanax, etc.).
There are, undoubtedly, psychological factors that contribute to an anxiety disorder, but that’s for another time.
When caffeine and anxiety collide
Well then, it is clear that the physiological mechanism of action of caffeine and the physiological mechanism of action of an anxiety disorder can be disharmonious. Excessive caffeine can greatly exacerbate an anxiety disorder. Tremors, difficulty breathing, cognition problems; these can all result when an anxious mind has too much caffeine.
As an aside, I was on benzodiazepines for a time, and I thought I could drink all the coffee I wanted to. I could, for a while. But the chemical storm was raging in my head, and, as strong as benzodiazepines are, caffeine can be much stronger.
My anxiety disorder is well-managed these days, so I keep my coffee to 1 or 2 cups per day. Some individuals with an anxiety disorder find that tea or matcha works well for them, while others may use supplements. Some people with an anxiety disorder are better off avoiding caffeine in their lives altogether. I cannot diagnose, and I cannot give medical advice, but for those of us with an anxiety disorder, the role that caffeine plays in our lives must be considered.
Thanks for reading! Wear the mask, social distance, wash your hands, stay safe!