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©2006-2011 Deborah Wiig
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Like 90 percent of Americans, you may be getting your daily caffeine fix in coffee or other sources. It can wake you up, improve your disposition and even enhance your performance, at least for a while. It’s the most popular behavior-altering drug.

For most people, two or three cups of coffee, or the equivalent, aren’t a problem. Four or more cups can cause restlessness, irritability, insomnia, headaches, stomach problems, even abnormal heart rhythms. But, for people who are especially sensitive to caffeine and people living with depression or anxiety, even a little caffeine is too much and should be avoided. 

Anxiety disorders, depression and caffeine
Caffeine works by stimulating the central nervous system. It can aggravate the symptoms of existing anxiety disorders, and can trigger panic attacks, according to the National Institute of Mental Health (NIMH).

"Caffeine produces the same physiological arousal response that is triggered when you are subjected to stress - increased sympathetic nervous system activity and a release of adrenalin," writes Edmund J. Bourne, Ph.D. in the Anxiety & Phobia Workbook. It keeps you in a chronically tense, aroused condition, leaving you more vulnerable to generalized anxiety and panic attacks. Caffeine also causes a depletion of vitamin B1 (thiamine), one of the so-called anti-stress vitamins.

If you have an anxiety disorder, you should limit caffeine or avoid it.

People who are depressed may want the "lift" they get from drinking coffee, but it can have the opposite effect as it wears off. It can contribute to anxiety and mood swings. And even small amounts of caffeine can keep you from getting enough sleep, which can make depression worse. You might want to avoid caffeine for a week to see how it affects your mood.

It isn’t just coffee that contains caffeine
Your average cup of coffee has about 100 milligrams of caffeine. Soft drinks can contain as much as 50 milligrams per 12-ounce serving. Some caffeine occurs naturally in certain ingredients, but some products have it added, as in energy drinks, which can have more than 300 milligrams per serving. Other sources of caffeine, according to the Mayo Clinic, include:

• Pain relievers, such as Excedrin and Anacin, up to 130 mg of caffeine. 
• Black tea, brewed, 8 oz., 47 mg
• Decaffeinated, black tea, 8 oz., 20-40 mg
• Green tea, brewed, 8 oz., 30-50 mg.
• Starbucks Tazo Chai Tea Latte, 12 oz., 75 mg
• Chocolate, 1.5-oz. bar, 8 mg

Cutting the caffeine
If caffeine isn’t a good choice for you, cut back or eliminate it. A person living with depression or an anxiety disorder should consume no more than 100 mg. per day.

Because it’s habit-forming, quitting cold turkey can cause withdrawal symptoms, such as headaches, fatigue, irritability and nervousness. These symptoms can be reduced by gradually cutting down the amount you consume. Try replacing your morning cup of java with herbal tea or one of a variety of coffee substitutes made from chicory, roasted grains or soy. 

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Sources
Caffeine and psychiatric symptoms: a review. (2004) Broderick P, Benjamin AB, Journal of the Oklahoma State Medical Assoc.7(12),   
Daniel Hall-Flavin, M.D., psychiatrist, Mayo Clinic, Caffeine-and-depression
Lee MA, Flegel P, Greden JF, Cameron OG.(1988) Anxiogenic effects of caffeine on panic and depressed patients, Am J Psychiatry. 145(5)
Anxiety Disorders and Chronic Pain, The Anxiety Disorders Association of America

Page updated October, 2010