How Does Caffeine Affect Anxiety?

Coffee, tea, soda, and other foods and beverages containing caffeine are consumed by many adults each and every day, so it is perhaps not surprising to learn that caffeine is the most commonly used drug in the world. Because caffeine is so intertwined in our daily diets, it is often easy to forget that it is a drug that, while legal, still has psychoactive effects. 

Increased alertness is one of the key attractions for many people, but elevated arousal levels are not always ideal, particularly if you have anxiety. If you are prone to anxiety or have an anxiety disorder, too much caffeine might exacerbate your symptoms, interfere with your sleep, and potentially induce feelings of panic in some people.

This article discusses the impact caffeine can have on the body, including how it can affect anxiety. It also explores what you can do if you think that your caffeine intake might be contributing to feelings of anxiety.

What Is Anxiety?

To understand how caffeine can affect anxiety, it is important to first understand what anxiety is and the symptoms it can cause. Anxiety can be a normal reaction to stressful life events, and to a certain degree, it can help prepare your body to deal with environmental threats. But too much anxiety can lead to intense and excessive fear and worrying about everyday events.

Common symptoms of anxiety can include:

• Chest pain
• Chills
• Difficulty concentrating
• Feelings of fear
• Irritability
• Muscle tension
• Rapid heart rate
• Shortness of breath
• Sweating
• Trembling
• Upset stomach

Specific patterns of symptoms depend on the type of anxiety disorder a person is experiencing. Such anxiety disorders can include:

• Generalized anxiety disorder (GAD) is characterized by excessive worries unrelated to a specific source.
• Panic disorder involves having intense panic attacks that strike unexpectedly.
• Social anxiety disorder (SAD) is a condition that causes intense feelings of extreme anxiety in social situations.
• Post-traumatic stress disorder (PTSD) is no longer included in the anxiety disorders section of the DSM, but anxiety can be a symptom of PTSD, which can occur after experiencing a traumatic event.

Effects of Caffeine

Caffeine is a natural stimulant found in many plants, including coffee beans, tea leaves, cacao pods, and kola nuts. It can also be produced synthetically and added to medications, beverages, and foods.

It also has several other effects on the body, including acting as a diuretic, which increases urination and removes salt and fluids from the body. It can also interfere with the absorption of calcium, increase blood pressure, and increase the release of stomach acid.

How a person reacts to caffeine varies from one person to the next and depends on a variety of factors, including genetics, body mass, metabolism, and the quantity consumed. Caffeine's effects typically begin around an hour after consuming it, and the effects may last up to six hours.

While caffeine is not harmful in moderate amounts, consuming too much can lead to unpleasant side effects and health problems. Some of these side effects of caffeine include:

• Anxiety
• Dependence
• Dehydration
• Headaches
• Heartburn
• Nervousness
• Rapid heart rate
• Restlessness
• Sleep difficulties
• Tremors
• Upset stomach

Giving up caffeine can also cause symptoms of caffeine withdrawal, including headaches and fatigue.

How Caffeine Affects Anxiety

If the side effects of too much caffeine sound familiar, it might be because these effects are very similar to symptoms of anxiety. It isn’t uncommon for people to mistake caffeine’s side effects for feelings of an anxiety attacks.

Symptoms of anxiety and the effects of caffeine affect the activity of the sympathetic nervous system, the part of the autonomic nervous system that controls the body's fight-or-flight response. The fight-or-flight response refers to the way your body mobilizes and responds to threats in the environment. When activated, this response triggers a host of physiological and psychological reactions, including increased respiration, blood pressure, and muscle tension.

One 2022 study found that caffeine doses equivalent to five cups of coffee could induce panic attacks in a large portion of people with panic disorder. The study also found that caffeine didn't just increase anxiety levels in people with panic disorder—healthy adults reported more anxiety as well.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) also recognizes caffeine-induced anxiety disorder as a distinct condition. It is a subclass of substance/medication-induced anxiety disorder and is characterized by experiencing anxiety or panic attacks as a direct result of caffeine consumption.

Caffeine use may also contribute to anxiety problems in other ways. For example, it can lead to sleep disturbances. Poor sleep can, in turn, play a part in the onset and maintenance of anxiety disorders. Research has found that problems with sleep are a predictor for the onset of generalized anxiety disorder in children and adolescents.

Some animal studies have also shown that long-term caffeine use might permanently alter brain excitability. Such effects may be more pronounced among adolescents who habitually consume excessive amounts of caffeine, leading to an increased risk of developing anxiety.

Interactions Between Caffeine and Anxiety Medications

It is also important to be aware of how caffeine use might impact medications that are utilized to treat anxiety disorders. Drug interactions can occur, which may cause unwanted side effects or impact how well your anxiety medication works.

Treatment for anxiety often involves psychotherapy, medication, or a combination of the two. If your doctor prescribes a medication to treat your anxiety, it is important to understand how caffeine might interact with your medications and the effect it might have on your anxiety symptoms.

Medications that are commonly prescribed to treat anxiety include:

• Anxiolytics: Buspar (buspirone)
• Benzodiazepines: Xanax (alprazolam), Ativan (lorazepam), and Klonopin (clonazepam)
• Beta-blockers: Propranolol and atenolol
• Selective-serotonin reuptake inhibitors (SSRIs): Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), and Zoloft (sertraline)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): Effexor (venlafaxine) and Cymbalta (duloxetine)

Interactions may occur depending on the type of medication you are taking. For example, if you are using a benzodiazepine medication such as Xanax, caffeine may counteract the depressant effects of the drug, causing the two to cancel each other out.

Caffeine can reduce the efficacy of beta blockers. You should avoid caffeinated products if you are taking these medications.

Some research suggests that caffeine can increase the antidepressant effects of some medications, including Wellbutrin and other common antidepressants such as Prozac and Lexapro. This interaction may potentially lead to increased side effects while taking these antidepressants.

Cutting Back on Caffeine

According to the Food and Drug Administration (FDA), the typical dose of caffeine is around 400 mg per day. This equals about four cups of coffee per day.

Consuming more than 400 mg a day may result in adverse effects. However, if you are sensitive to the effects of caffeine or have a condition that might be worsened by caffeine, such as anxiety, you might experience problems at even lower doses.

If you are concerned about how caffeine is affecting your anxiety symptoms, there are things you can do to cut back on how much you are consuming each day. The first step is to be aware of your caffeine intake. Check labels to see how much caffeine is in the foods, beverages, and medications you consume.

Once you know more about your caffeine sources, gradually reduce your daily intake. Cutting back slowly can help minimize the risk of unpleasant withdrawal effects.

As you reduce your dose, look for lower-caffeine or caffeine-free substitutes. For example, you might opt for herbal teas or decaffeinated coffee.

A Word From Verywell

If you are struggling with feelings of anxiety, it is always a good idea to consider if caffeine might be playing a part in worsening your symptoms. Lifestyle modifications such as cutting back on caffeine, getting enough sleep, and engaging in regular exercise may help you better manage your anxiety, but it is also important to talk to a doctor or mental health professional. Effective treatments can help you deal with anxiety and prevent it from worsening.