Many university students (and professors) start their day with a cup of coffee. In fact, coffee is a normal part of North American culture and beyond [1, 2].

Nevertheless, debates exist around its potential health and mental health effects.

A controversial diagnosis of “caffeine use disorder” appeared in the Diagnostic and Statistical Manual (DSM) in the year 2013 [3]. Alan J. Budney and colleagues from Darmouth College and the American University [4] state that “the subjective and behavioural effects of caffeine also parallel those of other substances, particularly stimulants, which are commonly misused [5][6].” Such a diagnosis requires the presence of the three most important characteristics of any addiction: “repeated, unsuccessful attempts to quit or cut down, withdrawal, and continued use [of the substance] despite harm” [4].

This means that the individual needs to have several serious, failed attempts at trying to drink less coffee. In terms of withdrawal, an individual must have negative physical effects if he/she reduces their intake in the form of headaches and fatigue, for example. Finally, even when negative consequences are experienced as a result of consuming coffee (e.g., serious health problems, panic attacks), the individual is unable to stop without help.

Despite this recent diagnosis, it is important to note that most people are able to regulate their coffee intake by taking moderate doses (i.e., about 400-500 mg or about 2 cups per day), leaving six-hour intervals between cups, and not drinking before bedtime [7]. In these moderate doses, coffee seems to increase alertness and positive mood without negative consequences [8].  Furthermore, small to moderate doses of daily coffee intake may help prevent Alzheimer’s [9] and Parkinson’s disease [10].

Coffee can also used as an exercise enhancer for people who are recovering from heart failure, leading to temporarily increased cardiovascular capacity, endurance, and higher muscle pain threshold [11]. However, these kinds of effects have been noted in generally healthy individuals. Certain at-risk individuals are recommended to abstain from drinking coffee, or to do so only in small doses, such as those with osteoporosis [12] and/or pregnant women [13].

Despite the positive effects on health and cognition if taken moderately, higher doses seem to lead to negative effects, such as increased anxiety and heart palpitations [14]. In fact, there doesn’t seem to be any benefit in drinking more than a cup every 6 hours [7]!

Coffee’s effects on mental health, however, are more controversial. Though coffee can boost your mood, studies demonstrate that those individuals who drink coffee (especially in large amounts) seem more likely to have certain mental symptoms, such as depressive bouts, anxious moods, and stress [15]. This association between mental health and coffee intake is not yet well understood.

One possible explanation is that heavy coffee drinkers also tend to smoke and the effects of coffee might be more negative when combined with nicotine [14]. It is also possible that drinking coffee is an attempt to regulate mood and stress [14].

Another important finding related to mental health and coffee intake is that people who are prone to panic attacks are more likely to experience anxiety after drinking coffee [14]. Caffeine may also precipitate panic attacks in individuals with already diagnosed anxiety disorders. Therefore, the use of caffeine is not recommended for these individuals.

All this being said, in general, low-to-moderate doses of caffeine don’t seem to be harmful. However, what is becoming increasingly obvious, is that anything, including the items we consume on a day-to-day basis, can become problematic if taken to the extreme. So, to encourage a timeless mantra: Everything in moderation.

 

By: Ioana Arbone
Edited by: Alisia Bonnick
Image by: Jenny Soriano & Adley Lobo

 

References:

[1] Weinberg, Bennett Alan and Bonnie K. Bealer. 2001. The World of Caffeine: The Science and Culture of the World’s Most Popular Drug. New York: Routledge.

[2] Courtwright, David T. 2001. Forces of Habit: Drugs and the Making of the Modern World. Cambridge: Harvard University Press.

[3] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

[4] Budney, A., Dustin, C., & Juliano, L. (2015). Evaluating the Validity of Caffeine Use Disorder. Current Psychiatric Representation, 74-79.

[5] Stern KN, Chait LD, Johanson CE. Reinforcing and subjective effects of caffeine in normal human volunteers. Psychopharmacology (Berl). 1989;98(1):81–8.

[6] Silverman K, Griffiths RR. Low-dose caffeine discrimination and self-reported mood effects in normal volunteers. J Exp Anal Behav. 1992;57(1):91–107.

[7] Heatherley SV, Hayward RC, Seers HE et al. (2005) Cognitive and psychomotor performance, mood, and pressor effects of caffeine after 4, 6 and 8 h caffeine abstinence. Psychopharmacology 178: 461–70.

[9] Jarvis MJ (1993) Does caffeine enhance intake above absolute levels of cognitive performance? Psychopharmacology 110: 45–52.

[10] Ross GW, Abbott RD, Petrovitch H et al. (2000) Association between coffee and caffeine intake with the risk of Parkinson disease. Journal of the American Medical Association 283: 2674–9.

[11] Notarius, C.F., Morris, B. and Floras, J.S. (2006), ‘‘Caffeine prolongs exercise duration in heart failure’’, Journal of Cardiac Failure, Vol.12 No. 3,pp.220-6.

[12] Barrett-Connor, E., Chang, J.C. and Edelstein, S.L. (1994), ‘‘Coffee-associated osteoporosis is offset by daily milk consumption: the Rancho Bernardo study’’, Journal of the American Medical Association,Vol. 271 No.1, pp.280-3.

[13] Fenster, L., Hubbard, A.E., Swan, S.H., Windham, G.C., Waller, K., Hiatt, R.A. and Benowitz, N.L. (1997), ‘‘Caffeinated beverages, decaffeinated coffee, and spontaneous abortion’’, Epidemiology,Vol. 8 No.5, pp.515-23.

[14] Smith, A. (2002). Effects of Caffeine on Human Behavior. Food and Chemical Toxicology, 1243-1255.

[15] Rogers PJ, Heatherley SV, Mullings EL et al. (2006) Licit drug use and depression, anxiety and stress. Journal of Psychopharmacology 20 (Suppl.): A27.