June 6, 2002
Cutting down on caffeine?
This morning you decided to skip all the cups of coffee that have been a part of your life for a long time. Whether you were trying to be healthier, beat an upset stomach or avoiding feeling jumpy during a presentation at work, you were full of good intentions. Now, in the middle of the afternoon, your head hurts, you feel sluggish and you suspect that your brain is just not working very well.
What’s really frustrating is that you just may be right, according to Dr. Stephen Dager, professor of psychiatry and behavioral sciences and of radiology at the UW. Dager, who admits to drinking copious amounts of coffee daily, has done imaging studies on the effects on the brain of caffeine withdrawal through the UW Diagnostic Imaging Sciences Center and the Center for Anxiety and Depression.
“Caffeine has a lot of interesting effects on the brain, including a reduction in blood flow. It also increases brain metabolism and energy utilization, thus accelerating brain activity,” Dager says. “The reduction in blood flow is why a lot of headache relief compounds contain caffeine in their formulas. Its effects on accelerating brain activity are why you feel more alert after a cup of coffee.”
Caffeine withdrawal, however, makes many people feel more irritable, less sociable and less able to concentrate. Stopping caffeine abruptly also causes headaches due to a resulting rebound in blood flow to the brain.
“Caffeine is the most widely consumed psycho-stimulant in our society,” Dager says. “It is also a drug, and as a drug it has withdrawal symptoms.”
The addictive nature of caffeine isn’t a good reason in itself to avoid caffeine, unless you suffer from a certain limited range of health problems, such as panic disorder or other anxiety problems. Caffeine has also been implicated in the formation of breast cysts in some women.
“People who are prone to anxiety or panic attacks tend to be sensitive to caffeine,” Dager says. “I frequently evaluate people who have severe panic or anxiety and are still drinking buckets of coffee. Before I start thinking about starting them on a medication, I always recommend that these people discontinue caffeinated products, including coffee, tea, many soft drinks and chocolate, to see if that relieves or reduces their anxiety.”
So what’s a jumpy coffeehouse patron to do? An abrupt drop in caffeine levels could leave you with a headache, irritable and distracted.
“When we were doing our studies on caffeine, we asked people to go on a caffeine holiday,” Dager says. “It was easier for some individuals to cut back gradually, first by reducing the cups of coffee and tea they had every day, and then, for some people, drinking decaf coffee or tea, which still contain a very small amount of caffeine. This can be a convenient way to reduce caffeine intake while still having the taste and preserving that social ritual that goes along with coffee drinking.”
If you find that you just can’t quit drinking coffee, there are no other clearly identified reasons that you should do so.
“The main thing is to be aware that one cannot abruptly stop caffeine without the risk of experiencing some mildly to moderately obnoxious withdrawal symptoms,” Dager says. “The magnitude and duration of withdrawal appears to be closely associated with the amount of caffeine you habitually consumed.”
