GAD Symptoms How Does Caffeine Affect Anxiety? By Kendra Cherry Kendra Cherry Facebook Twitter Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology. Learn about our editorial process Updated on October 18, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Mongkol Nitirojsakul / EyeEm / Getty Table of Contents View All Table of Contents What Is Anxiety? Effects of Caffeine How Caffeine Affects Anxiety Drug Interactions Cutting Back on Caffeine 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. According to one study, 85% of the U.S. population consumes at least one caffeinated beverage every day. 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. Caffeine stimulates the central nervous system, making you feel more alert and energetic after consuming it. 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: AnxietyDependenceDehydrationHeadachesHeartburnNervousnessRapid heart rateRestlessnessSleep difficultiesTremorsUpset stomach Giving up caffeine can also cause symptoms of caffeine withdrawal, including headaches and fatigue. Caffeine Addiction Symptoms and Withdrawal 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. The effects of consuming too much caffeine can often feel indistinguishable from anxiety symptoms. And if you already have an anxiety condition, evidence indicates that it can worsen your symptoms. 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. Recap Caffeine can worsen symptoms of anxiety and interfere with sleep. Some research indicates that chronic caffeine use might increase your risk for developing an anxiety disorder. 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. If your doctor prescribes an anxiety medication, always talk to them about potential drug interactions. Ask if it is safe to consume caffeine while you are taking your medication and about any potential adverse affects you might experience. 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. Caffeine Content of Common Beverages: Amounts found in some frequently consumed beverages include:8 oz cup of black or green tea: 30 to 50 milligrams8 oz cup of coffee: 80 to 100 milligrams8 oz energy drink: 40 to 250 milligrams12 oz canned soda: 30 to 40 milligrams 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. If you or a loved one are struggling with anxiety, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 15 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Meredith SE, Juliano LM, Hughes JR, Griffiths RR. Caffeine use disorder: A comprehensive review and research agenda. J Caffeine Res. 2013;3(3):114-130. doi:10.1089/jcr.2013.0016 Mitchell DC, Knight CA, Hockenberry J, Teplansky R, Hartman TJ. Beverage caffeine intakes in the U.S. Food and Chemical Toxicology. 2014;63:136-142. doi:10.1016/j.fct.2013.10.042 Richards G, Smith AP. A review of energy drinks and mental health, with a focus on stress, anxiety, and depression. J Caffeine Res. 2016;6(2):49-63. doi:10.1089/jcr.2015.0033 Juliano LM, Huntley ED, Harrell PT, Westerman AT. Development of the caffeine withdrawal symptom questionnaire: caffeine withdrawal symptoms cluster into 7 factors. Drug Alcohol Depend. 2012 Aug 1;124(3):229-34. doi: 10.1016/j.drugalcdep.2012.01.009 Klevebrant L, Frick A. Effects of caffeine on anxiety and panic attacks in patients with panic disorder: A systematic review and meta-analysis. Gen Hosp Psychiatry. 2022 Jan-Feb;74:22-31. doi:10.1016/j.genhosppsych.2021.11.005 American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022. Shanahan L, Copeland WE, Angold A, Bondy CL, Costello EJ. Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2014;53(5):550–558. doi:10.1016/j.jaac.2013.12.029 Tchekalarova JD, Kubová H, Mareš P. Early caffeine exposure: transient and long-term consequences on brain excitability. Brain Res Bull. 2014;104:27-35. doi:10.1016/j.brainresbull.2014.04.001 Arnold MR, Williams PH, McArthur JA, et al. Effects of chronic caffeine exposure during adolescence and subsequent acute caffeine challenge during adulthood on rat brain serotonergic systems. Neuropharmacology. 2019;148:257-271. doi:10.1016/j.neuropharm.2018.12.019 Howland RH. Buspirone: Back to the future. J Psychosoc Nurs Ment Health Serv. 2015;53(11):21-4. doi:10.3928/02793695-20151022-01 Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis. J Psychopharmacol. 2016;30(2):128-139. doi:10.1177/0269881115612236 Belayneh A, Molla F. The effect of coffee on pharmacokinetic properties of drugs : A review. Biomed Res Int. 2020;2020:7909703. doi:10.1155/2020/7909703 Szopa A, Poleszak E, Wyska E, et al. Caffeine enhances the antidepressant-like activity of common antidepressant drugs in the forced swim test in mice. Naunyn Schmiedebergs Arch Pharmacol. 2016;389(2):211-221. doi:10.1007/s00210-015-1189-z Kale PP, Addepalli V. Augmentation of antidepressant effects of duloxetine and bupropion by caffeine in mice. Pharmacol Biochem Behav. 2014;124:238-244. doi:10.1016/j.pbb.2014.06.005 Food and Drug Administration. Spilling the beans: How much caffeine is too much? By Kendra Cherry Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for GAD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.