I am thrilled to announce to you all that after a long and difficult journey, I am finally ready to make the following proclamation with absolute confidence:
I love coffee.
Groundbreaking, right? I know. Coffee is in many ways the quintessentially american addiction. Especially in my age bracket of overscheduled twenty-somethings, caffeine intake has reached a status of necessity akin to oxygen and vitamin B12.
So why am I so proud of this seemingly ubiquitous sentiment?
Well, I have panic disorder, and when you read about anxiety, one of the major no-nos is caffeine. Anxiety patients, myself included, are often taught to avoid it like the plague, and learn all its hidden forms like energy drinks and dark chocolate. I developed an extreme phobia of caffeine– even a tiny accidental intake was enough to send me skyrocketing into panic.
Then, a couple of years ago, a therapist gave me a disconcerting homework assignment: Drink coffee.
She wasn’t asking for a lot– just one cup right before our next appointment– but I was afraid. As someone who is already hypersensitive to caffeine (it runs in my family), the physical symptoms caused by even a few sips were enough to trigger a panic attack, and because the sensations were brought on by an external source (the coffee), I felt unable to control them with my breathing and relaxation techniques. But I did as I was told. I drank the coffee, showed up for my appointment, and took the first steps toward divorcing myself from all those negative associations with caffeine. Yes, it’s a stimulant. Yes, it can make my heart race, my pupils dilate, and my hands and body feel shaky. But caffeine, as powerful as it is, no longer controls my mind. I now understand how to take a step back, notice how my body is reacting, and understand why I feel the way I do. I know how much caffeine I can tolerate comfortably and what physical sensations come at different times after drinking coffee. I am still very sensitive– I usually use the old coffee grounds left in the filter after my sister has poured her morning brew, and that’s enough to make me feel stimulated and alert for several hours. But that’s okay. I accept my sensitivity and am no longer frustrated and afraid.
You see, one of the most life-altering, self-perpetuating symptoms of an anxiety disorder is avoidance– cutting out activities, situations, etc that bring on feelings of anxiety and panic. This in turn builds major phobias of the avoided events, leading to more avoidances and in some cases severe agoraphobia, where you can be afraid to leave your house for any reason. In my quest to overcome anxiety, my goal is to have as few anxiety-imposed limitations as possible.
The cure for avoidance is simple, if not easy: it’s exposure, a controlled, systematic reintroduction to avoided situations and events. In asking anxious people to avoid caffeine, doctors are merely adding one more phobia to the list. Yes, limiting or cutting out caffeine (as well as other stimulants, like sugar) can be useful at first, or during a particularly rough patch of anxiety, but I believe that it’s more important to remove the fear and mystery of caffeine over the long term. I don’t drink coffee every day; I don’t feel the need to, but I enjoy a cup every now and then and appreciate the extra little boost of joy and energy it brings to my life. Most of all, I am proud of the fact that I can drink coffee if and when I choose to do so. This everyday act, which so many people take for granted, represents another small victory on the way back toward a life unconstrained by panic.
All this being said, moderation is key. If you are thinking of reintroducing caffeine to your diet, take it slowly; I’ve been on and off tea and coffee for several years now, and it took some time and a lot of careful noticing to figure out how much is effective without giving me heart palpitations and too much nervous energy. For example, a small soy latte at Starbucks (75 mg of caffeine) is usually OK, but a small coffee with soy milk (260 mg) makes me feel horrible for hours afterward. Also, caffeine is a drug, and it is addictive in large quantities. Developing an addiction to any drug is a bad idea, especially for those with anxiety, as withdrawal can be a major trigger for panic.
To help, here’s some information about the relative quantities of caffeine in various coffees and coffee drinks. Remember, sugar is a stimulant as well, and many coffee beverages pack a lot of it, providing a double-whammy of stimulants to quickly spike (and crash) your blood sugar. I personally avoid refined sugar, especially in sweetened drinks, because I don’t like the way it makes me feel and I believe it’s detrimental to my health, but the choice is yours. Also notice that caffeine content varies significantly between brands, even for the same beverage. A small coffee at Dunkin’ Donuts has only about half the caffeine of a small coffee from Starbucks. When reintroducing caffeine to your diet, it may be helpful to keep a food journal at first. Writing down how different amounts and sources of caffeine make you feel can help you decide which quantities, forms, and timing work for you.
For Starbucks aficionados:
For the Dunkin’ crowd:
How do you use (or avoid) caffeine in your daily life? Friend or foe?