Quitting Caffeine: Kicking the Habit Isn’t That Simple

While caffeine may seem like a harmless but necessary drug to get you through the day, the Wall Street Journal reports that it’s now the basis of two official diagnoses in the mental-health bible released in May, with a third under consideration. The most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, frequently called DSM-5, includes both caffeine intoxication and withdrawal. Both of these conditions are counted as mental disorders when they harm an individual’s ability to function in daily life.

Caffeine intoxication had been included in the previous version of the manual, known as DSM-IV, as a diagnosis. However, caffeine withdrawal was upgraded in DSM-5 from a “research diagnosis” to a diagnosis. Also, caffeine use disorder, which is when a person suffers disconcerting side effects and isn’t able to quit, was added to DSM-5 as a research diagnosis, meaning it needs more analysis to be included.

However, the new mental health diagnoses come with debate.

“Caffeine intoxication and withdrawal both occur fairly frequently but only rarely cause enough clinically significant impairment to be considered a mental disorder,” said Allen Frances, who chaired the task force that established the previous version of the DSM and has been an outspoken critic of the latest version. “We shouldn’t medicalize every aspect of life and turn everyone into a patient,” he added.

“The symptoms [of caffeine withdrawal] overlap with a lot of other disorders and medical problems,” said American University psychology professor Laura Juliano, who guided the DSM-5 Substance-Related Disorders Work Group. “We’ve heard many times people went to the doctor for chronic headaches or because they thought that they had the flu and it turns out it was caffeine withdrawal and they didn’t even know it.”

While caffeine is addictive, studies have shown that it is actually related to some health benefits. Nevertheless, various experts say that some individuals should avoid caffeinated goods, like those with anxiety, high blood pressure, insomnia, and diabetes.

In order to be diagnosed with caffeine withdrawal, a person has to experience at last three of five symptoms within 24 hours of stopping or decreasing caffeine intake: headache, fatigue or drowsiness, depressed mood or petulance, difficulty focusing, and flulike symptoms like nausea or muscle pain. Withdrawal symptoms often begin 12 hours after consumption and reach their peak at 24 hours.

For the majority of people, the symptoms will disappear in around a week and that may be preferable to spending a few weeks decreasing your caffeine intake only to find that the last step in quitting still leads to withdrawal symptoms.

Among routine caffeine drinkers who go without caffeine, headache is reported about 50% of the time and functional impairment about 13%, said Dr. Roland Griffiths, a professor at Johns Hopkins University School of Medicine in psychiatry and neuroscience who advised the DSM-5 work group.