Can caffeine make social anxiety worse?

Dear Caring Partner,

Whether a morning cup of joe keeps your partner happily alert or nervously jittery may depend on how much caffeine is consumed. While not definitively causal, a number of studies have shown a dose-dependent relationship between excess caffeine consumption and stress, anxiety, and depression. This relationship’s direction could go either or both ways; that is, excess caffeine consumption might exacerbate these conditions or people with these conditions might use caffeine consumption as a coping strategy. As you may know, moderating caffeine consumption is unlikely to eliminate your partner’s anxiety but it might, based on your observation, make it more manageable for him. For your partner, trial and error may be a good approach to finding balance.

In small amounts, caffeine may boost physical and mental functions, which can include staying more awake and alert, mood improvement, faster reaction and information processing times, and even better exercise performance. There are no serious adverse health effects attributed to caffeine consumption in moderation. In fact, some studies have even found a protective effect of low doses of caffeine against anxiety and depression. As consumption increases, the effect flips, with research showing a link between moderate to high levels of caffeine and an increased risk for anxiety and depression. The effects on anxiety are more pronounced for males than females. It’s good to keep in mind that research does not suggest that caffeine consumption causes these conditions; rather, caffeine intake is among many factors that contribute to these conditions.

As you may have observed with your partner, many different types of variables and situations may trigger his social anxiety, such as stress, diet, environment, genetics, physical appearance, conditioned responses, and negative thought patterns. People with this condition may feel afraid, worried, or embarrassed interacting with or at the prospect of interacting with other people in social situations. These feelings may result in physical symptoms such as blushing, sweating, nausea, trembling, muscle tension, faster heartbeat, dizziness, and breathing difficulty. For some, self-management techniques such as meditation, healthy sleep habits, and regular physical activity may help reduce anxiety. Other than do-it-yourself strategies, psychotherapy or medication (or a combo of the two) are two common, effective treatments for social anxiety. These treatments aim to improve confidence in social situations and change disruptive thoughts. If your partner is already seeing a mental health professional about social anxiety, he could discuss the effect of caffeine that you or he has noticed and discuss developing a caffeine reduction plan.

If your partner is true to his brew, perhaps he will find a level of caffeine that doesn’t impact his behavior; this may take time and trial and error. He may consider starting by gradually decreasing his caffeine intake, perhaps drinking half decaffeinated and half caffeinated. Then he may try steadily switching to more "de" than "caf." Since even decaf has some caffeine in it, he may also want to try other lower caffeine or caffeine-free coffee substitute beverages. Some other foods, drinks, and medications also have significant caffeine content, so your partner may want to also read food labels carefully if he’s trying to cut down overall caffeine consumption. It's key to note that the United States Food and Drug Administration (FDA) requires caffeine to be labeled only if it is added to the product, not if it occurs naturally (e.g., chocolate ingredients in a packaged dessert).

With these tips, hopefully your partner will be able to stay comfortably caffeinated and happy at the same time. 

Take care,