Bp Magazine Blog: Can Coffee Cause Anxiety for People with Bipolar Disorder?

iced coffeeThis is one of my most popular posts for the BP Magazine blog. I Love Coffee- but my bipolar anxiety hates it…

I love the taste of coffee.

I sometimes let my guard down for real iced coffee. Not the decaf Americano iced coffee, but the kind of coffee that is cold brewed. Yum!

Click here to read the rest of my BP Magazine blog on the topic.

PS:  Caffeine exacerbates the side effects of many bipolar disorder medications, especially those that are ‘activating’ such as Abilify and anti depressants such as Effexor,  Prozac and Zoloft.  But… to be honest, I was able to drink plenty of caffeine when  I was on lithium as it was so sedating!

What is your experience with caffeine?

PS: As I’ve gotten older- my ability to deal with caffeine has gotten better!

31 comments to Bp Magazine Blog: Can Coffee Cause Anxiety for People with Bipolar Disorder?

  • Terry

    I LOVE!!!! coffee. It helps me get through my morning fogginess and I drink it all day long. I switch to decaf in the afternoon. My anxiety is always through the roof, so I’m going to take your advice and see how a week of decaf only goes. I’ll let you know.


  • HB

    I can’t drink coffee either. It makes me really shaky. I still like caffeine a little bit and most days I can drink a cup of green tea without getting shaky. However, sometimes, my reaction to caffeine depends on my mood. It can make me a bit hypomanic or if I’m already hypomanic, it can make it worse. I also have trouble sleeping at night if I have caffeine in the afternoon or evening.

    On the other hand, a little bit of caffeine can help if I’m a bit depressed.

    I love the taste of caffeinated coffee too, but I can remember how badly it made me feel in the past…. and that memory is strong enough that I really try to stay away from it.


  • Even though I don’t have anxiety… my doctor always cautions me to watch my intake of caffeine since he says that it can cause hypo-mania etc.

    I drink caffeinated coffee in the mornings…and I’m like you- I love it. But, I have to be ever so careful, cause it seems like such a fine line between enjoying it and all of sudden having had too much of it!

    I wonder if anyone has ever proven why there is the taste difference? Cause if I’m offered decaffeinated coffee I usually just pass it up! Go figure!

    Julie, you do a great job with your blog and your new book is great! I have a new support group called Fresh Hope (a Christian support group -now two groups- for those who have mood disorders and their loved ones) http://www.FreshHope.us And I told them about your book and a we’ve talked about the difference between “feeling like doing something” verses just doing it and feeling better about simply having gotten it done! Thanks for your insights!

    Gripped by Grace,

  • Brandi

    I can handle (and very much NEED) one cup of coffee in the morning. But if I have more than one cup, I am in trouble. Shaky, jumpy, just miserably anxious all day. And if I have ANY caffeine after noon, I am up all night. My husband makes cold brew iced coffee and I have to stay away from that altogether.

  • This is also true for dark chocolate for me, and it is hard, because I adore chocolate. But I cut back to almost nothing with dark chocolate, except some homemade hot cocoa that I use unsweetened coca in. If I forget and have more than 1, my anxiety shoots through the roof all day long.

  • Andrea

    I have definitely noticed a connection between caffeine and hypomania, but it isn’t always consistent. Sometimes upping my Topamax mainly when I need to increase it for other reasons anyway) has helped. Looking back, I can definitely recognize hypomanic tendencies when I had too much caffeine before I was diagnosed and went on medication.

  • Tiffany Sugg

    I used to drink a TON of caffeine. Coffee when I got to work (2 cups), and then when I left to do my route at work I’d stop by the gas station and get a large mtn. dew. I did have some anxiety, annoying but manageable…but I found that all the sugar in the soda combined with large amounts of caffeine would make me feel really gross later on in the day.
    Now I have a cup of coffee maybe once every other day at work, and I’ve cut out ALL sodas (meds=weight gain, meds+sugar=MORE weight gain). I don’t even drink juices anymore because of the sugars in them. One small coffee, and I’m on water the rest of the day. Now, I rarely have a mid-day crash, and I’ve been pretty anxiety free since I cut down on the caffeine. I have more energy now too, no crashing 🙂

  • bpbookworm

    Ideally I would have to avoid caffeine completely to feel the best. Even in small amounts, I notice jitters, irritability, heart palpitations, stomach/intestinal discomfort, and even exacerbation of anxiety that can lead to feelings of panic. (I live with bp II w/features of OCD and ADD, and don’t have a co-existing anxiety disorder, but have experienced two panic attacks that I can clearly remember.) When I feel physically so uncomfortable, any mood disorder symptoms I am currently feeling get exaggerated, too. I try to limit caffeine as much as possible by sticking to allowing only my favorite caffeinated beverage: chai. I limit my other drinks to water, decaf root beer, lemonade, juices, milk, milkshakes for a treat, etc. In wintertime I’ll occasionally have hot chocolate. For me it’s not terribly hard because I don’t like to consume a lot of liquids aside from the water I need to drink for my health (to keep hydrated) and to accompany meals – I don’t really crave much to drink except a good cup of chai once in awhile. 🙂 I’m not even a huge chocolate fan, although I rarely turn down the offer of a piece of dark chocolate if you catch me in the right mood. What can be a challenge sometimes is when I’m at a gathering and there is only soda that is caffeinated (and no water option). At those times if my husband is with me, I share a drink with him so I just get the caffeine in moderation. I need to make sure I bring my own bottled water – In cool weather, I can keep several bottles in my car and they’ll be good to go without refrigeration.

  • Jen

    I don’t notice a difference in taste at all. In fact, i look forward to my decaf. The real upside is that I can brew a pot all for myself.

    If I need a little jolt, I get a decaf mocha. There is a little bit of caffeine in the chocolate. It is just enough to get me going, but not so much that I get shakey and lose sleep.


  • trashfire

    you’ll have to pry my cold dead hand off the espresso machine…

    but seriously, I probably drink more of the stuff than I should, but my anxiety comes from disorganized thinking and not completing things, which coffee helps with. To keep the jitters down, I sometimes switch to genmaicha, a Japanese green tea with toasted rice in it. Very zen, has caffeine but is much more mellow. Decaf? Rather drink plain water.

  • rahul

    I grew up drinking chai every morning as a tradition. Regular Tea makes me jittery and jumpy and very anxious throughout the day. If I have tea and have my stomach empty for couple of hours, my whole day is extremely anxious. My Dr. suggested decaf chai, but as some of you mentioned earlier avoiding caffeine completely is the best way to overcome anxiety. The days when I dont drink chai I try to go for a workout. It freshens up your mind and your realize, what calm and composure feels like.
    I am working on my anxiety very actively, avoiding Tea has been the biggest challenge. Friendly suggestion for those with anxiety do not stop trying. Also one good thing happened to me, “chammomile Tea”, is the best for relaxation.I have found ‘Calm’ tea at Starbucks very relaxing too.

  • Lori E. Havens

    Thank you so much for your good advice about the effect of coffee when we are bi-polar. Now I know what has been causing anxiety in me for so many years. I started drinking coca cola when I was young and as I got older started drinking other sodas and got really hooked on Pepsi and got really addicted to that. Now for many years it has been coffee. And also other caffeinated drinks and now my body is kind of addicted to it but since I take a medication for anxiety the two don’t mix to good. This past week and also last week I found by drinking plenty of water and really hardly anything else that I have felt really good and relaxed but when I start drinking coffee I get tense and also just want to be by myself. I don’t want to be around people then because I don’t know if I can deal with any conversation that might be negative and how I will react. But I hardly ever drink soda and have coffee that I just got that is half the caffeine and it is probably best to go off gradually right since it is a drug. I had a bad reaction last year to being reduced off of my anxiety med and ended up in hospitals and it was the worse experience that I have ever gone through. I wish that I had never started meds. That there must have been a way that things could of been taken care of by diet. I don’t know. If you have any help to give me I would really appreciate it.

  • I do consider all the ideas you have introduced to your post.
    They’re really convincing and can certainly work. Nonetheless, the posts are too short for beginners. May you please lengthen them a little from next time? Thanks for the post.

  • Good post, bad news. I love my coffee. My standard Starbucks order is: “Big. Bold. Straight up. All the caffeine.” Tried decaf, but it’s like drinking tap water instead of bottled. Never could stand the taste, and I’ve never heard of decaf espresso.

    Too much? I can tell when I’m too wired to do really exacting work – like fixing some code in my website. When even my ADHD friends tell me I’m getting too wild.

    I usually limit myself to two cups, and I try to watch that closely. Also, if I go to Starbucks I make sure I burn off that extra caffeine with a good hard bike ride.

  • Tony

    I’ve also heard of sufferers of BP advised by doctors to avoid caffeine (even chocolate, refined foods, sugar), but cannot find any scientific literature that shows any correlation between this and moods.

    Remember that caffine, in large quantities, tend to cause issues with non-BP.

    • Hi Tony,

      There is a definitely link between caffeine and anxiety as well as caffeine and sleep- that is the main link with bipolar disorder. And… since any sleep problems can lead to mood swings, caffeine can cause mania and depression. I can have caffeine when I’m taking lithium as the lithium makes me so sleepy. If I’m not taking meds, the caffeine causes too much anxiety. The main problem is with energy drinks! Julie

  • steve

    I’m new to the bypolar thinking as I have just been diagnosed. I have been using coffee to keep me from going into and getting out of a low. Take this info sparingly though. I’m not yet on meds and just starting out with all this. I just am using it like a med to help out untill other real help is given.

  • big dipper parts

    Excellent read, I just passed this onto a colleague who was doing just a little research on that. And he truly bought me lunch because I identified it for him smile So let me rephrase that.

  • Luther Basch

    You could definitely see your expertise in the work you write. The sector hopes for even more passionate writers like you who are not afraid to mention how they believe. Always go after your heart. “In America, through pressure of conformity, there is freedom of choice, but nothing to choose from.” by Peter Ustinov.

  • Geno

    I’m sorry, but the way the majority of the posts are describing reactions to coffee and caffeine are just how regular persons do. Some subtle ups and downs, jitters, fast heart rate are common place for anyone. Debilitation for those of us who truly suffer: ZERO sleep, suicidal ideation, ceaseless ruminations, hyper mania such as uncontrollably wanting to catch a plane to another country, finding yourself irresistibly packing luggage at four in the morning, THAT is bipolar. Far too many people are using our condition as an excuse for a bad day and the drug/psychiatrist industry is to blame. For a lack of a better example: just because you stubbed your toe, does not mean you broke the bone. We would do anything for your lifestyle and those kind of simplistic problems, so stop skewing the stats with your whining and let us get real statistics for real solutions and cures. Please.

    • Hi Geno, It does sound like one big whine fest when people with bipolar disorder have to talk about triggers! I may not have been clear enough on this post as to why caffeine is such a problem for some people. It’s the way it affects sleep. Many people with anxiety continue to drink coffee and just deal with the jitters, etc, but if a person with bipolar disorder drinks too much caffeine- especially from energy drinks that may also have other stimulants, the problem is that the sleep is affected. Bipolar disorder is basically a sleep disorder, so anything that causes lack of sleep can lead to a pretty serious mood swing. When I’m taking lithium, the side effects make me so tired I actually need caffeine to stay away. When I’m not taking much lithium- such as now- I can’t drink coffee. Hope this information helps. I never want others to think that trigger management is an excuse for bad behavior. Instead, it’s a tool to stop the behavior that drives others crazy! Julie

      • anon

        Bipolar is NOT a sleep disorder.

        It *affects* sleep and is *affected* by sleep, but it’s not a sleep disorder.

        There’s not one reputable published medical study that proves the direct correlation between caffeine and bipolar. Caffeine can keep a person awake, which if done long enough can trigger mania in BP. Reasonable amounts of caffeine don’t trigger mania unless the person stays awake too long.

        • Hello- thank you for your reply to my post. I should have made myself more clear. A friend of mine works with a very reputable psychiatrist who wrote a book on bipolar disorder with Dr. Kay Redfield Jamison first gave me the idea that bipolar disorder is also a sleep disorder. He said to my friend, “I believe that we will one day see bipolar disorder as a sleep disorder.” I agree with him whole heartedly. I’ve had to major sleep studies done in the hope that there was something other than bipolar causing my sleep problems. I was cleared of sleep apnea. It was just plain old bipolar disorder. We know so little about this illness. Every single symptom we experience affects our sleep, but we also know that sleep affects every single one of our symptoms. My coauthor Dr. John Preston has been the most instrumental in helping me look at my sleep and how it affects my moods. He writes about caffeine in all of our books and considers it one of the main external triggers of bipolar disorder symptoms. I in no way believe that it causes bipolar disorder itself. Bipolar is genetic. I’m talking about triggers. I still drink coffee- but I find that I can only have it when I’m not experiencing anxiety- otherwise it’s a pure trigger. It’s certainly a good topic for discussion! Thanks again for your comments. Julie

  • Aron Holub

    I completely agree about Easter candy, it is definetly my favorite candy. Especially Peeps I only get them during Easter.However I never tried these Hershey Easter eggs but they do sound really good and it is pretty sad that they only have them out once a year.So I guess now I’m going to have to wait til next Easter to try them.

  • I believe that avoiding processed foods may be the first step in order to lose weight. They could taste great, but highly processed foods have got very little vitamins and minerals, making you feed on more in order to have enough electricity to get with the day. If you are constantly consuming these foods, transferring to cereals and other complex carbohydrates will let you have more vitality while ingesting less. Interesting blog post.

  • Sarah Weeks

    I definitely find that caffeine makes me more excitable and more likely to be manic. This is not always true but I do really like to take the risks that often, especially because I am already pretty moody and also because of work.

    • Hello Sarah,

      Thank you for your comment. I know exactly what you mean about taking risks with things that make us manic. It’s hard to remember that what we are doing in the moment can actually have huge repercussions in our future. I keep my coffee use to the very early morning and that seems to help me. Why does it taste so good! Julie

  • Jeff Barnet

    In 37 years diagnosed with manic-depressive illness, I have seen it all. I’ve been stabilized on lithium and ativan since 1996, and I cannot take anti-depressants because I go manic on them within one to two weeks. I use coffee, maybe 2 strong cups in the morning, to stimulate me into an alert and productive state. I have also gone off caffeine 100%. I noticed less anxiety, more peacefulness, a natural waking response before the alarm. Also, my focus, energy and concentration at work was shot. I decided the antidepressant effect and productivity effect was more important to me than a slight lowering of anxiety and natural waking. This illness will literally kill you, and it can easily destroy your career. The science does not prove that caffeine has a universal affect upon people with m-d illness. Think fort yourself. Observe yourself. Make the best decision you can with this tricky condition. For me, a little coffee seems to help against depression and lack of concentration. It’s the best I can do.

  • Anber S

    Most days I can handle caffeine. I tend spend more days on the depressive end than the manic end. During my depressive phases I need all the caffeine I can get just to make it through the day. During my manic phases I can usually handle a small amount, but if I exceed one cup I am much more prone to anxiety and panic attacks. Especially if I have had a change in my routine. My husband says I start acting and talking like I used to when I would get very emotional after getting too drunk (I stopped drinking altogether a couple years ago). Chamomile tea has been one of the greatest things I have found to help me get through my manic phases.

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