If you experience fatigue, headache and difficulty focusing after you pulled an all-nighter and had a lot of coffee, a mental health care provider could diagnose you with caffeine withdrawal.
The American Psychiatric Association just released the fifth edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5). In the revised version, caffeine withdrawal has been classified as a “caffeine-related disorder.”
“Caffeine is a drug, a mild stimulant, which is used by almost everybody on a daily basis,” said Dr. Charles O’Brien, who chairs the Substance-Related Disorder Work Group for DSM-5. “But it does have a letdown afterwards. If you drink a lot of coffee, at least two or three [236 ml] cups at a time, there will be a rebound or withdrawal effect.”
Caffeine-related disorders are not a new category in the DSM, as the DSM-IV also included the section. The new edition shows caffeine withdrawal as a direct consequence of caffeine intoxication. Symptoms of intoxication include restlessness, nervousness, red face, gastrointestinal upset, muscle twitching, rambling speech and rapid or irregular heartbeat.
Once a person stops consuming caffeine, withdrawal brings on depression, headaches, fatigue and difficulty concentrating.
"The symptoms of caffeine withdrawal are transitory, they take care of themselves," said clinical psychologist Robin Rosenberg. "It's just a natural response to stopping caffeine, and it clears up on its own in short order."
Caffeine joins the ranks of other addictive substances in the DSM such as alcohol, cannibis, nicotine and heroin.
Some substance abuse clinics already view caffeine as a potentially hazardous substance and therefore do not allow patients or employees to bring the contraband into the facility.
“We feel that there is enough data to support a caffeine-withdrawal syndrome,” said DSM-5 work-group member Alan J. Budney in 2011. “There are enough people who go into withdrawal — that if they don’t get caffeine, it becomes a real syndrome and can affect work, sleep, or whatever they need to do. So we’re suggesting that it ‘make the big leagues’ and become part of the DSM to make sure everyone is aware of it.”
The new DSM designation for caffeine withdrawal suggests that psychiatrists believe caffeine could be habitually and compulsively used to the point that it could disrupt normal emotional, behavioral and socio-occupational functioning.
"It isn't clear that [caffeine use disorder] is clinically significant," O'Brien admitted.