The American Psychological Association’s new Diagnostic and Statistical Manual of Mental Disorders (DSM) has acknowledged caffeine withdrawal as an official diagnosis, and also included “caffeine use disorder” as a “research diagnosis.”
This is a controversial decision, but most people can recognize the crankiness after skipping a morning cup of coffee, and it has prompted many to question our nation’s caffeine addiction.
You might be wondering about your own consumption — where do professionals draw the line between “recreational” coffee consumption and caffeine use disorder? Are you addicted to caffeine?
The DSM-5 decision: Caffeine withdrawal
The DSM essentially has levels of diagnosis, so some conditions are mentioned but not officially classified as a diagnosis. This was previously the case for caffeine withdrawal, which was listed as a research diagnosis in the DSM 4. The problem is that research takes time, and even results that indicate withdrawal from caffeine exists don’t definitively prove that it does.
This means that research on a topic has to mount and mount before anybody can really be sure that something exists. For psychological conditions, this process is documented in how things appear in the DSM. Some conditions, like caffeine withdrawal in the past, have some notable evidence for their existence but need further research. To acknowledge this, the DSM uses the term research diagnosis, basically meaning a possible diagnosis depending on the results of further study.
Caffeine withdrawal has now achieved the status of official diagnosis, alongside caffeine intoxication. The new DSM also includes caffeine use disorder, which is basically equivalent to caffeine addiction, resulting from the known intoxicating effects and the evidence for withdrawal from caffeine. This could basically mean that in the near future, psychiatrists across the country would officially recognize a five-cup-a-day coffee habit as a disorder — providing other criteria are met, of course.
Caffeine intoxication and withdrawal
The officially recognized conditions — caffeine intoxication and caffeine withdrawal — have more precise definitions, being assessed on several different criteria. Since caffeine is a psychoactive drug, caffeine intoxication can and does occur. The symptoms of caffeine intoxication include insomnia, flushing, twitching muscles, excitement, rapid heartbeat and stomach troubles. These are probably familiar to most coffee-consumers, since it’s pretty high in caffeine (over twice as much as in a cup of tea), but it’s now an officially recognized diagnosis.
Withdrawal is also a pretty well-known phenomenon, and there are five key symptoms. For the official diagnosis to apply, a caffeine-consumer would need to experience three of these symptoms within 24 hours of consuming caffeine: headache, flu-like symptoms, fatigue or drowsiness, irritability, and difficulty concentrating. This falls right in line with what many people may have experienced in day-to-day life after skipping a morning cup of coffee.
Is caffeine addiction serious?
Something that has probably slowed the progression of these conditions is the fact that they are pretty minor. So while you can definitively say that caffeine is a stimulant drug, it’s almost always referred to as a “mild” stimulant, and it follows that addiction and withdrawal to it will be fairly minor. Nobody wants to feel cranky if they skip a morning coffee, but you can’t exactly say that it’s comparable to sedative, alcohol, or heroin withdrawal.
What you can do about a caffeine addiction
In reality, most people who suffer from caffeine use disorder (assuming such a thing does exist and will be recognized in a future DSM) will be able to effectively manage the problem by themselves. There are many useful tips for reducing your caffeine consumption, and it isn’t just switching to decaf. The best thing to do is to decrease your consumption gradually, drinking less and less coffee over time to minimize the effects of withdrawal. However, there will still undoubtedly be some notable effects when you begin to lower your intake.
Count the number of caffeinated drinks you drink ordinarily. This establishes a baseline for your consumption, and you’re recommended to reduce your daily intake by two cups each week. If this doesn’t work for you as an outright strategy, you can also switch your ordinary drink to something less caffeinated. You don’t have to go full decaf, since there are half decaffeinated options too. However, it might be more enjoyable if you mix half a cup of coffee with half a cup of hot cocoa, or even if you switch to drinking tea.
The nation’s drug of choice: Caffeine
Despite the furor surrounding prescription medication abuse and other illicit substances, if caffeine is counted as a potentially addictive drug, it’s evidently the most widely used one in America, with 83% of citizens drinking it. (Read: Coffee Consumption Increases in U.S., Association Survey Shows)
It might not have the severe physical risks associated with addiction to illicit substances, but the inclusion of withdrawal and intoxication in the DSM-5 legitimizes the diagnosis somewhat. Technically speaking, four out of five people you meet use at least one drug — the coffee bean.