Essential reading for those who can’t get through the day without a cup of coffee
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From being a beverage casually consumed over a friendly conversation at a cafe, coffee has become a part of office culture. Most working professionals will attest to drinking several cups of coffee to get through the workday. Pulling an all-nighter before an important presentation is preceded by stocking up on drinks laden with caffeine. Our Food For Thought series, looks at how the food we consume influences our mood and behaviour. In this column, Dr Rizwana Nulwala, a Mumbai-based practising psychotherapist at Krizalyz Counselling and Mental Health Services, explains how caffeine works in the brain to make us alert and the after-effects of having too much caffeine.

How Caffeine Works
Caffeine-based drinks are synonymous with getting things done because caffeine is a stimulant which makes us feel ready for action. It impacts the central nervous system and results in increased excitability. It is believed that caffeine works by blocking the adenosine receptors in the brain which regulate the production of dopamine. Caffeine stimulates the brain to believe that the body is under attack. The increased focus derived from consuming caffeine is the by-product of the body alerting itself to respond to potential dangers. Similar to drugs like cocaine and amphetamines, caffeine boosts the production of dopamine in the body. Dopamine helps the brain to focus and concentrate.

How Much is Too Much
Thanks to it being legal and easily available no matter where you are, caffeine is considered to be the most common psychoactive drug used worldwide. It is found in beverages, soft drinks, chocolates and some weight control medications as well. A cup of regular brewed coffee contains 135 mg of caffeine. A typical can of an energy drink contains about 80 mg of caffeine. Up to 400 mg per day, which converts to about 4 cups of coffee, is considered a safe intake of caffeine. More than 4 cups of coffee a day could result in withdrawal symptoms (more on this below). It is time to re-evaluate your caffeine intake when you consume more than 250 mg at one time which is about 7 espresso shots in one go.
Although mild to moderate use of caffeine is considered to be safe, the recent editions of both the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) list excess caffeine use as a clinical disorder with clear signs and symptoms. An individual who tends to consume more than 250 mg of caffeine at one time is classified as having a caffeine intoxication disorder. If you suspect that you or a loved one has this disorder, please consult a mental health professional and do not self-diagnose. There are programmes to help people overcome caffeine intoxication disorder.

If you find that you are consuming caffeine excessively, you can take steps to reduce your intake or switch to decaffeinated beverages. You could even shorten the brew time of your coffee or opt for herbal beverage options. Some over the counter pain relievers also contain caffeine so opt for a caffeine-free pain reliever.

Effects of Caffeine
Feeling restless, nervous or excited? There's probably too much caffeine in your system. Restlessness, nervousness, excitement, insomnia, a flushed face, gastrointestinal disturbances and a rambling flow of speech and thought are just a few of the noticeable symptoms of caffeine intake.

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When you've been regularly consuming a large amount of caffeine and stop or reduce this intake, you could also experience caffeine withdrawal. You will notice the symptoms of caffeine withdrawal within 24 hours of stopping the consumption of caffeine. Some of these symptoms include headaches, a marked fatigue or drowsiness, low mood or irritation and difficulty concentrating. Some people could also experience flu-like symptoms. Caffeine tends to increase the symptoms of anxiety in some individuals which can worsen the withdrawal symptoms for such people.

Studies are currently being undertaken to understand the effects of caffeine use on people who have depression, eating disorders and anxiety. It is found that some individuals are more sensitive to caffeine use. Some studies suggest that adults with Attention Deficit Disorder can benefit from some caffeine use as it helps increase focus. This should, however, be verified with a doctor before one starts consuming the caffeine.

Dr Rizwana Nulwala is a Mumbai-based practising psychotherapist at Krizalyz Counselling and Mental Health Services. She is also attached to Xavier's Institute of Counselling Psychology, Mumbai and the Urja Trust, an NGO.
She has been a DAAD exchange scholar under the Indo-German exchange programme. Dr Nulwala completed her BA from St Xavier's College and her Master's and Doctorate from Tata Institute of Social Sciences (TISS), Mumbai. For further queries about this column or mental health, reach her at krizalyz@gmail.com

Disclaimer: This column explores a relatively new area of the link between food and mental health. Readers are recommended to avoid self-diagnosis and to consult a professional counsellor/medical doctor in case of doubt.

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