Study: Caffeine, Stress, and Brain function

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

According to the Food and Drug Administration, caffeine is widely available and upto 80% of adults have caffeine everyday, upto 200mg, which is about 10 ounces of coffee (1).

Sometimes caffeine is used to help stay awake, alert, keep up with academic demands, etc.

While the many benefits of caffeine have been widely documented, problems and side effects caffeine are not as widely known.

One study looked at the impact of caffeine on stress (2).

Who was involved in the study? (2)

  • 25 participants who used caffeine regularly or were light user of caffeine.
  • Subjects received placebo or caffeine (3.5mg per kilogram of body weight, about 238mg for a person weighing 150 pounds)

What was measured? (2)

  • Blood pressure, cortisol (stress hormone), norepinephrine and epinephrine (also involved in stress response and other functions).
  • Measurements were taken at rest, during a stressful laboratory task, and afterwards at rest.

What were the results? (2)

  • Compared to placebo, caffeine caused more than DOUBLE the levels of epinephrine and cortisol, both involved in stress response.
  • Effects were similar in both habitual and light users.
  • Habitual use of caffeine did not development of tolerance to the bodily response.
  • Even at rest, caffeine increased blood pressure and plasma norepinephrine levels.

What do the results mean?

Caffeine may increase your stress level whether you are using caffeine sporadically or regularly.

What are some other effects of too much caffeine?

  • Caffeine had as early as 7am lead to less efficient sleep and reduced total sleep at 9pm (3).
  • Some people have more daytime sleepiness because of caffeine related sleep disruption (4).
  • Caffeine can reduce bloodflow to the brain by up to 27% (5)
  • Too much caffeine can cause (1):
    • Worsening of anxiety
    • Jitteriness
    • Nervousness
    • Sleep disturbance
    • Headaches
    • Make your heart beat faster,  palpitations, high blood pressure, abnormal heart rhythms

What are some caveats?

  • This is a small study and there are many studies showing positive and negative effects of caffeine.
  • Not everyone has the same benefits or side effects caffeine.
  • The AMOUNT of caffeine that has beneficial and harmful effects can be different for different people.
  • Some people can metabolize caffeine much faster or slower than others (6).
  • For some people, it can take days to weeks to see benefits from reducing or eliminating caffeine.
  • Stopping caffeine abruptly can lead to withdrawal headaches, irritability, and other symptoms.

Are you feeling stressed, irritable or anxious? How is your caffeine intake? Could you benefit from less?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://www.fda.gov/downloads/ucm200805.pdf
  2. Land JD, Adcock RA, Williams RB, Kuhn CM. Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption.  Psychosom Med. 1990 May-Jun;52(3):320-36.
  3. H.P. Landolt, E. Werth, A.A. Borbely, D.J. Dijk.  Caffeine intake (200 mg) in the morning affects human sleep and EEG power spectra at night. Brain Research, 675 (1–2) (1995), pp. 67–74.
  4. T. Roehrs, T. Roth. Caffeine: sleep and daytime sleepiness. Sleep Med Rev, 12 (2) (2008), pp. 153–162.
  5. Addicott M.A., Yang L.L., Peiffer A.M., Burnett L.R., Burdette J.H., Chen M.Y.. et al. The effect of daily caffeine use on cerebral blood flow: how much caffeine can we tolerate? Hum. Brain Mapp. 2009;30:3102–3114.
  6. Cornelis, M. C. et al. Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption. Mol. Psychiatry 20, 647–656 (2015).

Hidden Consequence E-cigs

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Electronic cigarettes or E-cigs, have become popular in recent years for a variety of reasons.
Some tout the tobacco free alternative as a way to lower cancer risk.  Others claim it’s less addictive and less risk of lung disease.  These claims have been investigated via long term studies.

There are also risks of much higher nicotine ingestion than traditional (tobacco based) cigarettes leading to nicotine toxicity (1).
A recent small study, by Barrington-Trimis and colleagues, suggest another unexpected consequence of e-cigarette use (2).
Who was studied?
300 students,  in the 11th or 12th grade (2).
What was the study design? (2)
  • Questionnaires were given in the 11th or 12th grade, and again after they turned 18 years old.
  • Some questions included whether they use e-cigarettes, traditional (tobacco) cigarettes, whether they  smoke tobacco based cigarettes now or intend to do so in the future.
What were the results?  (2)
  • 40% of participants who reported e-cigarette use at the beginning of the study ended up using traditional (tobacco) cigarettes by age 18, vs only 11% of students who never used e-cigarettes.
  • After adjusting for different variables,  e-cigarette users were over 5 times as likely to initiate traditional smoking as those who had never used e-cigarettes.
  • The e-cigarette users who reported having no intention of smoking traditional (tobacco) cigarettes at the beginning of the study had a 9.7 x odds ratio of using traditional cigarettes by the end of the study.
What do the results mean?
  • According to this study, smoking e-cigarettes might increase your chances of smoking tobacco based cigarettes.
  • This is concerning because of the variety of negative mental health and physical consequences of tobacco use.
  • Smoking cigarettes can increase depression and anxiety (3,4).
Is e-cigarettes worth the feelings of anxiety, depression, and tiredness? Will you feel better if you exchange it for healthier ways of living?
What are some resources regarding tobacco use?
Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.
References:
1. Ordonez J, Forrester MB, Kleinschmidt K. Electronic cigarette exposures reported to poison centers. Clin Toxicology 2013;51:685
2. Barrington-Trimis JL, Urman R, Berhane K, et al. E-Cigarettes and Future Cigarette Use. Pediatrics. 2016; 138(1):e20160379
3. https://u.osu.edu/emotionalfitness/2015/04/15/does-smoking-increase-anxiety-and-depression-if-i-quit-will-i-feel-better/
4. Taylor G, et al. Change in mental health after smoking cessation: systematic review and meta-analysis. OPEN ACCESS. BMJ 2014;348:g1151 doi: 10.1136/bmj.g1151 (Published 13 February 2014)

How You Can Become More Resilient

By R. Ryan S Patel DO, FAPA, OSU-CCS Psychiatrist

Many students will experience more stress as the semester comes to an end.

Many will also experience other stressful events such as life tragedies, trauma, difficulties with finances, work, relationships, health, emotions, etc.

Practicing and increasing resilience in yourself can be helpful with these situations.

What is resilience?

Resilience has many definitions, here are some useful ways of thinking about resilience:

  • An ability to recover from or adjust easily to misfortune or change (1)
  • Emotional resilience is one’s ability to adapt to stressful situations (2).

What are some ways to increase resilience?

The key is to adjust.

The American Psychological Association’s report on Resilience (3) offers 10 methods to increase resilience:

Adjust your thinking

1. Practice developing confidence in your ability to solve problems.  It can be helpful to occasionally remind your self about times in the past where things were difficult and you problem solved through it.

2. Keep perspective.  Take a step back and remind yourself of the big picture, and where your current situation fits. Are you blowing things out of proportion? Or are you being realistic?

3. Keep a positive outlook by visualizing what you want instead of worrying about what you don’t want.

4. Look for solutions.  Stressful things will happen but shifting your focus from worrying about the problem to looking for solutions can be powerful. Just the change in thinking can help you feel better; and the solutions are a bonus!

5. Accept that there will often be change. It can be very helpful to accept the things that you cannot change and shift your energy to the things that you can change.

Act differently:

6. Move toward your goals:

  • Make sure that your goals are realistic.
  • Take a small step. Doing things regularly, even something small, that move you towards goals will help you feel better.

7. Take decisive actions towards problems instead of avoiding or procrastinating. This will also help reduce feelings of frustration.

8. Look for opportunities for self-discovery.

  • What lesson can you gain from the loss or setback?
  • The report goes on to say that many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality and heightened appreciation for life.

9. Connect with others:

  • Accept help and support. Counseling at OSU is a great resource.
  • Helping others can also benefit the helper. Some examples include: student organizations, civic groups, non-profit organizations, faith-based organizations, volunteer groups, or other local groups.

10. Connect with yourself:

  • Do activities that you enjoy and find relaxing.
  • Exercise regularly.
  • Get enough sleep.
  • Avoid alcohol, caffeine, drugs.

The report also suggests other ways that might strengthen resilience:

  • Journaling your thoughts and feelings
  • Meditation/Yoga
  • Spiritual and/or religious practices

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. http://www.merriam-webster.com/dictionary/resilience
  2. http://stress.about.com/od/understandingstress/a/resilience.htm
  3. http://www.apa.org/helpcenter/road-resilience.aspx