Listen to your Body

No matter the temptation, caffeine will not be going back on the menu.

“Since giving up caffeine, I don’t get mania induced by what I take in my body. If I do experience mania, it’s just my brain acting up,” Elisa says.

For those who are on the fence about how much, if any, caffeine to consume, Elisa has this advice: “Listen to your body. Only you know your body and how it responds.… Be your own advocate.”

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What Does the Science Say About Bipolar & Caffeine?

There is a quite sizable body of research on caffeine’s effects on the human body, for better and for worse. When it comes to sleep quality, the evidence tilts overwhelmingly to “thumbs down.”

An analysis of 58 previous studies, published in the journal Sleep Medicine Reviews, concluded that caffeine consumption tends to increase the time it takes to fall asleep, reduce total time spent asleep, and disrupt slow-wave sleep—the third and deepest phase of “non-REM” sleep.

(REM stands for “rapid eye movement,” which marks the fourth phase of the sleep cycle. While the body remains comatose in REM sleep, brain activity picks up markedly.)

Much of the brain and body’s restorative activity happens during slow-wave sleep, also known as deep sleep.

In a paper published in the journal Pharmacology, Biochemistry & Behavior, American researchers surveyed 28 peer-reviewed studies focused on military personnel. The analysis showed that sleep duration decreased—and psychiatric symptoms increased—as caffeine use went up.

However, sleep-deprived personnel showed improved cognitive and behavioral outcomes and better physical performance after caffeine consumption.

All of that happens because caffeine molecules attach themselves to adenosine receptors in the brain. Adenosine slows down cell activity, contributing to fatigue and drowsiness. In essence, caffeine keeps us sharper and more energetic by temporarily blocking adenosine’s effects.

Adenosine plays an important role in our sleep-wake cycle. When it can’t do its job, basic sleep patterns get disrupted.

So caffeine may contribute to poor sleep, which can lead to fatigue, which can lead to the need for a boost from caffeine … can anyone say “vicious cycle”?

Of course, there’s always a proviso that individual reactions vary. Outcomes also vary depending on the amount of caffeine consumed and when during the day consumption happens.

However, addiction specialists note that someone who drinks just one cup of coffee a day may still be dependent. The determining factor is how affected you are when you don’t have your regular “fix.”

What to Know About Caffeine Withdrawal Symptoms

Symptoms of caffeine withdrawal vary in intensity and duration from person to person. According to researchers from Johns Hopkins Medicine, simply skipping a day—or perhaps even a serving—may result in withdrawal symptoms for the sensitive.

Their list: headache; fatigue or drowsiness; dysphoric mood, including depression and irritability; difficulty concentrating; and flu-like symptoms of nausea, vomiting, and muscle pain or stiffness.

“Abrupt fluctuations in the amount of caffeine on a day-to-day basis can cause negative effects with mood, focus, and sleep,” warns Heathman.

Ironically, another outcome of quitting caffeine may be a temporary increase in insomnia.

Know Your Numbers

The table below lists average levels of caffeine in a variety of sources. Note that your serving size may differ from that listed.

Beverages
Energy drinks (16 ounces) — 80–300 milligrams
Coffee (8 ounces) — 80–100 mg
Espresso (1.5-ounce shot) — 65 mg
Black tea (8 ounces) — 47 mg
Regular or diet soft drinks (12 ounces) — 40 mg
Green tea (8 ounces) — 28 mg
Decaffeinated coffee (8 ounces) — 2–4 mg
Decaffeinated tea (8 ounces) — 2–5 mg
Soft drinks without caffeine (12 ounces) — 0 mg

Other products
Protein powder — 0–120 mg
Protein and snack bars — 0–100 mg
Pain relievers — 0–100 mg
Dark chocolate (1 ounce) — 12–24 mg

An additional caution: Vieta advises those with bipolar to not consume energy drinks that contain psychoactive agents such as taurine and glucuronolactone.