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Coffee and OCD: Does caffeine help or hurt?

Mar 21, 202410 minute read

Coffee and Mental Health

If you’re like many people, one of the first things you do after you wake up is sip a cup of coffee. What you may be wondering, though, is whether coffee could impact your OCD. It is, after all, a stimulant that pumps up activity in your brain and nervous system. And it can boost the levels of stress hormones in your body, like cortisol and adrenaline. 

Let’s take a look at how caffeine might impact your mental health—with special insights on how it specifically affects OCD from Tracie Ibrahim, LMFT, CST, Chief Compliance Officer of NOCD, the leading telehealth provider for OCD treatment.   

Well, let’s start with an understanding of how coffee affects us. Although it’s about 98% water, coffee contains more than 1,000 chemicals. (Who knew?) Most researchers focus on caffeine, which is believed to account for most of coffee’s effects on the brain. Caffeine is a very common stimulant, found naturally in dozens of plants: coffee, of course, but also tea, kola, and more.

Does coffee affect OCD?

Most clinicians suggest that you limit your coffee intake if you have OCD or an anxiety disorder. This is because the stimulant effects of caffeine can boost the activity of your nervous system.

How does it do that? Well, caffeine blocks the effects of adenosine, a chemical in your body’s cells that builds up during the day and makes you sleepy at night. Adenosine regulates the release of other chemicals like dopamine and serotonin. Dopamine sparks temporary feelings of pleasure, while serotonin contributes to lasting feelings of happiness. Both of these chemicals play a role in your mental health, sleep, and more.

By suppressing the effects of adenosine, caffeine allows dopamine and serotonin to flow more freely. The boost in these chemicals can make you feel energized and alert. As anyone who’s ever had to pull an all-nighter will attest, it reduces fatigue, and seems to improve focus and performance on some tasks. 

But at the same time, it may increase levels of the stress hormone cortisol, and trigger bodily reactions like fast heartbeat and restlessness, leaving you with a jittery feeling. “This can trick your brain into thinking you’re anxious—and then you become anxious,” explains Ibrahim. And that might cause your OCD symptoms to surface.

But not every expert agrees that caffeine is necessarily bad for people with OCD. A 2010 review published in the Journal of Alzheimer’s Disease noted that while caffeine can increase anxiety, it may actually be beneficial for some OCD patients. Why? Because OCD “is more related to control of thought and behavior than to fear and worry,” according to the study authors.

In a 2008 trial, seven of 12 patients with OCD saw improvement on 300 milligrams of coffee daily (which is around three 8-ounce cups of coffee). More recent research has yielded similar results. A 2019 study in the Journal of Family Medicine and Primary Care reported lower OCD symptoms among patients given up to 300 milligrams of coffee daily. Meanwhile, a 2020 study in the Journal of Anxiety Disorders reported that OCD patients who consumed caffeine had less distress, fewer compulsions, and more success resisting their compulsions.

However, these studies are small and don’t discount the evidence that caffeine can potentially worsen anxiety, especially in high doses. Even the author of the 2008 study pointed out that caffeine remains a “well-known anxiety producer in many people.” 

Not to mention, caffeine can interfere with sleep if you consume it late enough in the day. “People with anxiety and OCD have increased anxiety after a night of inadequate sleep,” says Kimberley Quinlan, LMFT, a specialist in OCD, anxiety, and OCD-related disorders.

Medication is another factor to keep in mind. There are more than 100 known interactions between caffeine and prescription drugs, whether it enhances the drug, creates side effects, or makes the drug less effective. For example, many anti-anxiety drugs, sleeping pills, and mood stabilizers fall into this last category. It’s always good to check with your doctor if you take medication or have preexisting conditions, and it’s important to take any negative reactions seriously. 

Should I avoid caffeine if I have OCD?

The effects of caffeine can vary from person to person. “Maybe you can have a cup of tea and not notice anything, while the next person goes off the charts,” Ibrahim says.

That’s why she recommends taking note of how caffeine affects you personally. Of course, that might require a bit of experimentation—and that’s exactly what she suggests many of her patients do.

“I often recommend trying a couple of days or a week where the patient doesn’t use caffeine, and see if they notice a difference,” says Ibrahim. “More times than not, they come back saying, ‘Oh my gosh, I didn’t realize how much the caffeine was affecting me.’”

In fact, Ibrahim recalls one patient who started her day with coffee and drank another cup during lunch. When she skipped it for a few days thanks to Ibrahim’s advice, the results blew her away. She realized she wasn’t actually as anxious about work as she thought—it was largely the caffeine that made her feel that way. And as a result she was better able to focus at her job, since her anxiety and OCD symptoms were no longer revved up from those doses of caffeine.

The same may or may not be true for you—the only way to find out is to try. “Notice the difference in your body and in your symptoms with caffeine, and without any caffeine—and write it down,” suggests Ibrahim. “Be aware so that you can adjust your behaviors and choices around caffeine based on what you found out about yourself.”

If you notice that caffeine makes your anxiety worse, you may want to cut back or even eliminate it completely. Because caffeine is a drug, if you’ve grown dependent on it, it’s a good idea to talk to your doctor about how to taper off. The Food and Drug Administration (FDA) says it’s best to cut back gradually to reduce withdrawal effects like headaches—although rest assured that they’re temporary.

Of course, getting the motivation to cut back may be one of the hardest parts. Many of us are deeply attached to our coffee routine. If this is true for you, then think of the reasons you drink coffee and consider whether there may be better alternatives. For example, if your primary reason is for energy, maybe you could develop a more consistent sleep routine, go for walks, or stretch to get the boost you’re looking for. 

If you just really like the taste of coffee, consider decaf. “The patient I mentioned before switched to decaf,” says Ibrahim. “And she started drinking green tea, which has a lot less caffeine, so you can sort of compromise there.” Or you could try beverages like seltzers or herbal teas.  

You don’t necessarily need to eliminate caffeine altogether if that doesn’t seem realistic for you—and if it doesn’t seem to affect your symptoms. Ibrahim has OCD, and she has coffee a couple of times a week. 

If you drink coffee and have increased OCD and anxiety symptoms, she suggests trying to keep some perspective on the situation: “Just remember to attribute it to the caffeine you chose to have earlier and not make it a big deal. And be more ready to do response prevention because you might feel your compulsions a little stronger.”

A few studies suggest that many people can self-regulate their coffee consumption, learning to avoid drinking coffee to the point of becoming anxious. A study involving 43 patients suggests that people with anxiety disorders “have increased caffeine sensitivity, which leads to decreased consumption.”

Keep the following factors in mind if you want to regulate your caffeine intake:

  • It’s best to stick to low or moderate doses of caffeine, if any. Higher doses of at least 400 milligrams are more likely to trigger anxiety and possibly OCD symptoms. “Limit caffeine to one cup each day,” suggests Quinlan.
  • Your body may become dependent on caffeine if you have it too often, causing you to need more of it to get the same perk. To avoid that, you might limit your caffeine intake to when you feel you really need it.
  • Try to avoid caffeine late in the day. Caffeine stays in your system for quite a while, and research shows that having it even six hours before bedtime can interfere with your sleep. And lack of rest could possibly lead to more anxiety.
  • Many caffeinated beverages like soda, coffee, and energy drinks contain a lot of added sugars that can make anxiety worse. So you may want to look into no-sugar or low-sugar options.

Ultimately, your caffeine routine is a topic to raise with your doctor, especially if you’re concerned about its effects on a medication or health condition such as OCD.

Could coffee affect my mental health in general?

Since OCD often goes hand in hand with other mental health disorders, no exploration of OCD and caffeine would be complete without digging into this topic. It turns out that this research is only somewhat less paradoxical than the research concerning OCD specifically.

An umbrella review of 218 meta-analyses (that’s a lot of research) published in the BMJ concluded that consumption of coffee, “had a consistent association with lower risk of depression and cognitive disorders, especially for Alzheimer’s disease.” Keep in mind, though, that the research is still in its early stages, and drinking coffee isn’t a treatment for depression. 

In fact, since it might cause sleep problems in some people, coffee could worsen mood. Plus, withdrawal symptoms can exacerbate irritability and fatigue.

The previous study in the Journal of Alzheimer’s Disease also linked fewer than six cups of coffee a day to a lower risk of suicide. But the researchers pointed out that high doses of caffeine can lead to psychotic and manic symptoms, and that people with panic disorder and performance social anxiety disorder may be especially vulnerable to its anxiety-producing effects. 

Meanwhile, a 2023 study suggested that people who drank two to three cups of coffee per day were less likely to have anxiety and depression, but the risk increased for people who had more than this amount. This means that, for many people, how much caffeine you’re consuming matters at least as much as whether you’re having it to begin with.

Things other than lifestyle changes that help OCD

If you’ve read this far, it’s likely because OCD has a measurable impact on your life (you’re not alone in that). You may want to understand how your lifestyle choices—right down to the beverage you choose to put in your mug each day—can play a role in your mental health disorder. While lifestyle changes are always worthy of discussion, what people most need to understand is that your daily habits are not a substitute for evidence-based treatment. And when it comes to OCD, there’s a really specific treatment that’s considered the gold standard (meaning that research shows it works much better than alternatives for most people).

It’s called Exposure and Response Prevention (ERP) and it involves facing your fears. Don’t worry, though — it’s not as intimidating as it sounds. That’s because you typically rank your triggers from least to most scary, and gradually make your way through the list as you become more comfortable and confident. And you’re guided by a clinician every step of the way. It’s crucial to seek the aid of therapists who are specifically trained in ERP—and that’s exactly what we offer here at NOCD.

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The bottom line about caffeine and OCD

As much as we wish we could provide a clear perspective, the fact is that the research on coffee and OCD is mixed. The relationship between caffeine and mental health is complicated, and it may vary depending on the person, the dose, and any medications you take.

Regardless, many experts discourage caffeine if you have a mental health disorder like OCD. Since caffeine is a stimulant, it may worsen anxiety, particularly when you get more than 300 mg a day. A few studies suggest that amounts of caffeine below this may reduce symptoms for some people with OCD, but these studies are small. 

So it comes down to you doing what feels right for you. And don’t hesitate to consult a healthcare provider if you’re concerned that caffeine might be affecting your OCD.

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