My husband knows not to talk to me before I have my first cup of coffee in the morning. Maybe not even until after the third.
And the times I’ve been forced to forgo those daily cups? Headache, crankiness, fatigue—and did I mention crankiness?
Obviously, I must have a mental disorder. Or at least I do according to the new edition of the American Psychiatric Association’s mental health manual, the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5
The manual, considered the bible of diagnoses by doctors and insurance companies, was released May 22 and includes a new coffee-related diagnosis: “caffeine withdrawal,” which describes the symptoms of stopping or dramatically reducing one’s daily coffee habit.
DSM-5 notes that the symptoms of caffeine withdrawal include fatigue, headache and difficulty focusing. (Really? I feel that way after listening to five minutes of the Sunday political talk shows.)
The previous manual had listed “caffeine intoxication” — the jitters, insomnia, nervousness and rapid heartbeat you can get from downing waaay too much coffee, Jolt or other caffeinated beverages — but not withdrawal.
This edition, though, is evidently concerned about those of us whose bodies have become dependent on our daily java, causing withdrawal symptoms if we don’t get it.
“Caffeine is a drug, a mild stimulant, which is used by almost everybody on a daily basis,” Charles O’Brien, M.D., chair of the substance-related disorder work group for the DSM-5, told the New York Post. “But it does have a letdown afterwards. If you drink a lot of coffee, at least two or three [6-ounce] cups at a time, there will be a rebound or withdrawal effect.”
While eventually the no-caffeine headaches and fatigue do go away, our dependence on caffeine could have psychological and behavioral effects that doctors need to consider, the experts said.
But does this really make caffeine withdrawal a mental disorder? That’s the question Boston Globe health writer Deborah Kotz posed to psychologist Alan Budney, Ph.D., of the Geisel School of Medicine at Dartmouth College, who also served on the DSM committee.
Budney equated a daily morning coffee fix to a daily need for a cocktail. “The caffeine consideration isn’t really any different from alcohol, which is a legal substance but can also be misused” and produce a temporary withdrawal syndrome, Budney told Kotz. (He did say that a mental disorder diagnosis of “caffeine withdrawal” should be made only if symptoms cause “clinically significant distress” or impair a person’s daily functioning.)
Yeah, well, I’m not buying it. What about sugar withdrawal, or daily morning Diet Coke withdrawal, or the overwhelming sadness when PBS’ Downton Abbey ends and you know it will be months before the next season starts? Why are they only picking on coffee?
There are lots of questionable habits we have that can cause temporary withdrawal pains. But to call it a mental disorder? I’m not a shrink, but that seems kinda crazy to me.