Dear Alice,

My partner suffers from mild social anxiety. Is it possible that this disorder can be aggravated by stimulants such as coffee? I have noticed that on days he drinks lots of coffee, the disorder seems worse, and he is more uncomfortable.

Please help! If we can eliminate possible aggravates of the disorder, he would be so much happier!


Caring Partner

Dear Caring Partner,

Certain triggers, such as caffeine, a stimulant, increase social or even general anxiety. If you haven't yet, you may want to talk with your partner about what you have noticed. Then you can raise the issue so that he may consider decreasing his caffeine consumption, even as an experiment, to see if it has any effect in either managing or reducing his anxiety. As you may know, eliminating caffeine entirely will not eliminate his anxiety, but it will probably, based on your observation, reduce it enough to be more manageable for him, and, as a result, for you.

Social anxiety can be triggered by stress, diet, environmental factors, genetics, conditioned responses, and negative thought patterns. Some of the conditioned responses and negative thought patterns can be changed with therapy, and some of the former triggers are sometimes treated with medication. It's not clear if your partner has access to either of these, but he might consider these strategies, as well. If your partner is already seeing a counselor about social anxiety, he could discuss the effect of caffeine that you and/or he has noticed, and discuss his "caf reduction plan."

If your partner is true to his cuppa joe, perhaps he will find a level of caffeine that does not impact his behavior; this may take time and trial and error. He can start by gradually decreasing his caffeine intake, perhaps drinking ½ decaf and ½ caf. Then he can steadily switch to more "de" than "caf." This is easier if he makes and/or pours his own coffee. Since even decaf has some caffeine in it, he may want to try natural, caffeine-free coffee alternatives, such as Cafix.

Incidentally, caffeine is also found in tea and chocolate. Drinking herbal or decaffeinated black or green teas and eating carob instead of chocolate are ways to reduce or eliminate caffeine from your partner's menu. Many medications also contain caffeine, such as over-the-counter migraine treatments, so it's worth looking over the active and inactive ingredient lists. In addition, caffeine may be present in other food items, so if he is concerned, he can read food labels to see if caffeine is an ingredient. The U.S. Food and Drug Administration (FDA) requires caffeine to be labeled only if it is added to the product, not if it occurs naturally (in chocolate ingredients in a packaged dessert, for example).

Finally, about one-fifth of people with social anxiety disorder also have an alcohol use issue. Studies show that some people use alcohol in social situations to deal with and reduce feelings of stress or anxiety. Once a person realizes that alcohol can be used to this end, s/he is likely to continue drinking alcohol as a means of coping with these issues. This said, it may be useful for your partner to consider his alcohol consumption, if he drinks alcohol, as well as his caffeine intake.


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