Physicians recommend that bipolar patients avoid consumption of caffeinated substances such as coffee. Caffeine disrupts bipolar patients' sleep cycles, contributing to attacks of mania and hypomania. A 2009 study uncovered an even more alarming finding. It showed that drinking coffee appears to increase suicide attempts among bipolar patients.
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Bipolar disorder, or manic depression, is a mental illness characterized by cycles of extreme mood swings. The illness is genetic. A bipolar patient usually has a bipolar parent and other close relatives with bipolar disorder. Bipolar symptoms are caused by unusual changes in brain functioning, which are not yet fully understood. The illness cannot be cured but can be stabilized with medication, psychotherapy and lifestyle changes, so that patients can usually live productive lives.
A Depression and Bipolar Support Alliance publication, "Food and Mood," offers help to bipolar patients seeking advice on good eating habits.
During bipolar manias, a person's mood may escalate from happiness into an irrational state, psychosis, in which the person develops hallucinations, seeing things that actually are not occurring, or delusions, such as a false belief that the person has superhuman powers, accompanied by abnormally high levels of energy and insomnia for days at a time.
In milder elevated states, hypomanias, a bipolar patient usually does not become psychotic but may become energized, overly optimistic, take on too many projects and sleep very little.
When a bipolar mania is over, a patient drops out of the elevated state into either normality or depression. A bipolar patient entering a depression may experience a gradual loss of energy and interest in life activities. As the depression worsens, the bipolar patient may become irrationally self-critical and suicidal, and sometimes become psychotic, experiencing negative hallucinations and delusions.
Physicians have long been aware that bipolar patients are adversely affected by caffeine. Caffeine-created insomnia can help trigger or escalate a mania or hypomania, and can make bipolar patients more anxious and panicky.
A 2009 Italian study by C. Baethge and several colleagues, "Coffee and cigarette use: association with suicidal acts in 352 Sardinian bipolar disorder patients," examined the effects of smoking and coffee drinking on bipolar patients and uncovered an even more disturbing effect of caffeine. Bipolar patients who drank coffee were 2.42 times more likely to attempt suicide than patients who did not drink coffee. Bipolar patients who smoked were 1.79 times more likely to attempt suicide than nonsmokers.
The Italian study is the first report suggesting that caffeine can cause bipolar patients to attempt suicide. The co-authors of the study warn that even legal substances that affect peoples' moods and energy levels may have harmful effects on bipolar patients. Bipolar patients should avoid caffeine consumption and should give up smoking.