Caffeine and Self-Medication in ADHD: Why Coffee Calms You

It was something I noticed long before the diagnosis: when I drank coffee I did not speed up; on the contrary, I could stay in one place. For a long time I thought it was an oddity specific to me.

Later I heard the same sentence from other people living with ADHD. "Coffee calms me, sometimes it even makes me sleepy." A stimulant calming someone sounds contradictory. In fact it is not.

Why it can calm

Attention works best within a certain range of arousal level. When the level is too low, the mind starts producing stimulation itself: fidgeting, changing the subject, reaching for the phone, shaking the foot.

Caffeine raises this level. For someone below the range, the result looks from outside like calming down: the fidgeting decreases, she can sit, she can gather her attention.

So caffeine does not slow you down. It provides the stimulation that was missing anyway, and the mind stops producing its own.

A parenthesis has to be opened here, because this observation is often misused: an inference like "coffee does me good, so I must have ADHD" cannot be made. Stimulants show some effect on attention and self-control in everyone. The diagnosis is made from the history, not from the response to a substance.

Calming down does not always mean slowing down. Sometimes it means arriving at the right level.

The real place of caffeine

This must not be exaggerated. Caffeine is a mild stimulant and its effect is not comparable to that of the medications used for ADHD. The consensus statement of the World Federation (Faraone et al., 2021) covers in detail the medication options proven in ADHD treatment; caffeine is not on that list.

The practical meaning: caffeine can be a helper, it is not a treatment.

Where it can be useful:

• In the first hour when morning inertia is heaviest
• Right before a short and boring job
• At the well-known crash hour of the afternoon, provided you drink it early

Where it does harm:

• Sleep. This is the most important. In ADHD sleep is already fragile and a delayed sleep phase is common (Kooij and Bijlenga, 2013). Coffee drunk in the afternoon can delay falling asleep at night and worsen every symptom the next day. I covered why sleep is so central in the article on ADHD and sleep.
• Anxiety. Caffeine can increase anxiety. Because ADHD and anxiety often occur together, this is an important point. The details are in the article on ADHD and anxiety.
• Swings. A high amount of caffeine leaves a drop when its effect wears off, and this drop increases the imbalance through the day.

How I found my own setting

There were periods when I thought I should give up caffeine completely. I did not last more than a few days in any of them, and each time I felt worse.

What worked was not quitting but fixing its hour. I set myself a single rule: no coffee after a certain hour in the afternoon. What I drank in the early hours of the morning did not change; my night did.

I suggest you try this for a week, because seeing it in your own data is unlike any sentence you read. In the same week also write this down: how many times a day do you take caffeine? Many people answer this question with "I don't know," and for a long time I was one of them. Counting for a week gives enough information to decide.

One more detail: when coffee is used to cover over the distress of the day, it slides to an insidious place. If you reach for coffee automatically when you are bored, when you cannot start a job or when you are restless after a conversation, there is something other than caffeine going on there.

Caffeine is not only in coffee

There is a reason that when you count, the number comes out bigger than expected: caffeine does not come from a single place. It occurs naturally in tea leaves, in the kola nut that gives cola its taste and in the cocoa chocolate is made from; it is also added synthetically to some painkillers, cold medications and products sold for staying awake (MedlinePlus).

In energy drinks a high amount of sugar is added beside the caffeine. A curve that rises fast and falls fast makes the energy of the day, already fluctuating in ADHD, fluctuate even more. Those drunk in the evening hit sleep directly.

If you take medication

For someone who takes stimulant medication, caffeine becomes a separate subject. When the two are taken together, the effects on heart rate, restlessness and sleep can increase.

This does not mean a strict ban but it is something you should tell your doctor. Telling them how much caffeine you take and at what hour is information that really helps in adjusting the dose. The general frame of medication treatment is in the article on ADHD medication treatment.

Self-medication

Here we move on to a more serious heading.

It is common for people who are undiagnosed or not being treated to turn to various substances to manage their symptoms. In the glossary it appears as self-medication, and the important thing is this: it is not experienced as a conscious decision. Nobody begins with "I'm drinking to manage my symptoms." It is noticed that something does you good, that is all.

Nicotine. Because of its stimulant effect it can provide a temporary improvement in attention. It is reported that smoking is more common in people with ADHD and that quitting is harder. The details are in the article on ADHD and smoking.

Alcohol. It can be used because it slows the speed in the mind and cuts the evening inability to stay still. It disrupts sleep and worsens the symptoms the next day. The details are in the article on why alcohol is riskier in ADHD.

Other substances. When used to meet the need for stimulation, the risk grows quickly.

What these three have in common is that all of them work in the short term. If something did not work, it would not continue anyway. The problem is that the price of its working comes late.

This is a subject that needs to be talked about. If you use alcohol, nicotine or another substance to manage your symptoms, it is appropriate to talk about it with your doctor. Not to be judged, but because it is information needed to set up the treatment plan correctly. This use can also hide the diagnosis itself. If you want to get support in Türkiye, ALO 183 can be a starting point.

Correcting a wrong piece of information

There is a common fear: ADHD medications are addictive and lead to substance use.

The meta-analysis by Wilens and colleagues (2003) reports that in people with ADHD treated with stimulant medication in childhood, the risk of substance use in later years did not increase, and in some data was even lower. The consensus statement of the World Federation (Faraone et al., 2021) also evaluates the safety profile of appropriate use under a doctor's supervision positively.

The reverse looks more correct: untreated ADHD can increase the risk through self-medication.

The way to stay at peace with coffee

There is no need to declare caffeine an enemy. Knowing what you use it for is enough.

My distinction became this: if I use coffee while going into a job, there is no problem; if I use it to cover up a feeling, there is something else there and coffee does not solve it, it only postpones it. Noticing this helped more than every attempt at quitting.