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' Caffeine Withdrawal '

Introduction
The Diagnostic and Statistical Manual of Mental Disorders DSM-5 provides detailed analysis of the issues with the caffeine consumption, caffeine disorder, caffeine withdrawal, and caffeine intoxication. According to DSM 5, the consumption of caffeine can result in various negative impacts on the health such as 1) Restlessness; 2) Nervousness; 3)Excitement; 4) Insomnia; 5) Flushed face; 6) Diuresis; 7) Gastrointestinal disturbance; 8) Muscle twitching; 9) Rambling flow of thought and speech; 10) Tachycardia or cardiac arrhythmia; 11) Periods of inexhaustibility; 12) Psychomotor agitation. . The impairment is one of the major issues with the caffeine consumption that can affect the performance of an individual in social, occupational, or other important areas. The consumption of caffeine is very regular in daily routine in the form of coffee, tea, chocolate, caffeinated soda, energy drinks, and in other such forms. Caffeine consumption has become a common practice across the world without realizing its negative impacts on health and life of an individual. In order to avoid the negative impacts of caffeine, many people try to avoid caffeine, which is known as caffeine withdrawal, but there are various negative impacts and issues associated with the caffeine withdrawal. This paper addresses various aspects associated with caffeine withdrawal. Caffeine withdrawal can also have negative impact on the health such as caffeine intoxication that result in serious issues with the person affected.

Discussion
There have been various arguments and issues associated with the inclusion of caffeine withdrawal syndrome in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Initially caffeine consumption, its disorder, and intoxication were not included in the DSM. Later, negative impacts and its issues resulted in including these symptoms and disorders in the DSM. However, the symptoms from caffeine withdrawal were not recognized as the mental or psychological issue. Under such conditions, the American Academy of Addiction Psychiatry (AAAP) accepted the need for including negative symptoms of caffeine withdrawal in DSM 5. There are various important aspects associated with the caffeine withdrawal and its negative impact or clinical distress such as Substance Abuse and Mental Health Issues, lack of trust of consumers on the companies, there are various issues associated with consumption and withdrawal.

Symptoms
There are many problems associated with the consumption of caffeine such as caffeine intoxication, restlessness, nervousness, excitement, muscle twitching, rambling flow, anxiety disorder, insomnia, flushed face, diuresis, and gastrointestinal complaints. All these conditions and symptoms are very common and can result in creating long-term psychological issues or compliment/aggravate other mental, psychological disorders. However, caffeine withdrawal also has many negative impacts and can result in worst outcome for the individuals. According to DSM 5 (2013), under the diagnostic criteria 292.0(F15.93), the prolonged daily use of caffeine can result in negative impact and its abrupt cessation, withdrawal, or reduction within 24 hours can result in worst impact. Sudden withdrawal of caffeine can case following mental issues as:

' 1. Headache.'

' 2. Marked fatigue or drowsiness.'

 3. Dysphoric mood, depressed mood, or irritability. 

 4. Difficulty concentrating. 

' 5. migraine, '

 6. viral illness. 

 7. Flu-like symptoms (nausea, vomiting, or muscle pain/stiffness). .

Sudden withdrawal of caffeine can also result in creating severe issues such as severe psychological issues that also affect mental functions and social interaction. Under such conditions, it is not possible for an individual to overcome the problems associated with the sudden avoidance of caffeine. There is specific criteria that involve prevention of individuals from the negative impact of caffeine withdrawal. According to DSM 5 (2013), the abrupt cessation of caffeine ingestion result in caffeine withdrawal syndrome, which has also become an important psychological conditions with symptoms such as “headache; marked fatigue or drowsiness; dysphoric mood, depressed mood, or irritability; difficulty concentrating; and flu-like symptoms (nausea, vomiting, or muscle pain/stiffness)” (DSM 5, 2013, p. 506). Under the withdrawal practice, there are various negative impacts on the health of the individuals. Headache is the major symptom of caffeine withdrawal, which can be diffused, gradual, throbbing, severe, and sensitive. This negative impact or caffeine withdrawal symptoms occurs when the person decides sudden withdrawal from use of caffeine without medication or other medical assistance. Therefore, it is possible to withdraw from caffeine, but there are some proper methods and approaches along with medication to prevent from negative impact of withdrawal and medication also assist in refraining from the caffeine use in future. Therefore, proper medical treatments and change in the routine is important. The guidance is properly provided in order to avoid any negative impact with methods and techniques for gradual or steady approach for the caffeine withdrawal. This process does not require use of medical assistance and doctor, but the medication provides better and permanent solution to treat the issue and symptoms of caffeine withdrawal.

Impact on Behaviour and Diagnosis
Sudden abstinence from caffeine results in impaired behavioural and cognitive performance. Some common issues include difficulty to concentrate on daily routine, problem with the performance of daily tasks, dull and sleepy feelings, decrease in energy and motivation, headache and laziness. These aspects resulted in affecting the behaviour such as irritation, frustration, anger, annoyance, anxiety, and other such behavioural issues. According to DSM 5 (2013), the caffeine withdrawal syndrome results in headache in approximately 50% of caffeine withdrawal cases. Another major issue is functional impairment among 24% of the cases. However, it is more common that more than one symptom occur due to caffeine abstinence such as headache, impairment, and other such problems. Apart from headache and functional impairment, there are many other conditions such as “viral illnesses, sinus conditions, tension... depressive disorder, panic disorder, antisocial personality disorder” and other such problems (DSM 5, 2013, p. 507).

Solutions to Deal with the Symptoms of Caffeine Withdrawal
There are many recommendations to deal with the symptoms of caffeine withdrawal such as instead of sudden withdrawal and complete abstinence from caffeine, it is better to gradually decrease the quantity of caffeine intake. This is one of the most effective and natural process to avoid the caffeine. For example, if a person consumes 3 cups of coffee of tea, and suddenly stops taking coffee or tea by avoiding it 1-2 time, it is not effective. Instead of avoiding it completely during 1-2 times a day, it is better to reduce quantity every three times. Instead of full cup, the quantity can be reduced to 3/4th cup all three times. This quantity can be continued for some time, unless the person feels satisfied with the 3/4th cup, and then gradually reduced this quantity to half cup. This approach is more effective in order to avoid negative effective of caffeine withdrawal. Another suggestion is by DSM 5 (2013), according to which, the consumers can decrease the caffeine consumption by using it less frequently, “Gradual reduction in caffeine over a period of days or weeks may decrease the incidence and severity of caffeine withdrawal”

Risk Factors
There are various risk factors associated with the caffeine use and withdrawal such as heavy consumption can result in mental disorders, eating disorders, substance abuse, behavioural issues, and many other such problems. On the other hand, the sudden withdrawal after sudden withdrawal can result in worst impact on the mind and body. There are no severe side effects or symptoms of caffeine, if consumed in normal quantity. However, the conditions can be worst, if the person is under some medical treatment, pregnancy, hospitalizations, travel, and during other such routines. Under such situations, the sudden withdrawal of caffeine is also very negative. However, the symptoms of caffeine withdrawal can be different in different cases such as it can be from mild to serve depending on the consumption, approach of withdrawal, or sensitivity of an individual for the consumption of caffeine. According to Poole et al (2016), chronic caffeine can also result in affecting learning and memory in adults, children, and adolescents. It is also observed that there are differential effects on hippocampus-dependent learning.

Clinical and Medicinal Support
Caffeine withdrawal appears to be very difficult without motivation. In such conditions if a person says bad words, then it is essential to change and to look for the effective solution. However, proper care and use of medication help in overcoming the issue of support and efforts to stay away from caffeine. ISIC the institute for scientific information on coffee (2017) also emphasize on the need for control consumption of caffeine.

Conclusion
In conclusion, it is important to avoid caffeine intake because, not only heavy consumption of caffeine has negative impact, but sudden caffeine withdrawal can also result in developing negative impact such as headache, impairment, substance abuse, and many other such issues.