
The military’s obsession with energy drinks is contributing to PTSD - spking
https://www.militarytimes.com/off-duty/military-culture/2018/10/26/the-militarys-obsession-with-energy-drinks-is-contributing-to-ptsd-study-finds/
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danielrhodes
Would this even be a story if people were drinking coffee instead? The active
ingredient in Red Bull is caffeine. Yet a cup of coffee has more caffeine than
a Red Bull. Their marketing has been very effective in convincing people that
energy drinks are more than just a caffeinated drink with a bunch of other
chemicals that don’t really work. Because of that, people vilify these various
drinks, and now we get an article telling us that the drinks are contributing
to PTSD, instead of the obviously greater contributing factor: being in a war
zone under constant threat of death.

~~~
jcrawfordor
Red Bull is honestly not that popular in this crowd though, the major energy
drinks you see are Monster, Rockstar, and as mentioned, Rip It (really an
offbrand of the former two from the maker of Shasta/La Croix). These typically
have 160mg of caffeine, which is high for coffee although not by a large
margin. The culture around them seems to encourage much greater consumption
though, with oversize cans (e.g. 24oz with over 250mg caffeine) not unusual
and many people having multiple drinks a day. It does seem like something
about them, perhaps the addition of a great amount of sugar, encourages more
consumption.

I'm also a little confused by your accusation, since the article discusses a
comparative study of two groups, both in a warzone, and finds increased mental
health effects in the group with higher caffeine consumption. No one is
denying that combat conditions contribute to adverse mental health effects,
but the whole point of the article is that these seem to be exacerbated by
caffeine use.

Sleep deprivation is becoming a real concern in multiple military branches,
and I suspect that the mental impact is not due to the caffeine per se but due
to the culture around it: consumption of hundreds of mg of caffeine is viewed
as an acceptable alternative to sleep. This is definitely also an issue with
coffee, but energy drinks seem to be predominant today.

~~~
R_haterade
Gotta have my /sipps/ tho.

I'm actually curious now if the 30 year old boomer meme is in any way an
outgrowth of the Iraq war. The aesthetic the meme embraces reminds me a lot of
the guys I knew my age and older who served. Gonna have to reflect on this a
bit.

~~~
jdhn
Never thought I'd see a reference to the /sipps/ meme on HN, yet here we are.

Personally, I think the 30 year old boomer meme is rooted more in the fact
that internet culture moves so fast these days that anything even a few years
old is considered dated. Combine that with the definite cultural differences
between Millennials and Gen Z, and the boomer meme makes sense.

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jondeng
Does this story show any causation or is it just correlation? From my
experience in the Army and deployed it was the units closest to the FLOT who
would have the most energy drink usage- if you don't have other creature
comforts (sleep, hot chow, safety) you tend to resort to things that you can
access, like cheap energy drinks. These units would also see the most combat
and have the highest prevalence of PTSD.

~~~
ebullientocelot
This rings true from my experience in Afghanistan too. We did route clearance
in RC North, and were often out for days at a time. Very little bad sleep, end
up scraping together whatever cigarettes were available so few people had
their preferred brand, the same tired MREs, plastic tasting water which was
used for brushing teeth as well as drinking, etc. We did, however, get cases
of Rip It and huge boxes of Cliff Bars from the chow hall, sometimes two or
more to a truck (3-6 guys). Eventually, all you want is a "flavor" of some
kind, and it starts to matter less and less where it comes from. We were all
aware that it was better for us to drink the shitty water, but the desire for
some kind of gratification eventually overwhelms even the most conscientious
efforts to be healthy or maintain balance.

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nhkssol
Nothing in the article links energy drinks to PTSD.

> High energy drink use, which was classified as consuming two or more drinks
> per day, was significantly associated with those survey respondents who
> reported mental health problems, anger-related behaviors and fatigue, the
> authors found.

The above passage is about as close as the article gets to its title, and it's
left vague by combining mental health problems, anger-related behaviors and
fatigue into the same statement.

~~~
mattkrause
Also the causal direction between say, fatigue and energy drink consumption,
is not at all obvious....

~~~
drngdds
Considering the effect of caffeine on sleep, it's a very small leap to make

~~~
IC4RUS
It actually a fairly large leap, considering that caffeine can impair sleep
quality, causing more fatigue or fatigued people could be consuming caffeine
to reduce the fatigue.

In many people, both may be happening, so teasing out the direction of
causation is difficult.

~~~
andai
The two go really well together. I recently quit coffee and started sleeping
10 hours a night. It's hard to get to sleep on time when I've had coffee, but
if I get enough sleep, I don't need to have coffee to feel awake.

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emersonrsantos
The current facts about coffee and sugar are the following: drinking coffee is
good for your mental and physical, while sugar is linked to depression,
addiction, anxiety, heart problems, obesity and not surprisingly, PTSD:

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522929/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522929/)
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086302/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086302/)
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056806/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056806/)

~~~
flipp3r
You're leaving out many things about coffee. Specifically, caffeine, which
energy drinks are often loaded with. Caffeine on its own can cause anxiety
(See "Caffeine-induced anxiety disorder") and is linked to depression. Let
alone workers consuming caffeine during work time with headaches(or other
withdrawal symptoms) on their days off who still haven't figured it out the
stuff is just plain not good for you.

~~~
brom2
I've stopped drinking coffee as it would frequently give me anxiety and
sometimes panic attacks. I now drink tea or water at work. However, I still
need to work harder on cutting down on sugar.

~~~
andai
I suspected coffee was giving me anxiety which bordered on paranoia. I stopped
drinking coffee and it went away immediately. A week later (today) I had a cup
to see how I'd respond. Severe anxiety came back within half an hour. Very
interesting.

~~~
brom2
I found that small amounts of alcohol have a similar effect. Keep drinking
though and the depressant effects then start to kick in and the
anxiety/paranoia subsides.

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loeg
Does the military still hand out amphetamines and/or modafinil, or is caffeine
really the alertness/wakefulness drug of choice?

~~~
aphextron
>Does the military still hand out amphetamines and/or modafinil, or is
caffeine really the alertness/wakefulness drug of choice?

Actual stimulant use is restricted to special forces and flight crews. But
anecdotally, the energy drink consumption in the Army is out of control. I can
remember people literally ordering pallets of Monster to show up on training
exercises. Nicotine too. It's not uncommon to see someone with a dip of Skoal
in both sides, smoking a Newport 100, and drinking a Monster all at the same
time. It's just a necessary escape when you're living in an environment that
has your fight-or-flight response engaged 24/7 causing total CNS overload,
with zero access to alcohol or hard drugs and 4 hours of sleep a night.

~~~
chrisseaton
> I can remember people literally ordering pallets of Monster to show up on
> training exercises.

What like as a replen demand? Aren't they restricted to using issued rations
on an exercise? And how are they getting them deployed?

~~~
UncleEntity
> Aren't they restricted to using issued rations on an exercise?

That and what you can manage to bring with you.

Back when I was in the infantry you carried whatever you took to the field so
we tended to pack light(ish). I used to take a little camp stove so I could
have hot coffee in the morning and other people would pack stuff like ramen or
whatever.

Even when we were living in holes ~1km off the Iraqi border they managed to
get us cigarettes though that's not one of the "issued rations"...also pretty
sure that's when I got that camp stove so other things were possible. Before
that, when we were staying is some dilapidated warehouse in Saudi, they had
pallets of Pepsi get delivered on a regular basis for the chow hall.

On my last trip to Iraq they had pretty much whatever you wanted at the PXs
and we (civilian contractor types) used to smuggle a bunch of canned drinks
out of the chow halls instead of buying them but don't really remember if they
had energy drinks in the coolers since that's not my thing.

Think I got a bit rambley there...

~~~
rdl
Red Bull cans fit in 37/40mm round ammo pouches/elastic loops, something I
learned in Iraq (I never had a 40mm, but there are a lot of molle pouches for
40mm which were useful for other stuff).

Also Amazon or reship-stuff-from-Amazon to APO/FPO addresses was great.

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mig39
I'd say the #1 contribution to PTSD is the traumatic stress.

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otriv
Perhaps the people who have PTSD are more likely to drink energy drinks?

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Simulacra
That and dietary supplements. So many people take dietary supplements without
ever getting a simple metabolic panel to even see if they need the
supplements.

~~~
Pharmakon
I just read a BBC story about a man who nuked his liver by taking concentrated
green tea capsules. He requires a full transplant and four years later his
kidneys are failing and he has chronic abdominal pain. It seems that one or
more compounds in green tea (safe as a beverage, problematic as a concentrate)
may negatively impact liver function in some genetically vulnerable
populations. Truthfully though, it’s not known exactly what happened, only
that it does happen.

~~~
jfk13
For anyone interested, that story was discussed in
[https://news.ycombinator.com/item?id=18299354](https://news.ycombinator.com/item?id=18299354).

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snek
Just to be safe, until I see more data I'm going to assume PTSD causes energy
drinks.

~~~
mattkrause
I know you’re being snarky, but the idea of someone self-medicating is not
totally bonkers, which would indeed put the causality on PTSD, not the drink.

The classic example is that schizophrenics are _much_ more likely (3x or so)
to smoke. Interview with patients suggest that it helps control symptoms and
there are somewhat plausible biological mechanisms that could explain why.

Stimulant use (mostly cocaine) is a bit more common in some neuropsych
conditions. I don’t know of any studies about caffeine and PTSD specifically,
but it seems pretty similar.

