There are times when symptoms of anxiety are so bad and debilitating that they require medication treatment. In many cases, a person’s first full blown panic attack lands them in the Emergency Room. This happens because symptoms of anxiety can be misinterpreted as physical issues such as a heart attack, asthma attack or stroke. At the ER treatment options are usually discussed (including a referral to a psychiatrist or psychotherapist), and a small amount of anxiety medication is prescribed then and there for immediate relief of symptoms. These medications are easily misused by panic and anxiety sufferers due to their fast efficacy, and the idea of seeking psychiatry or psychotherapy is often abandoned. These medications usually fall under the umbrella of Benzodiazepines. Benzodiazepines are classified as schedule IV depressants under the Controlled Substances Act. Benzodiazepines commonly prescribed include the following medications:
- Alprazolam (generic for Xanax)
- Clonazepam (generic for Klonapin)
- Diazepam (generic for Valium)
- Lorazepam (generic for Ativan)
- Triazolam (generic for Halcyon)
For a more comprehensive list you can visit the Wikipedia page forBenzodiazepines
These medications bring effective relief of panic and anxiety symptoms within 10-20 minutes. At first they may seem god-sent, a welcomed respite from chronic anxiety, and a sure arsenal against panic attacks. Benzos, however, will not work forever at the same low dosage you started them on, and can backfire. They lend themselves to over usage, and dependence on these medications can develop. Dependence on Benzos is just as serious as on any other controlled substance. As in any other case of dependence, tolerance may develop. Tolerance is when the dose of medication that you started with is no longer doing the trick, and you need more of the medication to get the same effect you had when you first took it. So, for example: if you took 1 mg of Xanax at first, and it made your anxiety better, 3 months later you may need 1.5 mg to feel better. What might happen if you do not take the higher dose is more anxiety. What might happen if you stop taking it all together: anxiety, TENFOLD. Why? Because you will be going through withdrawal. Benzos are associated with something called protracted withdrawal. What this means is that withdrawal symptoms may be present for a long amount of time, 6 months to 1 year.
The best way to come off of Benzos is to wean off under the medical supervision of a psychiatrist. “Weaning” means that you come off gradually, taking smaller and smaller doses of the drug until you are taking none. Here are some of possible withdrawal symptoms from Benzos during or after weaning off:
- Increased Anxiety
- Increased Panic Attacks
- Irritability and Angry Outbursts
- Insomnia
- Muscle Spasms
- Hypochondria (fear of having diseases)
- Aches and Pains
- Dry Mouth
- Paranoia
- Obsessions (intrusive, repetitive thoughts)
- Compulsions (repetitive actions)
- Loss of Appetite
- Depression (with possible suicidal tendencies)
- Sweating
- Tremors
- Nightmares
- Headaches
- Flu-like symptoms
- Mood Swings
- Stomach problems (IBS)
The worst thing you could do is to stop taking the medications abruptly. This is true of most psychotropic medication, and especially true of anti-anxiety medication. Some potential withdrawal symptoms after terminating Benzos abruptly are:
- Confusion
- Severe Depression and possible Suicide Attempts
- Delusions (believing things that are not true)
- Mania (a symptom of Bipolar Disorder involving increased activity, sleeplessness, anxiety, or anger)
- Hallucinations (sensing/hearing/seeing things that others don’t)
- Convulsions
- Violence
- Coma
Anxiety is a powerful force, and disorders related to it are serious. It should be addressed from multiple angles: psychotherapy, medication, diet, exercise, social support, meditation and relaxation. Using Benzos is not a long term solution for anxiety, so be careful. Using Benzos as your only treatment for anxiety could be detrimental to your emotional health, causing you further anxiety, increased panic, and develop a drug addiction on top of it all. If you have been taking Benzos for over 4 months, please contact a psychiatrist for consultation, and commence psychotherapy to address the root of the problem.