Tuesday, March 08, 2005

Getting off benzodiazepines (for sleep/anxiety)

When I first was given a prescription for a benzodiazepine, my doctor warned me that some people thought they could be addictive, but he did not believe that they usually were. He said they were intended for short-term use, and should only be taken every other day if possible. Another doctor later told me that his clinical intent when using this type of medication on an extended basis was to give the patient time to 'work things out' and let the body and the neurochemistry recover. I asked what I should do to recover, and he did not know, he only said that some people recovered on their own. Over time I learned that the situation was far more complex than appeared. I am not against using benzo drugs, but I now realize that patient education about how to solve the real problems behind the need for benzo is what is desperately needed. So I will tell my story in hope of helping someone wrestling with the benzo beast.

When I started using benzo I was experiencing the beginning of a crushing case of CFIDS. I had not slept well for over a year, and had actually gone without sleep for a week several times. The benzo drugs saved my life. Over the years I tried most of the major types of benzo, and I became dependent on them, but not addicted. My thought was always 'if only I could sleep naturally, I would not need them.' And that was true. The few times I could sleep without them, I did not need nor take them again until I had insomnia. A few times I also took them for anxiety. I tried natural sleep aids, and some helped. A few were good enough to replace the benzo for a day or two, but not for very long. Eventually I came to rely on the benzo.

The experience of getting off benzo was not what I had expected. The first time I seriously tried to get off them I was not prepared. I actually had severe digestive upset the next day, and received some acid damage to my stomach as a result. So I decided to take a slower route and find ways to gradually make the shift. But I could not just 'get off' the benzo. It was not like a habit, like breaking a sugar habit. It was a biological dependency. My life depended on the use of the benzo.

Eventually I learned that the benzo drugs and similar ‘sleep’ and ‘anxiety’ medications can sedate the digestive and immune systems as well as the rest of the nervous system. I think this is a primary reason to find alternative treatments. For a long time I thought of benzos as sleeping pills. I tried most of the different formulations, settling on Ativan most of the time. However, eventually I learned that benzos are actually anti-anxiety meds, and not true sleep inducers. They stimulate GABA binding, which has a calming effect on the CNS. Our digestive system produces benzodiazepine, so taking benzo drugs is an enhancement of what should be a natural process. So If a person needs benzos to sleep, they probably have a primary anxiety problem and may not be producing or releasing the benzo properly. This does not mean that the person will be aware of the anxiety problem, although I was partly aware. Sometimes the anxiety is a background noise, part of our automatic response to stress, discomfort or pain. But still, it is anxiety and panic responses that are what is being treated by the benzo. And the discomfort causing the anxiety response certainly could be caused or aggravated by CFIDS or Lyme co-infections, because of the neurotoxins and the continual detox and neurological discomfort. I came to believe that if I could solve the anxiety, then perhaps I could sleep naturally again without the benzo. This turned out to be true, but only when the anxiety was solved 24x7, not just for a few hours at night.

Here is what I eventually learned. In order to get off benzos, a person has two choices. #1. replace them with something else; #2. solve the original cause and eliminate the need for them. I tried #1 and found that sedating my self with any other drug or herb or hormone (melatonin) had side-effects and was not a long-term solution. Just dodging the bullets. Sooner or later you have to work through #2 to fix the problem.

And to fix #2 I had to solve ALL anxiety and tension in my life, AND find a way to re-learn to relax while going to sleep, even when I did not feel well or have pain or had stress in the day. And this is hard with co-infections because they aggravate any anxiety/tension you feel. But it is possible, I am evidence of that. I was the worst of the worst cases. I had absolute insomnia for 7 years with only one period of remission for about 6 months when I first went on antibiotics. And it just got worse and worse. I would have died without the benzos. I realized that I was failing at finding the cause. So I focused on lots of holistic changes, a LOT of them over about a year long period, and that finally released the stress/tension response to the co-infection toxins and allowed me to sleep naturally again. And getting off the benzos improved my digestion immediately, and my immune system came back to life. I believe the better sleeps is allowing a more natural healing process to progress now.

And this holistic approach included adding minerals (the salt/c protocol) which were important, going through 9 months of deep-level emotional processing, used a guided anti-anxiety meditation for about 6 months (purchased from www.panic-anxiety.com), and using a hot pack around the neck 24x7 for relaxation, which was critical. Also, I addressed my mental hyperactivity (a form of ADD) using meditation methods I created to help re-learn how to have balanced brain usage, and that was very important. I eventually re-trained my body and I now can relax again, and even have slept during the day sometimes, which I have not ever done before in my adult life. I know now that I have finally started to ‘overcome’ a life-long problem. And I believe the solution is tied to learning 24x7 relaxation and re-training the mind-body to rest.

So getting off benzodiazapine turned out to be a complex, multi-year holistic struggle. But the beast can be defeated. In the process of solving my anxiety problem I made significant progress with my other major health problem, CFIDS. I am sure that the improved immune response from getting off benzo is helping my body fight CFIDS better.

One final note, I am not angry about benzo, I still keep it around and have used it a few times for one night, when I was very sick, had a bad day, or was too agitated and stressed to sleep. However, I have not needed it after that. What really bothers me is the lack of patient education about using this drug, and many other drugs. Perhaps the patient situations are too unique and individualized, or perhaps there really is insufficient understanding right now about this type of illness to train patients. But in my case, I know I could have benefited greatly from some guidance through this complicated recovery path. I have not really explained the full details of what I had to work through, maybe sometime I will write that up more fully, but I hope at least I have shared the main idea. These types of drugs do not solve any of the causes of stress related disease. Without a lot of holistic work to solve the underlying issues, these drugs can create a monster. And there is a lot of general guidance about dealing with the holistic issues, but little overall guidance for getting off of these medications. Without addressing the whole problem, I believe that most people in my situation will find the challenge of getting off of benzo to be overwhelming.

2 Comments:

Blogger Cort said...

I'd love to hear how you're doing - your story is so intriguing. Maybe I'd love to interview you for my blog at aboutmecfs.org/blog. Hope to hear from you.

Cort

June 5, 2009 at 9:23:00 AM EDT  
Blogger Kurt said...

I have stayed off benzo, other than rare use when I am sick and need some help with sleep, maybe a few times each year.

June 5, 2009 at 4:06:00 PM EDT  

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