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Disclaimers: Regrettably, there are some psychiatrists that will still disagree with the content of this topic. But in general, the trend is moving towards what I said 10 years ago. Benzodiazepines are absolutely the worst thing you could do for long standing anxiety. Having said that, trust your physician in terms of anxiety care. Don’t self medicate of course. Choose your physicians wisely.
Where do you want to collect data on the treatment of anxiety or subacute anxiety or chronic anxiety? The Internet? Your best friend? Respected scientific journals?
Benzodiazepine use has always been considered a misuse of that class of sedative drugs drugs when it comes to treating lingering anxiety. But, psychiatrists who regularly operate in a world devoid of consideration of the organic implications of care, prescription or otherwise, hold fast to the feeling that if it fixes the problem in the short term, it’s the right solution.
Trouble is, the not so short term and the long term. Benzodiazepines are moderately to severely addictive. When it comes to dosing a benzodiazepine, some patients complain of worsening anxiety 24 hours after their first dose. Yes, those first 24 hours are spectacular. They are in the clouds, what matters doesn’t matter anymore. Like that. But about a day later, they all report that they need the benzodiazepines more than they did a day ago. That’s called addiction. It starts almost immediately.
And it’s been confirmed. It truly starts almost immediately according to patient reports. But, biochemically, receptor proliferation has been scientifically confirmed to occur after a single dose in a manner consistent with an addiction that begins about a day later.
So, the patient’s anxiety grows and grows. The need for benzodiazepines grows and grows. And anxiety grows and grows. It’s a vicious cycle. And there are other side effects above and beyond their famously life altering addiction.
Benzodiazepines are anti-cholinergic. If you recall from your grade school biology, the brain is over 90% controlled by acetylcholine. So, those receptors are cholinergic. If benzodiazepines are anti-cholinergic, then, yes, I have just stated what you are thinking: benzodiazepines are anti-brain. So, years after escalating on there use, your brain is ready for Sunrise or another retirement home, i.e., decades prior to other less chemically induced dementias. It is felt that retirement homes are filled with patients that escalated on benzodiazepines throughout the 60s and 70s. And now 80s.
Fortunately, in the 90s, we started becoming aware of this. And today, people are realizing that it’s a dementia worth avoiding.
So. Addiction for one. Dementia for two. A third affect of benzodiazepines is obesity. So, you get larger and larger. That’s never good. And it’s a tough price to pay for fighting anxiety the incorrect way.
And the larger you get, the more anxious to get. So, that, in and of itself, contributes to the increased use of the benzodiazepines, too.
It’s actually quite hard to imagine anyone who will benefit from benzodiazepines other than pharmaceutical companies and flourishing psychiatric practices.
So, what to do instead? There are other drugs. Most of them are dirty, and if used for the decades that you’re going to need them because anxiety is a multi-decade disorder, then you WILL see their side effects. Hypertension, obesity, lack of efficacy after a while, and more.
A much better treatment for new anxiety that seems to be lingering on and chronic anxiety is developing proper coping mechanisms. You can read about them. I will talk about them in another topic. Or, you can go to a licensed counselor to learn about coping mechanisms. The whole thing has become quite scientific. And our parents didn’t necessarily teach us about coping mechanisms. Those are usually fairly cheap visits. Insurances cover some of them. You will learn a great deal. You don’t have to be an ill patient to value from licensed counseling. Anyone that has any kind of anxiety will benefit from a counselor.
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