- Benzodiazepines are a type of psychoactive drug that calm symptoms associated with anxiety, but they’re incredibly difficult to give up once you start taking them: you can’t just skip a dose.
- It seems most psychiatrists are still in the dark about the side effects of such drugs and their long-term effects on the brain.
- The withdrawal symptoms brought on by coming off psychoactive drugs are considered worse than those associated with giving up cocaine.
Sara is a pseudonym but below is a true account of the past twenty years of a woman’s life which, when not consumed by relying on benzodiazepines and mood stabilisers, were spent living in fear of side effects and the worry of permanently being dependent upon medication.
My worst nightmare? Having forgotten to order my meds well in advance — only to discover that evening that I’m missing a tablet. Because missing a tablet means having to run to the pharmacy in the dead of night and trying to persuade the pharmacist to overlook the fact that my prescription is out-of-date. What’s so bad about one sleepless night? Well, one night is all it takes to completely sabotage a painstakingly achieved balance.
Psychoactive drugs are like certain recreational drugs: you can’t just stop taking them all of a sudden or skip a dose; the anxiety, palpitations, and nervousness that result appear immediately, all while your mood plummets. And while they’re easy to pick up, no one really knows how to help you stop once you no longer need them.
It seems like psychiatrists are just as stumped as their patients. How else can you explain that most who’ve ever taken psychoactive end up doing so for 10, 20 or 30 years, just like me?
Benzodiazepines: the euphoria you can’t resist
My name’s Sara, I’m 38 and I have a son.
I remember the day I took my first dose like it was yesterday. I was 20 and I was on holiday at my grandparents. As I walked home, my vision blurred, my heart began palpitating and I was overcome with acute anxiety.
I was visited by a family friend who happened to be a psychiatrist, and that’s when it all began: with benzodiazepines. Apparently harmless, within seconds they halt anxiety dead in its tracks, eliciting a slight sense of euphoria.
But there’s a caveat: they’re impossible to ditch. They become a crutch for whenever the need arises. As soon as I left the house, I was automatically overwhelmed by panic attacks and forced to return home. It went on like this for a few years, always leaving with vials in my bag and taking my drops in the day and in the evening.
Psychotherapy didn’t work either
In the meantime, mainly as everyone had encouraged me to, I embarked on a Freudian psychoanalysis course. Thrice a week for over 10 years, I would take the stairs to the seventh floor of the building (I suffer from claustrophobia) to lie at an elderly woman’s feet. More often than not, she’d just fall asleep behind me.
The lengthy analysis proved mostly to be a failure, so much so that by the time I’d finished, I fell into a state of terribly acute anxiety. The psychoanalyst’s response was to say she couldn’t do anything, and so she sent me to a psychiatrist.
The psychiatrist gave me a mood stabiliser, then withdrew the treatment. I spent that summer in a state of such bad insomnia that I resorted in vain to harmful and ineffective hypnotics. Finally, she gave me an antidepressant that triggered what ended up as months of unbearable anxiety.
I was forced to stop work and ended up spending my days waiting for some hope of respite every evening — but I could no longer sleep. And I still hadn’t received a diagnosis. In psychiatry, every doctor tells you something different but the worst thing is that no one had ever explained the side effects to me. No one helped me when I needed it most.
Mental disorders are not diagnosable through neuro-imaging
When you’re mentally ill, you blame yourself and, any time you feel it’s getting worse, you convince yourself that it’s in your head. Often, those who treat you as a “relapse” also preach the same idea, yet there is now literature that explains that mental illness isn’t a straightforward condition that can be established with a CT scan.
The other widely held belief is that psychoactive drugs restore possible imbalances in the brain. But a growing number of studies are beginning to tell a different story: that psychoactive drugs themselves, which should only be used in the most extreme of emergencies, are actually one of the culprits when it comes to altering the neurological balance.
Alterations result in psychiatrists then trying to rebalance the brain with additional psychiatric drugs, and it goes on and on in an endless cycle. The trouble is that almost all the time, the meds aren’t healing the problem; they’re simply holding symptoms at bay (if that) — and quitting can make you feel even worse. And once a patient can’t stop, the most they’ll ask to do is change their therapy or just switch from one psychiatrist to another.
Psychoactive drugs for life?
Eventually I did, at last, find someone who didn’t tell me (in the usual brusque and patronising tone) that anxiety is just a part of life: I was given a more precise diagnosis of bipolar disorder and immediately changed drugs: I was put on lithium-based mood stabilisers.
After the psychiatrist who prescribed me those meds passed away, I was handed over to another doctor, who operated using the same school of psychiatry. No antidepressants; always mood stabilisers and antipsychotics — which are used today to suppress anxiety even in those who aren’t psychotic — coupled with benzodiazepines in the evening.
I resumed normal life and everything, work and family, seemed to be going well — until I fell pregnant. Despite years having passed since my improvement, I hadn’t actually come off the drugs.
The psychiatrist preferred for me to continue them and actually advised that I should be on lithium for life. I was scared of coming off them, and so, by switching a few prescriptions around, I had continued up to my pregnancy to take them just as though someone would take insulin for diabetes.
Psychoactive drugs and pregnancy
Pregnancy is a difficult time for those suffering from any chronic disease, but particularly so for those taking psychoactive medication. Studies have shown that many substances can be taken during pregnancy without any hitches. But others are definitely harmful to the foetus, including lithium, which I had to give up immediately.
Initially, everything seemed to be going fine, but then I slowly began to deteriorate. I ended up suffering terribly throughout my pregnancy, whether with extreme insomnia, acute anxiety or the compelling urge to have an abortion, just to escape the endless pain that, again, no one seemed able to diagnose.
It was so bad that I gradually upped the dosage of the drugs I could safely take while pregnant and did so tenfold, but even before the birth there was also the issue of breastfeeding: benzodiazepines can be taken during pregnancy but not while breastfeeding.
Giving them up led me into an even deeper relapse: I was completely absent throughout the birth and didn’t cooperate at all. A few hours later I was in such a bad way that I gave in to all my usual meds and took extras to get rid of the milk. It was such an agonising defeat for me, as I’d been dead-set on breastfeeding for a long time. But paradoxically, after a few hours, I was already standing and feeling fine.
The withdrawal is worse than for a cocaine addict
With hindsight I believe the undiagnosable pain throughout the pregnancy was certainly caused by a mixture of factors including the pregnancy itself, however, I also believe it was down to the suspension of my usual drugs.
Referred to as the rebound effect, these symptoms can be short to medium term but regardless of how long they last, the experience is simply terrifying, not unlike quitting cocaine or any other drug. I would love to have a second child, but I’ve not stopped my medications and am still on the doses I took during pregnancy.
Incidentally, a short time ago, I carefully read the disclaimers on my meds. Aside from vague indications of “sadness and depression”, there are a number of side effects — not just rare but frequent — that should set off alarm bells for anyone who’s considering them: increased suicidal tendencies, weight gain, involuntary muscle movements, swelling, nightmares, vomiting, dyspnoea, increased prolactin, serious heart problems and even death.
And those are just a few examples. Of course, I undertake regular blood tests, liver and heart checks by ultrasound, thyroid tests, and so on. But my only ultimate goal is to be able to stop them or to get up one day and chuck all the medicine in the bin.
Sadly, I know I can’t do that as I’d react awfully. My current psychiatrist is slowly lowering my dose of medication, but with a reduction that gradual, it would take a year to come off them – if all were to go well. Yet that’s how it is: either you come off slowly or you risk another relapse.
Red tape and bureaucracy
I’m now used to the red tape that comes with having to take medications longterm too. For some drugs that are particularly costly for the National Health Service in Italy (some come to $120 per pack), you need a treatment plan put together by a public mental health specialist, even if you’re in the care of a private specialist.
You have to turn up with your psychiatrist’s note, and hope the public psychiatrist doesn’t object to anything in your treatment plan: if they do, it’s hard to know how to go forward. You then take your treatment plan to your general practitioner and, assuming they don’t object either, they’ll give you your prescriptions without any hitches.
However, when I renewed my driving licence, I chose not to declare my use of psychoactive drugs as I should have done. As I understand it, everyone does the same. Why? Because otherwise, you end up in front of a medical committee threatening either to revoke your licence or impose upon you an absurd and expensive annual renewal.
If psychoactive drugs really affected your ability to drive, you’d have your driving licence revoked if you merely had anxiety or depression. In the case of driving, however, psychoactive substances are treated the same as drugs, which gives one further reason to believe they’re not a cure of any sort.
With hindsight, when I first panicked that I would have been better off taking cannabis, which I never did, it would have been less harmful.
And, above all, it would have been easier to stop.
This story originally appeared on Business Insider Italia and has been translated from Italian.