Updated: Nov 20, 2022
As a sufferer of Post-Traumatic Stress Disorder, I have long been a fan of Xanax. Yep, those words will get twisted and used against me by many, but the reality is that benzodiazepines certainly have their place in mental health in spite of being misused and abused by many, causing a significant number of experts to argue that they should be pulled from the market entirely. Here's the thing though, there is nothing like it when it comes to treating episodic anxiety and panic attacks. For some, maybe a very limited few, this really is the best approach.
The first two times I was offered a Xanax prescription, I had suffered significant trauma and hadn't slept for days. I was a complete zombie. The first script was offered after my son died. Months later I was still not sleeping, or working, or even able to cook. I was consumed by fear and grief, and was still enduring trauma as his death was being investigated. My family fell apart, my graduate studies were in jeopardy, my career was on hold, my ability to homeschool my children was void, fear and grief consumed me. I was frozen in time. Xanax saved my life and that one script lasted for a few years.
The second time I suffered overwhelming trauma I made an appointment with my PCP after several nights of not sleeping, and not even feeling fatigue. She was out on vacation so I met with the new hire. Without hesitation, I stared him straight in the eye and said, "I need Xanax." It had been maybe ten years since my previous script, so he looked back at me, also without hesitation and said, "Nope. That's not going to happen." Touche. He isn't my doctor and those sorts of scripts really should be reserved for the primary provider; I fully understood.
Then I explained my scenario, that I had just discovered while I was working night shift at the hospital and my husband was home with our children, with the air filter on blast offering the white noise he needed to sleep through the night, that a 28-year-old man was getting in our home and raping our 12-year-old daughter. This had been ongoing for six months and we had only found out because she had shared with us she was afraid she was pregnant. While that is enough to traumatize my soul into future generations, this man had groomed her through MySpace for months so I was able to go back and read all the gruesome acts he had manipulated her into engaging. The self-torture I endured questioning myself, how did I miss this? Where did I go wrong? This man took pictures of my husband and I sleeping and put them on the internet. He was hiding in our family room one day I was home alone and saw me walking around in nothing but my thin robe. I was beyond distraught. My daughter was 12 years old and I didn't think had even held hands with a boy at this point in her life. I was contemplating homicide. (Don't kid yourself. You would have too.)
The physician I had only just met didn't say a single word to me after hearing my story. He looked down at his script pad and offered me a full prescription for Xanax. Then he gave me his sincere condolences. That one script - that one bottle of Xanax was the only thing maintaining that thin line between sanity and falling into the abyss. Again, my life was saved, and so was the life of a pedofile that remains free even still today because do white, middle-class, Judeo-Christian prosecutors actually care about sexual assault? Nope. Not one iota. Not even enough to not lose her rape kit.
That Xanax bottle did get me through the next ten years. They long expired actually before I utilized them all. I was able to pull myself out of a really bad place and find healing. My daughter was able to find a great deal of healing as well, although we both suffer still even today with PTSD. Anxiety in itself though never really entered our lives outside of those two incidences. We had situational episodes, although there were times my childhood would sneak up on me and triggers would present, but I was fairly good at stuffing that down and simply eliminating any potential for future triggers.
That is until I my fortieth birthday. I discovered I was pregnant, and my husband subsequently left me within weeks - not interested in raising another child at the age of fifty. I was in private practice as a very busy midwife, with two young sons at home and another one on the way. He played little to no role in their life after leaving, because it was just too much for him (admittedly it had been the entire time he lived at home as well). My midwifery colleague was enduring her own personal crisis and on the day my husband walked out, we lost a baby at a birth she was attending in my absence. The culmination of all these events was more than I could continue to bear and I closed my practice. I simply could not be everything for everyone.
Once closed though and in my home, surrounded by equipment and furniture from my practice, stacked literally to the ceiling in most every room in my house, I began to have panic attacks. At the time, I didn't know what was wrong with me. Never having had any real anxiety outside of the two events above, and not identifying with a singular traumatic event at the time, I didn't recognize my frozen state as a mental health episode. I just didn't know why I was stuck leaning against the dining room wall unable to breathe, and knowing there was something really wrong with me.
Xanax again was a necessary healing tool. I entered talk therapy twice a week for months, along with EMDR, somatic therapy, hiking several times a week, watercoloring, group therapy, and loads of yoga. Pandora and Pintrest also played important roles. Five years and two prescriptions later, I am grateful benzodiazepines were available to me. Four total scripts over my entire lifetime and no question, Xanax saved my life.
Certainly there have been practitioners who have said the simple fact that I have a script means I shouldn't be practicing at all, or that this medication is always reckless and unnecessary, ignore that many, many people cope through their trauma with alcohol, rage, drugs, and sex addiction. When my healing stabilized, I hadn't acquired a new bad habit that I would also need to recover. I did put in the work behind the script to heal, and this is part of the practitioner's assessment when offering these medications, or might I argue, any and all medications. These should not be quick fixes, but when my mental health was hemorrhaging, benzodiazepines shut down the floodgates for me.
Here's the real tragedy though. Because so many practitioners have prescribed benzodiazepines haphazardly and far too abundantly without regard to the client's other coping behaviors or addictions or even their investment into healing, we have created a mecca of addiction and even mortality. Benzodiazepines mixed with alcohol is a really effective way to unalive oneself and this is the argument behind eliminating all access to these medications.
Xanax is good at providing calm during chaotic situations. It sedates the central nervous system, relaxing your brain and body. It allowed me to calm my brain and sleep after days of insomnia and racing thoughts. It slows the heart and respiratory rate. These effects can be extremely helpful when one has endured trauma or their trauma has been triggered and they are really struggling to break that sympathetic nervous system response. New tools need to be acquired however, and these tools must be practiced like any other skill one seeks to become efficient. We don't offer crutches and expect you to remain there. Physical therapy is necessary to get you back on your feet.
Sedation over a longer-term period can lead to memory problems; however, Xanax can also increase the incidence of Alzheimer's and dementia. The longer your brain is on Xanax, the more it will adapt and continue to slow function throughout your entire mind and body. What was only necessary in isolated incidences, because the necessity more regularly. Our bodies will become dependent on the crutches just to function on a daily basis.
Xanax releases higher levels of the neurotransmitter dopamine into the brain, making you feel pleasure. Over time, this excitement diminishes in the brain. Some users may even experience hopelessness and have thoughts of suicide. Right, because it is slowing you down like Eeyore. Those who had depression before may even find on Xanax they are more bipolar, with wild mood swings. Long-term Xanax can also, paradoxically, increase the same symptoms of anxiety and panic that it was originally prescribed to treat. This is a phenomenon of rebound anxiety or a condition in which increased anxiety returns in between doses.
Xanax is a short-acting drug, and it only lasts for a few hours. In the absence of healthy coping skills, anxiety can feel like getting worse each time the medication's calming effects subside. Admittedly, when I take Xanax, I notice nothing but then realize, "Oh, I am functioning! I am not spiraling in my thought patterns anymore." It literally just ceases my trajectory into the abyss, but again, I was very aggressively doing the work to heal, to process, to move the energy out of my body. I was learning tools and working to allow myself self-compassion.
We think addiction and dependence on Xanax is intentional, that it's caused by recklessness but our body's dependence is outside our own control. Regular use can be detrimental to healing. It is not the fix; it is the crutch that helps you get to therapy. This tolerance can happen in just a few weeks and then often, higher doses are needed. Dependence happens more with long-term use and simply means the body is so use to having the medication that now it needs it to function. Withdrawal can take more than a year with a number of psychological symptoms. Xanax abuse can also lead to overdose and death, particularly when mixed with alcohol.
No one sets out to be a long-time and consistent user of Xanax, but if you found yourself walking on crutches a year or a decade after spraining your ankle, wouldn't you wonder if maybe there was another option? The goal is to walk again on your own feet, right?
Xanax is the tool that helps you focus on therapies that will teach healthy techniques for managing anxiety, which isn't to say that therapy won't invite anxiety, tears, and heartache into your life. This is healthy and normal even though you feel like you are falling apart. We do need to feel some of this to heal. It's imperative that you work with your primary care provider closely when Xanax is provided because while I am a huge advocate for the benefits it can provide, particularly those with Post-Traumatic Stress Disorder, this is no joke. Like most everything, we have to remember Goldilocks. There is always a middle ground. If you'd like to talk about your options, give us a call. Healing and discovering who you are and what you are capable of is what we are all about. You are worthy of complete happiness and vitality your entire life. Lean in and invest in yourself.