Navigating benzodiazepine (benzo) withdrawal is a challenging journey, marked not just by physical symptoms but also by significant stress and anxiety. Let’s look at how to best reduce our stress, which is the third cornerstone of well-being: eat right, move enough, stress less, and love well.

Understanding the Brain During Benzo Withdrawal

Benzodiazepines act on the brain’s GABA receptors, inducing a calming effect. However, this calm state doesn’t allow for the brain to reach homeostasis (balance between calm and activated). To compensate for this, the brain adapts by downregulating some of the GABA receptors, leading to a hyperaroused nervous system. This can result in anxiety, agitation, panic, and stress.

Neuroplasticity and Recovery

The brain’s ability to adapt, known as neuroplasticity, means it can gradually upregulate the GABA receptors and reach homeostasis again. Engaging in stress-reduction activities can aid this recovery process by forming new neural pathways that promote calmness and resilience.

The Role of Stress Hormones

During withdrawal, the body may produce higher levels of stress hormones like cortisol, which can exacerbate anxiety and stress. Managing these levels is crucial for both physical and mental well-being.

Polyvagal Theory and Stress Reduction

The Polyvagal Theory, developed by Dr. Stephen Porges, offers insight into how the nervous system responds to stress. It suggests that our vagus nerve influences how we process stress and can be trained to promote a state of relaxation.

The Three States of the Nervous System

• The Sympathetic State: Often referred to as ‘fight or flight,’ (protect) this state is activated during high stress.
• The Dorsal Vagal State: This ‘freeze’ state  (protect) is a more primitive response, often resulting in feelings of numbness or dissociation.
• The Ventral Vagal State: The ‘social engagement’ state, (connect) where the body feels safe and is able to relax and connect with others.

Tips for Reducing Stress During Benzo Withdrawal

Engage the Ventral Vagal State

• Social Interaction: Safe, positive social interactions can stimulate the ventral vagal state. This might include spending time with loved ones or participating in support groups.
• Breathing Exercises: Slow, deep breathing can activate the vagus nerve and promote relaxation. Techniques like diaphragmatic breathing are especially effective.
• Humming, chanting, singing: Can help strengthen vagal tone.

Manage the Sympathetic Response

• Mindfulness and Meditation: These practices can help in managing the ‘fight or flight’ response, reducing the overall level of stress.
• Physical Activity: Gentle exercises like walking or yoga can help in reducing cortisol levels and improve mood.

Address the Dorsal Vagal State

• Grounding Techniques: Activities that help you stay present and connected to your environment, such as mindfulness or sensory activities, can be beneficial.
• Professional Support: Therapies like Cognitive Behavioral Therapy (CBT) can help in managing feelings of dissociation or numbness.

Additional Strategies for Stress Reduction

Cognitive Techniques

• Reframing Thoughts: Learning to identify and challenge stress-inducing thoughts can reduce their impact.
• Education: Understanding the withdrawal process can demystify symptoms and reduce anxiety.

Lifestyle Adjustments

• Sleep Hygiene: Good sleep is important but often hard to achieve in benzo withdrawal. To help with withdrawal driven insomnia, establish a bedtime and a routine, as well as turn off all screens hours before bedtime.
• WFPB Diet: A diet rich in plant-fiber andnutrients can support brain health and mood regulation, as well a heal the gut microbiome.

Creative Outlets

• Art or Music Therapy: Engaging in creative activities can be a therapeutic way to express emotions and reduce stress.
• Journaling: Writing about your experiences and feelings can provide a healthy outlet for stress and anxiety.

Mind-Body Practices

• Yoga or Tai Chi: These practices combine physical movement with mindfulness, helping to balance both mind and body.
• Massage or Acupuncture: These therapies can help in reducing physical tension and promoting relaxation. Only gentle massage should be used, and acupuncture is a ‘test and learn’ coping practice as it has been extraordinarily helpful to some, but has revved up others.

The Role of Support Systems

• Professional Guidance: Working with a healthcare provider or therapist who understands benzo withdrawal can be helpful.
• Community Support: Joining support groups can provide emotional support and practical advice from those who have gone through similar experiences.

Conclusion

Stress reduction during benzo withdrawal is a multi-faceted process that requires understanding the brain’s response to stress, utilizing principles from the Polyvagal Theory, and implementing practical strategies to manage symptoms. By engaging in activities that promote the ventral vagal state, managing the sympathetic response, and addressing the dorsal vagal state, individuals can find relief from the stressors of withdrawal. Incorporating cognitive techniques, lifestyle adjustments, creative outlets, and mind-body practices, along with seeking support, can aid in navigating this challenging journey towards recovery. Remember, while the path of benzo withdrawal is unique for each individual, the power to reduce stress and promote healing lies within a holistic, informed approach that nurtures both the mind and body.