Benzodiazepine withdrawal can have a powerful impact on individuals and their loved ones. This blog post aims to shed light on the complexities of benzodiazepine withdrawal and offers insights into how friends and family can support their loved ones during this challenging time. I have blogged about this in the past. You can read those posts here, and here. For how to support a loved one during the holidays, please read this post.
The Invisible Battle
Benzodiazepines, often prescribed for anxiety, insomnia, and other conditions, can lead to chemical dependence (which is not the same as addiction!) and withdrawal symptoms when discontinued. The journey through benzodiazepine withdrawal is not just a physical struggle but an emotional and mental battle.
One of the lesser-known truths about benzo withdrawal is the lack of awareness and understanding within the medical community, often leaving patients feeling misunderstood and abandoned, as well as facing misdiagnoses and treatments that may slow their healing or be harmful. It also causes arguments as friends or family may insist that their loved one seek medical help and turn their backs on them if they do not take the pill or undergo the treatment a benzo-ignorant doctor prescribes. It’s hard to imagine that in this day and age, medical professionals are ignorant about a medication that has been on the market since the 1960s. We in the benzo community have the same thoughts!
Withdrawal symptoms can be unpredictable, fluctuating from moments of relative calm to intense physical and emotional distress. This rollercoaster makes planning and commitment to social engagements nearly impossible, often leading to isolation, misunderstanding, and hurt feelings from friends and family. Due to increased symptoms, your loved one may make a date with you and have to cancel it at the very last minute. Your patience and compassion are very much welcomed.
The Downregulation of GABA Receptors
At the core of benzodiazepine withdrawal is the downregulation of GABA receptors in the brain. Benzodiazepines work by enhancing the effect of the neurotransmitter GABA, which induces sedation and relaxation. The medication makes the neurons in the brain too sedated, reducing the excitatory action (glutamate). The brain compensates by shutting down some of the GABA receptors to achieve less sedation. This neuroadaptation is what causes someone to experience benzo withdrawal symptoms, and it can occur within days, weeks, or months of taking a benzo as prescribed. When one has withdrawal symptoms while taking the medication, it is called tolerance withdrawal. If someone has symptoms in between doses, it is referred to as interdose withdrawal. The lack of working GABA receptors can cause anxiety, terror, insomnia, mental and emotional challenges, pain, weakness, burning, dizziness, and a host of other symptoms. For a list of possible symptoms, please go here.
Fear of the Unknown
One of the most harrowing aspects of benzodiazepine withdrawal is the fear and uncertainty regarding recovery. Many individuals worry if they will ever return to their pre-withdrawal state of health and well-being. This fear is compounded by a lack of definitive timelines for recovery, making the journey seem endless and daunting. In September 2020, the FDA black-boxed benzodiazepines and included in the prescription insert that withdrawal symptoms can last years for some people.
What’s Important to Know
Emotional and Cognitive Effects: Apart from physical symptoms, benzodiazepine withdrawal can significantly impact emotional and cognitive well-being. Mood swings, depression, anxiety, and memory issues are common. It’s important to understand these changes and not attribute them solely to the individual’s character or attitude or even past anxiety or mood issues. Most benzo withdrawal symptoms are NOT pre-existing anxiety, etc. Even people who have never had anxiety or other psychological challenges can experience anxiety, panic, terror, intrusive thoughts, etc., in benzo withdrawal.
Non-Linear Recovery Process: Recovery is often non-linear, characterized by “windows” (periods of some symptom relief) and “waves” (periods of intense symptoms). This pattern can be confusing and disheartening for both the individual and their caregivers.
Importance of a Gradual Taper: Abrupt discontinuation of benzodiazepines can be dangerous. A gradual tapering is crucial for safely reducing dependency. Do not encourage your loved one to speed up their taper or to go to a detox center to get off the medication quickly (unless there is a medical emergency that requires a quick taper off.)
Sensitivity to Stimuli: Individuals in withdrawal often have heightened sensitivity to stimuli like light, sound, and stress. This heightened sensitivity should be taken into account in daily interactions and environments.
The Role of Diet and Lifestyle: Eating a whole-food, plant-based diet, avoiding caffeine and alcohol, processed foods, sugar, and preservatives, and incorporating gentle physical activities can support the body’s recovery process.
Varied Duration of Withdrawal: The duration of withdrawal varies significantly among individuals. Do not compare your loved ones timeframe with anyone else.
Need for Emotional Support: Emotional support is vital. Listening, showing empathy, and being present can be incredibly supportive. Sometimes, just being there, even in silence, is comforting.
Managing Expectations: It’s important for both the individual and their loved ones to manage expectations regarding the pace of recovery. Patience and understanding that recovery is a gradual process are crucial.
Complexity of Withdrawal Symptoms: Withdrawal symptoms can vary widely among individuals. Understand that your loved one may be coping with symptoms that can only be described as torturous. There is no other medical condition quite like benzo withdrawal, and it affects people in all aspects of being human: mind, body, and spirit.
Protracted Withdrawal Syndrome: Some individuals may experience symptoms after eighteen months off the medication This is known as protracted withdrawal syndrome and can last for some time as symptoms fade.
1. Offer Emotional Support: The most valuable support you can provide is a listening ear and an open heart. Avoid giving unsolicited advice or judgments. Instead, simply ask, “What do you need? How can I help?” Listen carefully to the answer.
2. Understand the Unpredictability: Recognize that the individual may have good and bad days and that this unpredictability is a normal part of withdrawal. Be flexible and understanding about canceled plans or sudden changes in mood.
3. Educate Yourself: Learn about benzodiazepine withdrawal. Understanding the science behind it can foster empathy and patience.
4. Don’t Encourage Uneducated Support: Most healthcare professionals are uneducated about benzo withdrawal. Encouraging your loved one to seek help from such a professional can put them in harm’s way. Trust that your loved on is doing their research within the benzo community by educating themselves with knowledge from trusted sources such as this website (benzowithdrawalhelp.com), the Benzodiazepine Information Coalition, and the Benzo Withdrawal Premium Support group.
5. Promote a Healthy Lifestyle: Encourage and support healthy lifestyle choices, like a whole-food, plant-based diet, gentle exercise, and stress-reducing activities, which can play a crucial role in recovery.
6. Be Patient and Compassionate: Recovery from benzodiazepine withdrawal can be a long process. Show patience and compassion, understanding that your loved one is doing their best to cope with a highly challenging situation.
Self-Care Strategies for Caregivers
Caring for someone undergoing benzodiazepine withdrawal can be demanding and emotionally taxing. It’s also crucial for caregivers to take care of themselves. Here are some strategies:
Understand Your Limits: Recognize that you have limitations, and it’s okay not to have all the answers or be always available. Setting boundaries is essential for your well-being.
Seek Support for Yourself: Consider joining support groups for caregivers or seeking therapy. Sharing your experiences with others who understand can be incredibly validating and relieving.
Practice Self-Compassion: Remember that you’re doing your best in a challenging situation. Practicing self-compassion can help mitigate feelings of guilt or inadequacy.
Stay Informed but Avoid Overwhelm: While it’s beneficial to understand benzodiazepine withdrawal, ensure you don’t overwhelm yourself with too much information or take on the role of a medical expert.
Maintain a Healthy Lifestyle: Prioritize your physical health through regular exercise, a nutritious diet, and adequate sleep. This will not only improve your capacity to provide care but also your overall well-being.
Take Time for Yourself: Engage in activities that you enjoy and relax you. This can range from hobbies, spending time with friends, or simply having quiet time alone.
Practice Stress-Reduction Techniques: Techniques such as meditation, yoga, or deep breathing exercises can be effective in managing stress and maintaining emotional balance.
Seek Professional Health Advice: If you’re feeling overwhelmed, it’s important to talk to a healthcare professional. They can provide guidance and support tailored to your situation. (I work with many friends and family members who want benzo education and emotional support for themselves. Feel free to book a session.)
Educate Yourself on Compassion Fatigue: Caregiving can lead to compassion fatigue, a state of emotional exhaustion. Recognizing the signs can help you take timely action to address them.
Celebrate Small Successes: Recognize and celebrate small victories, both in your loved one’s recovery and in your journey as a caregiver. This can help maintain a positive perspective.
Keep a Journal: Documenting your thoughts and feelings can be a therapeutic way to process your experiences and track your emotional journey.
Stay Connected with Your Social Network: Don’t isolate yourself. Stay in touch with friends and family who can offer emotional support and a break from your caregiving responsibilities.
Remember, taking care of yourself is not a luxury but a necessity when you’re in a caregiving role. Your well-being is just as important as the well-being of the person you care for.
Benzodiazepine withdrawal is a complex and often misunderstood condition. It requires the understanding, patience, and support of friends and family. By educating ourselves and offering a supportive environment, we can make a significant difference in the lives of those undergoing this difficult journey. Together, we can help pave the path toward healing and recovery.
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