ONTD Political

Listening to Xanax
How America learned to stop worrying about worrying and pop its pills instead.
Source - NY Magazine
By Lisa Miller
Published Mar 18, 2012


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Last summer, near the end of my mother’s life, I woke up in my childhood bedroom in the middle of the night in a fever of panic. My heart was thrumming, my mind racing. In 1819, the English poet John Keats called anxiety a “wakeful anguish,” and so it was with me. Relief seemed impossible.

Then I had an idea. I wandered into the room where my mother lay dying and found the hospice nurse—a gentle, generous soul—sitting quietly beside my mother as she slept. She looked up from her fat paperback.

“Do you want to hold her hand?” she asked.

“No,” I said. “I’m looking for the Ativan.”

The nurse went back to her book, and I went rummaging through the pill bottles. Point-five milligrams and fifteen minutes later, the anti-anxiety medicine prescribed to my mother had bound itself to my GABA receptors, and I was calm enough to sleep. Afterward, I felt the occasional twinge of regret about my priorities at that moment. Then a friend told me she had swiped drugs from her just-dead mother to cope with her own surging anxiety. “I was glad for it,” she said.

In my Brooklyn kitchen last December, not long after a report circulated about veterinarians using Xanax to treat post-traumatic-stress disorder in military dogs, a neighbor mentioned that she had begun to carry Xanax in her purse after her first child entered kindergarten, for relief from the uncontrollable separation anxiety she felt each time she boarded the subway and headed to work. “It was just so obvious that time was passing, and I could never get it back,” she told me. Another friend, the breadwinner in her family, started taking Xanax when she saw that she was about to get laid off, then upped her dose when she did. Around Thanksgiving, I found myself sitting on a plane next to a beautiful young FIT graduate in a rabbit-fur vest. Before takeoff, she neatly placed a pillbox on her knees, plucked out a small tablet, and swallowed it. “Control issues,” she said sweetly, giving me a gorgeous smile. As we became airborne, she reached out and clutched my hand.

If the nineties were the decade of Prozac, all hollow-eyed and depressed, then this is the era of Xanax, all jumpy and edgy and short of breath. In Prozac Nation, published in 1994, Elizabeth Wurtzel describes a New York that today seems as antique as the one rendered by Edith Wharton. In the book, she evokes a time when twenty­somethings lived in Soho lofts, dressed for parties in black chiffon frocks, and ended the night crying on the bathroom floor. Twenty years ago, just before Kurt Cobain blew off his head with a shotgun, it was cool for Kate Moss to haunt the city from the sides of buses with a visage like an empty store and for Wurtzel to confess in print that she entertained fantasies of winding up, like Plath or Sexton, a massive talent who died too soon, “young and sad, a corpse with her head in the oven.”

This is not to say that clinical depression is ever a fashion statement—it’s not. In the nineties, just as now, there were people who were genuinely, medically depressed, who felt hopeless and helpless and welcomed the relief that Prozac can provide. But beyond that, the look and feel of that era, its affect, was lank and dissolute. It makes sense in retrospect that Clerks, that cinematic ode to aimlessness, and Eddie Vedder (in his loser T-shirt) came along as the country started its two-decade climb toward unparalleled prosperity. In 1994, all the fever lines that describe economic vitality—gross domestic product, median household income, the Dow—pointed up. Just as teenage rebellion flourishes in environments of safety and plenty, depression as a cultural pose works only in tandem with a private confidence that the grown-ups in charge are reliably succeeding on everyone’s behalf.

Anxiety can also be a serious medical problem, of course. It sometimes precedes depression and often gets tangled up with it (which is why Prozac-type drugs are prescribed for anxiety too). But anxiety has a second life as a more general mind-set and cultural stance, one defined by an obsession with an uncertain future. Anxious people dwell on potential negative outcomes and assume (irrational and disproportionate) responsibility for fixing the disasters they imagine will occur. “What’s going to happen?” or, more accurately, “What’s going to happen to me?” is anxiety’s quiet whisper, its horror-show crescendo the thing Xanax was designed to suppress. Three and a half years of chronic economic wobbliness, the ever-pinging of the new-e-mail alert, the insistent voices of prophet-pundits who cry that nuclear, environmental, political, or terrorist-generated disaster is certain have together turned a depressed nation into a perennially anxious one. The editors at the New York Times are running a weekly column on anxiety in their opinion section with this inarguable rationale: “We worry.”

Panicked strivers have replaced sullen slackers as the caricatures of the moment, and Xanax has eclipsed Prozac as the emblem of the national mood. Jon Stewart has praised the “smooth, calm, pristine, mellow, sleepy feeling” of Xanax, and Bill Maher has wondered whether the president himself is a user. “He’s eloquent and unflappable. He’s so cool and calm.” U2 and Lil Wayne have written songs about Xanax, and in her 2010 book Dirty Sexy Politics, John McCain’s daughter Meghan copped to dosing herself and passing out the day before the 2008 election “still in my clothes and makeup.” When news outlets began reporting that a cocktail of alcohol, Valium, and Xanax might have caused Whitney Houston’s death, it felt oddly inevitable. Coke binges are for fizzier eras; now people overdo it trying to calm down.

Anxiety can be paralyzing and life-­destroying for those who suffer it acutely. But functional anxiety, which afflicts nearly everyone I know, is a murkier thing. Not quite a disease, or even a pathology, low-grade anxiety is more like a habit. Its sufferers gather in places like New York, where relentlessness and impatience are the highest values, and in industries built on unrelenting deadlines and tightrope deals. The shrinks say that these people—urban achievers—retain a superstitious belief in the magical powers of their worry. They believe it’s the engine that keeps them going, that gives them an edge, that allows them to work weekends and at five o’clock in the morning, until at last it becomes too much. That’s where the pills come in.

“I use my anxiety to be better at what I do,” says an executive at a boutique PR firm. “A certain amount of anxiety makes me a better employee but a less happy person, and you have to constantly balance that. If I didn’t constantly fear I was about to be fired or outed as a loser, I’m afraid I might be lazy.” She takes a melt-in-your mouth .25-milligram tab of Klonopin once a week, she estimates: at bedtime, if work stress has her too revved up, or on the subway in the morning if her schedule for the day is making her sweat. Anti-anxiety drugs are the salvation of those for whom opting out of the to-do list isn’t an option.

Xanax and its siblings—Valium, Ativan, Klonopin, and other members of the family of drugs called benzodiazepines—suppress the output of neurotransmitters that interpret fear. They differ from one another in potency and duration; those that enter your brain most quickly (Valium and Xanax) can make you the most high. But all quell the racing heart, spinning thoughts, prickly scalp, and hyperventilation associated with fear’s neurotic cousin, anxiety, and all do it more or less instantly. Prescriptions for benzodiazepines have risen 17 percent since 2006 to nearly 94 million a year; generic Xanax, called alprazolam, has increased 23 percent over the same period, making it the most prescribed psycho-pharmaceutical drug and the eleventh- most prescribed overall, with 46 million prescriptions written in 2010. In their generic forms, Xanax is prescribed more than the sleeping pill Ambien, more than the antidepressant Zoloft. Only drugs for chronic conditions like high blood pressure and high cholesterol do better.

“Benzos,” says Stephen Stahl, chairman of the Neuroscience Education Institute in Carlsbad, California, and a psychiatrist who consults to drug companies, “are the greatest things since Post Toasties. They work well. They’re very cheap. Their effectiveness on anxiety is profound.”

Benzos can also be extremely addictive, and their popularity can be gauged by their illegitimate uses as well. According to the federal Substance Abuse and Mental Health Services Administration, rehab visits involving benzodiazepine use tripled between 1998 and 2008. Though benzos have come to signify the frantic ­overwhelmed-ness of the professional elites (they were discovered in the autopsies of both Michael Jackson and Heath Ledger), SAMHSA says the person likeliest to abuse the drugs is a white man between the ages of 18 and 34 who is addicted to another substance—alcohol, heroin, painkillers—and is unemployed. Last year, a 27-year-old man named Dominick Glowacki demanded that a Westchester CVS hand over all its Xanax while he held up the store with a BB gun. Jeffrey Chartier, the Bronx lawyer who represented Glowacki, says he’s seeing more and more cases of benzo abuse among young men who aren’t working. “Two pills and two beers make them as high as drinking the whole six-pack.”

In these anxious times, Xanax offers a lot. It dissolves your worries, whatever they are, like a special kiss from Mommy. “Often referred to as God’s gift,” reads the fifth definition of Xanax on Urban Dictionary. “You could come home with your house on fire and not even care,” reads another. “You don’t give a fuck about nothing.” So reliably relaxing are the effects of benzodiazepines that ­SAMHSA’s director of substance-abuse treatment, H. Westley Clark, says they’ve gained a reputation as “alcohol in a pill.” And their consumption can be equally informal. Just as friends pour wine for friends in times of crisis, so too do doctors, moved by the angst of their patients, “have sympathy and prescribe more,” says Clark. There are a lot more benzos circulating these days, and a lot more sharing.

In my social circle, benzodiazepines are traded with generosity and goodwill. My first Klonopin was given to me three years ago by a friend, during the third of seemingly endless rounds of layoffs. “You’ll know it’s working when you stop spinning,” she told me as she dug for the foil packet in her purse. Another friend admitted she has recently found herself playing fairy god­mother with her Xanax. To friends worried about enduring a family holiday, she doles out a pill; to colleagues fearful of flying, she’ll commiserate before offering a cure. “I can’t fly without half a Xanax,” she’ll say. “Want some?” (Such casual bigheartedness is perhaps abetted by how cheap alprazolam can be. “How’s this for something nutty,” the same friend wrote to me in an e-mail. “Just refilled alprazolam. It was $2.56 for 30 tabs. Less than pretty much anything in the drugstore except maybe gum or Blistex.”)

The beauty of a benzo is its simplicity. SSRIs like Prozac or Celexa can work on anxiety as well as depression, but take two to three weeks to kick in. A benzo is, plain and pure, a chill pill: You can take it when you need to without committing to months or years of talk therapy. A real-­estate executive I spoke to packs anti-­anxiety drugs whenever he travels to guard against the circumstance he most dreads: being stuck in a hotel room (or, as he was recently, on a family camping trip), unable to sleep and worrying about not sleeping. “It’s just one of my little neuroses,” he says. He finds that as long as he has the pills on hand, he rarely has to use them. “Just knowing they’re there makes me feel better.”

I understand what he means. The Ativan I snagged from my mother is mostly untouched since she died six months ago. Benzos are great when you are freaking out—and they’re great because you know that something will make you freak out, eventually.

The last anti-anxiety drug Americans loved as much as Xanax was called Miltown. Discovered by accident in 1955 by a researcher looking for a new muscle relaxant, it caught on almost overnight. In Hollywood and New York, where busy, glamorous people worked all hours to feed the masses’ appetite for information and entertainment, hostesses served martinis with a Miltown garnish. Tiffany & Co. produced a line of tiny jeweled cases in which a woman might carry her pills. Lucille Ball, Lauren Bacall, Tennessee Williams, and Norman Mailer all took Miltown. Not only did they take it, but they boasted about the relief they felt from the miracle drug the press dubbed “Executive Excedrin.” On his show, Bob Hope called Miltown the “I don’t care” pill.

Against a backdrop of the real and present threat of nuclear attack, it would not be an exaggeration to say that during the Cold War it was patriotic to take an anti-anxiety drug. The medicine kept ambitious working people (mostly men) on an even keel while their children were ducking and covering at school. Miltown allowed Americans to manage the stresses of modernity while “doing one’s job and earning a good salary, but also playing a social role: making decisions and completing tasks while maintaining confidence and control,” writes Andrea Tone in her excellent book The Age of Anxiety: A History of America’s Turbulent Affair With Tranquilizers. It wasn’t just that anxiety was normal. It wasn’t normal if you weren’t anxious.

Valium came along in 1963, developed by Roche to knock Miltown off its perch. Unlike Miltown, which was a word-of-mouth phenomenon, Valium was aggressively marketed as a consumer convenience. The target audience was women, whose grouchiness, stress, romantic woes, and mood swings the drug would cure. One 1970 ad showed “Mrs. Raymond,” a schoolteacher, facing a relatable female crisis. “Valium has helped free her of the excessive psychic tension and associated depressive symptoms accompanying her menopause,” it read. “Now she’s poised and cheerful again.”

Valium’s success was unprecedented. It was the first drug, according to Tone, to reach $100 million in sales. It was also the first drug to trigger in Americans the suspicion that they were being sold a panacea for a condition they didn’t have or that might otherwise be cured by fulfilling work, a good laugh, or a more empathetic husband.

Xanax, approved in 1981, was a massive technological improvement. Valium can linger in the system for as many as 100 hours and had gained a reputation for leaving its users hung over and zombified—“unable to feel warmth, unable to love, unable to cry, to taste, to smell,” as Barbara Gordon put it in her 1989 memoir I’m Dancing As Fast As I Can. Xanax has a similar chemical composition but a much shorter half-life, vanishing hours after it takes effect. It gained a foothold in the anti-anxiety market as a spot treatment; it was indicated for “panic disorder,” which had just been established as a legitimate pathology. But a growing number of Americans found that it worked on quotidian panic as well, the kind that comes with a child’s disappointing, future-ruining report card or an intimate dinner party at the home of the person who signs your paychecks.

Benzodiazepines also got a boost from the Prozac era. Though new research has raised questions about their efficacy, SSRIs revolutionized the way people sought and received treatment for minor mental illnesses. Before Prozac, a person with low-grade depression or anxiety would turn to talk therapy, which was expensive, time consuming, and not necessarily effective; another treatment was a family of drugs called tricyclics, which could have nasty side effects. After Prozac, that same person could take a much safer pill, and that pill could be procured with a simple visit to the family doctor. So even though doctors and drugmakers continue to recommend drug therapy together with talk therapy, people with minor mental illness have over the past ten years increasingly sought help from drugs alone. A study published in the journal Psychiatry in 2008 showed that 55 percent of all prescriptions for benzodiazepines were written by general practitioners, and according to the National Institutes of Mental Health, people in treatment for psychological problems now spend half their budgeted dollars on drugs and less than a third on therapy. In 1997, those ratios were reversed.

It may be that this moment in history justifies an increased use of benzos. Ronald Kessler, an epidemiologist at Harvard University, does sweeping, long-term studies for the National Institutes of Health. He has found that a quarter of Americans will have a diagnosed episode of anxiety—generalized anxiety disorder, panic, phobias, post-traumatic stress disorder, obsessive compulsive disorder—in their lifetimes. That number, he says, hasn’t changed in decades. But Kessler’s research doesn’t account for the blips he calls “situational anxiety,” which come with tough times: an underwater mortgage, a diminished retirement account, or a child deployed in a foreign war. A benzodiazepine, says Kessler, could be a reasonable answer to “a terrible situation.” Just as the exhausted new mother of a colicky 3-month-old might drink two cups of coffee in the morning instead of one, so might a banker facing the wrong end of a “strategic restructuring” pop a Xanax before an encounter with the boss. “This goes beyond the science,” says Kessler, “but it could be that a pharmacological solution is the smart thing to do.”

The question, then, is one of degree. The crises people face in these early months of 2012 are individual and circumstantial, yes, but they’re global and abstract as well, stemming largely from the haunting awareness (it’s certainly haunting me) that the fates of everyone in the world are intertwined and the job of protecting civilization from assorted inevitable disasters seems to have fallen to no one. “Situational anxiety” today stems from threats that are both everywhere and nowhere at once. How will the debtor nations in the eurozone ever manage to pay back what they owe? How can Israel disarm Iran’s nuclear program without inciting the messiest international conflict since World War II? How can you be absolutely, 100 percent sure the cantaloupe you had for lunch wasn’t contaminated with listeria that will make you or your kids or one of your guests deathly sick?

To the point: Do modern realities merit an increased dependence on Xanax? Steven Hayes, a clinical psychologist at the University of Nevada, believes that benzos stop a gap that evolution has yet to fill. As humans try to control an exponentially growing number of inputs with which they are confronted, “our attention becomes less flexible, our minds become more chattering, and the next thing we know, we’re frantic.” Humans are ill-equipped to process or accommodate all these new signals. “Our task now is to create modern minds for the modern world, and that modern mind has to be psychologically flexible.” In the absence of that flexibility, Hayes says, people need a bridge—a pill—between what life doles out and what people can realistically handle.

In 1972, a psychiatrist named Gerald Klerman coined the phrase “pharmacological Calvinism” to describe Americans’ tortured love affair with psychopharmaceutical drugs. Klerman was writing at the height of the Valium era, when its huge popularity lived alongside the perception, fed and perpetuated by the nascent feminist movement, that the pills were creating a generation of robot wives—numb, unfulfilled suburbanites forced into domestic servitude by the men who ran things, including the pharmaceutical companies. “You wake up in the morning,” wrote Betty Friedan in The Feminine Mystique, “and you feel as if there’s no point in going on another day like this. So you take a tranquilizer because it makes you not care so much that it’s pointless.” As fashionable as it was to take the pills, it was also fashionable to blame them.

On the one hand, Americans love convenience and scientific progress and thus herald drugs like Miltown and Xanax as miracle cures (like the washing machine or canned spaghetti) for the travails of modern life. On the other, Americans value self-­reliance and authentic experience and regard dependency on chemicals as weak. Especially in this era, when entire sectors of the population have devoted themselves to eating organic and giving birth without painkillers, when otherwise sane parents decline to vaccinate their children against fatal diseases, chemical purity is held up as a sacred shield against future environmental cataclysm and failures of personal health.

Benzos sit at the locus of all this ambivalence, the love and the loathing often bumping awkwardly together within the same person. The same people who rely on Xanax, joke openly about it, and share it with friends refuse to identify themselves on the record for fear of reprisal from colleagues and bosses (who, they tell me, are using it and joking about it as well). The same kinds of people who shop at the Park Slope Food Co-op, that high temple of food purity, also take the occasional Xanax to chill out. “Coming to the co-op and doing something that is easy and meeting people actually helps me relax (no Xanax needed!),” one member opined about her work shift on Yelp. The inconsistency dwells even in my own self: As I write this story, I keep wanting to insist upon my physical and mental health and the lightness of my benzo habit. I spin, I do yoga, I eat lean meats and vegetables. I take half a tablet of Ativan every three weeks. At most. Honest.

A friend of mine had dental surgery recently, a procedure she both hates and fears. So proud was she that she’d sworn off Klonopin that she decided to forgo the medication ahead of her dental appointment. “I thought, Don’t be a baby. That’s just weak. You should be able to handle things.” She had a panic attack in the chair and was “a total bitch,” she says, to the dentist. “Oh, wait a second,” she reminded herself as the drill whined and the tooth dust spattered, “there’s a medical reason for these things.”

Psychologists wish people wouldn’t take so many benzos and, especially, so much Xanax. “Surely it can’t be right that this level of pharmaceuticals makes sense,” says Hayes. Partly they say this out of professional obligation. Tone’s book refers to Xanax as “the crack [cocaine] of the benzodiazepines.” Its short half-life can mean disaster for people who use it daily: They crash as the drug is wearing off and immediately yearn for more. “The withdrawals are the worst (put me in the hospital),” reads a posting on a drug-rehab website. “Find something else to do like pot or beer.” Dr. Peter Breggin, who crusades against benzodiazepines, pointed out in an editorial in the Huffington Post after Whitney Houston died that even short-term use of Xanax can make people more anxious than they were before and that sporadic use can cause what he calls “medication spellbinding”: impaired judgment, loss of memory and self-control. “I have all these mixed feelings about psycho­pharmaceuticals,” says the friend who, like me, stole drugs from her deceased mother. “Messing with your brain chemistry isn’t something to be taken lightly.”

But the anti-benzo psychologists are also making a value judgment. They believe Americans would be better, and healthier, if they learned to manage their anxiety without pills. They believe people should feel their feelings. A pill can be a crutch, says Doug Mennin, an anxiety specialist at Hunter College who does private therapy for the functionally anxious. The more you use it, the less able you are to navigate life’s tough spots on your own. “I’m a New Yorker,” says Mennin. “I see dependency on pills all the time. What I say to clients is, ‘You’re selling yourself short a little bit.’ If you’re going through a stressful time, and you say, ‘I’m going to get some of these,’ then the next time you get to that kind of problem, you start seeking out that pill. If you didn’t have the pill, you’d probably be okay.” The mind is a muscle, Mennin adds. With practice, you can teach it to handle anxiety: “It’s the same kind of skill as learning a better backhand in tennis.”

Mennin, Hayes, and other anxiety researchers are excited about a new kind of treatment that seems to work even on ­therapy-resistant worriers. It’s called “acceptance therapy” or “mindfulness therapy.” Instead of trying to show a worrier how his anxiety is irrational, ill-founded, overblown, or corrosive to his physical health, intimate relationships, and personal happiness (the protocol in conventional therapies), the therapist instead endeavors to teach him to regard his anxiety with the cool dispassion of a Buddhist monk. Thus the patient doesn’t get “entangled,” as the shrinks say, with his anxiety. He doesn’t try to flee from it. Nor does he try to evade or suppress it. He sees that it’s there but resists the urge to respond to its call: to pick up the phone, turn on the computer, check the e-mail, eat that bag of cheese puffs, pour another drink, take that pill.

“If you can train people to be more in the present moment, they may be less worried about what could happen in the future. The idea is to be accepting of what your experience may be, whether it’s anxiety or sadness or boredom,” says Susan Evans, a professor of psychology and clinical psychiatry at ­Weill Cornell Medical College. “It may feel this way now, but it won’t feel this way an hour from now, a day from now, a month from now.” Evans teaches “mindfulness-based stress reduction” to groups on the Upper East Side. The cost of the training is $600 for eight two-hour sessions.

It turns out that I am afflicted not just with pharmacological Calvinism but with mindfulness skepticism as well. For while I believe, in theory, that learning to coolly regard my anxiety as a purple, hairy monster I could stash in my tote bag, as Mennin suggests, might steady my pulse on sleepless nights, I am suspicious of any cure that requires more effort and expense on my part and more hours away from my work and my family. In this skepticism, I am like my anxious peers. “We go through rough patches, and we do things that make us feel better,” says Lisa Colpe, an epidemiologist at the NIMH, with the vocal equivalent of a shrug. A lot of people with anxiety would simply prefer to live with it; they know that when it becomes unbearable, the drugs will be there.

A cure isn’t what the PR executive with the occasional Klonopin habit wants. “My own personal experience is that there’s a healthy level of anxiety, and I don’t believe ‘healthy’ is the absence of anxiety,” she says. “I live in a world that puts unreasonable demands on me, and sometimes I need help. I wish I could do it without the pills, but I can’t.”

The real love affair, then, is not with the pills but with the anxiety itself. Anxiety is like the spouse you’re stuck with for better and worse, who makes you nuts but has permeated your cells and without whom you cannot imagine your own heart beating. Anxiety lives with you day and night, holding your hand and nudging you to act, urging you to get up, do more, fix something, make something. Never satisfied, always pressing, it wants you to win, to outlast the others, to impress, excite, excel, astonish. And, as in a marriage, you comply, mostly agreeably, for your anxiety traces the rhythm of your life. Then one morning, it has you by the throat and you find yourself weepy and overwrought, unable to respond to its call. Like a reliable friend, Xanax is there, offering an intermission, the gift of quietude, a break. Because the truth is, and I’ll speak for myself here, I want tranquillity once in a while. But I don’t want a tranquil life.

CHILL-PILL MATCHMAKING
FOUR ANXIOUS ARCHETYPES AND THE DRUGS THAT MIGHT SUIT THEM.*

*All examples here assume low dosages. Case histories of real people are of course far more detailed and nuanced than these hypotheticals; those vagaries, along with physicians' preferences, mean that actual prescriptions will definitely vary.

Image and video hosting by TinyPic
Image and video hosting by TinyPic



I thought given all the governmental and media fearmongering, economic and political uncertainty, along with general societal disdain for mental illness (as well as dealing with emotions in general) that occurs, _P would find this interesting.
layweed 11th-Apr-2012 02:08 am (UTC)
Somewhat related, and also because it's been all over the news for the last week, an Austin PD police officer was shot early Thursday morning by someone who had been depressed and had been under the influence of Xanax and tequila. I overheard on the news that a few attorneys questioned by the local news said they should "put Xanax on trial" because..well..here's the quote:

"I just think that Xanax should be on trial whoever defends this case should put Xanax on trial," said Turner. "Xanax is a bad drug. It is over prescribed… It's a dangerous drug."

Here's the rest of the story: http://www.myfoxaustin.com/dpp/video/Friends-of-Suspect-Blame-Xanax-Alcohol-for-Shooting-of-Officer-20120409-ktbcw#axzz1rh3ssoYh

Edited at 2012-04-11 02:08 am (UTC)
chasingtides 11th-Apr-2012 02:14 am (UTC)
As someone with a (formerly active) benzo addiction, I didn't read this in its entirety. However, I do hold that the whole situation (but particularly the beginning, with taking other folks' meds) is hugely problematic, as is the whole prescribing en masse issue.
lux_roark TW-Suicide11th-Apr-2012 02:15 am (UTC)
I have PTSD induced panic attacks regularly following my mom's suicide. Ativan was something I took twice a day to control it, but my psychiatrist figured that Xanax would be a better option since it works faster and calms me down faster from the panic attacks. I only take 0.25-0.75mgs every 8 hours at the most. I generally only need it once every other day unless it's a particularly stressful day. I found that after I was diagnosed with schizoaffective disorder depressive type it was a lot easier to get a prescription for a benzo than when I was only considered having a history of depression and PTSD.

Edited at 2012-04-11 02:16 am (UTC)
romp Re: TW-Suicide11th-Apr-2012 06:20 am (UTC)
Were SSRIs considered or was the idea to get something that was stronger and would make a difference faster? Just curious. I've wondered how the 2 are used--seems like one is long-term and one short-term...
morgondag 11th-Apr-2012 03:03 am (UTC)
I've been on Xanax, on lots of Xanax, and drunk while on Xanax. None of those things helped me in the tiniest little bit with anxiety/panic attacks. Apparently, that's not normal. What is wrong with my mind? (Just asking myself, not expecting answers, here.)
violetrose 11th-Apr-2012 03:30 am (UTC)
One medication won't work for everyone. Prozac works for many people, but I found it did nothing but make me feel tired, lethargic and more depressed than when I started.

I'm on Citalopram now (I had it prescribed by a ward Psychiatrist after a brief time in hospital), and it works so much better than the Prozac ever did.
bestdaywelived 11th-Apr-2012 03:05 am (UTC)
I think that these medications are great for the people who need them. I despise doctors who will throw anxiety medications at anyone who asks, and people who will steal other people's medications.

I have several law school classmates who take Ritalin during the day, and then Xanax to sleep. They think that it's funny (and they have a huge competitive advantage over those of us who don't take Ritalin for its concentration benefits, honestly), but I don't.
endlos_schleife 11th-Apr-2012 03:28 am (UTC)
there seems to be quite a few people on my college campus who take adderall to finish their work load. I admit, the workload at my school is insane at points but that doesn't permit the use of prescription meds, especially if there are someone else's.
i_amthecosmos 11th-Apr-2012 03:12 am (UTC)
I am bipolar and Klonapin is just one of several drugs I take to regulate moods, eliminate anxiety attacks and let me get some damn sleep. I am also a recovering alcoholic, and I've never been tempted to abuse the Klonapin. I wouldn't take Xanax-it's bad for someone in my situation.

I know a lot of people in AA and related groups would question my soberity because of taking the Klonapin, but functionally it does far more good than harm.

The last time I skipped a dose I had the mother of all anxiety attacks, complete with auditory hallucinations. But I'd had those before, so I don't think it was withrawal. Maybe not.
silver_sandals 11th-Apr-2012 03:21 am (UTC)
I suffer from chronic anxiety and depression and am on medication for both of those and... I don't think I can really analyze this article with the right distance? It's just too emotionally tied to ableism for me. I'm sure it's making some very valid points. All I can say is that klonopin has worked really well for me- I take it when I can feel a panic attack coming on and it really helps.
muppetfromhell 11th-Apr-2012 04:15 am (UTC)
seriously.

Before I went on Zoloft I was in a position where I was crying at work at least once a week. I was very very against drugs because it felt like giving up on working through my issues.

Now I haven't cried at work in 2 months and in similarly stressful situations, without the unwanted physical reaction taking all of my focus, I am able to function well enough to mentally work through it and find reasonable solutions.

In other words, fuck this shit.
violetrose 11th-Apr-2012 03:41 am (UTC)
The idea of prescription drugs like benzodiazepines/tranquillisers being given out like sweets is weird to me. It was very common in the 60's/70's (the whole 'mother's little helper' phenomenon).

Maybe they are prescribed too often - but a lot of mentally ill people can rely on various medications due to lack of other available resources (like Psychiatrists, nurses carers, etc). Not to mention the fact that modern society is very isolationist and has a huge 'every man for himself' attitude, which I think has definitely contributed to a lot more people feeling lonely, depressed and anxious.

Of course, there's also the fact that we understand mental illness and health a lot more now, even if it isn't an exact science, and people are becoming less ashamed to admit that something is wrong.
i_amthecosmos 11th-Apr-2012 03:48 am (UTC)
My pharmacy makes me show my ID to get my Klonapin now. I don't blame them since benzos are so misused.
mollywobbles867 11th-Apr-2012 03:51 am (UTC)
I refused to take a Xanax right after my dad died, but now I wish I had. Over the span of three days, I had a total of 9 hours of sleep. I don't think it would have prevented my nervous breakdown and severe depression, but who knows? It may have made going back to work bearable and I wouldn't have had to resign.
mirhanda 11th-Apr-2012 04:20 pm (UTC)
I had the same sort of reaction when my dad died. Also, not eating for about a week. *HUG* That's a hard thing to go through.
fenris_lorsrai 11th-Apr-2012 03:51 am (UTC)
I had a scrip for Xanax due to having horrid panic attacks that would have me throwing up for thirty minutes at a go with heart palpitations. FUN.

I fucking hated it because I was so underweight that it was very easy to go from "lets not start the day with puking" to "its 3PM I should get dressed." tiny little difference in dosage and its zombietime.

I managed to take too much at one point right before game session and made me feel dizzy. so I lay down on the floor. "I'll get up in a minute!" My roommate and friends decided to leave me on floor for the evening and had game session punctuated about every twenty minutes with "I'm getting up in minute! I swear!" They were worried, but figured if I was laying on the floor and responsive where they could see me was better than putting me to bed where they couldn't see me and I MIGHT actually get up and hurt myself. Or fall out of bed. you alright down there? I'm getting up in a minute. sure you are.

They were playing Call of Cthulhu so the occasional "I'm getting up! I swear!" was apparently amusingly thematic. Cthulhu is rising soon. and sounds a lot like Fenris.

(and in case its unclear, I was totally cool with that. I'd rather have five friends sitting nearby making sure I was fine while they doing something else than having gotten hauled upstairs to be alone while too impaired to even get up)
mellieebelliee 11th-Apr-2012 04:27 am (UTC)
I got too anxious about my anxiety medication (not xanax) to take it so I never did. It actually kinda makes me lol at myself tbh.

Edit: Still have anxiety though so that sucks.

Edited at 2012-04-11 04:28 am (UTC)
silver_sandals 11th-Apr-2012 04:47 am (UTC)
Oh wow that really does suck, I'm so sorry.
nyxelestia 11th-Apr-2012 04:33 am (UTC)
I think a lot of this is tied into a broader culture of not teaching people, especially kids, how to handle shit in their lives.

I'm not doubting there are people who genuinely need these, who have serious disorders that can really only be treated with drugs.

That said, I see way more people take them because our culture insists everything and everyone is always good and happy, and thus people never learn how to handle the bad and downright shitty things in life. It's like the cultural-emotional version of what helicopter moms do to their kids - yeah, in the short run, they seem to be "helping" their kids, but in the long run those types of parents are just disabling their kids.

You're allowed to be sad, anxious, nervous, angry, and you don't always need to have a specific, solid reason for it. Unfortunately most people learn that too late, if at all, and they take drugs because they do need them - not medically, but psychologically, because our culture has been emotionally crippling all of us from the start. D:
silver_sandals 11th-Apr-2012 04:47 am (UTC)
Yeah, I would say that even if my medical conditions are caused by effed up brain chemistry, those cultural norms certainly have not helped. Both drugs and training myself to think differently than society has taught me has been necessary to get myself better.
foureyedgirl 11th-Apr-2012 05:11 am (UTC)
ugh sorry but just fuck this article. As someone who has suffers from anxiety/anxiety attacks for over a decade (if not more as a kid) and who has been prescribed Xanax in the past year, I am grateful for it. I'm in a really bad patch in my life right now, and I've never had more panic attacks than I've had in the past few months. Sometimes they are so bad that my entire day's dose allotment (small dosage to begin with) just slightly takes the edge off. And even so I am thankful for that. I don't have the luxury to sleep the attacks off anymore.
mycenaes 11th-Apr-2012 04:19 pm (UTC)
I hope you can feel better (if only a little less anxious for the time being), and I'm glad that there's drugs out there that can help you.
per_simmon 11th-Apr-2012 11:38 am (UTC)
I have a really hard time with writing about anxiety/depression where the starting premise is "there are people who really need these drugs, but then there are people who are just taking them because they're too weak/lazy to handle their own shit, and fuck them!"

That is exactly what I told myself for years before I started taking antidepressants, and what the people around me who also manage depression told themselves. There is a huge amount of cultural shaming surrounding needing psychological/psychiatric help, and this keeps people who are in pain every single day from getting help that is available to them. I feel like this article is contributing to that, particularly in the paragraph where the author says that anxious people secretly love their anxiety.

I tried for years to try and manage my depression and anxiety on my own, by limiting my activities, exercising, diet, talk therapy- and nothing worked. I still had panic attacks, severe nightmares, trouble leaving the house, I was unpleasant to my loved ones (just because I was expending an enormous amount of energy on just getting through the day)..When I finally started taking Cipramil the relief I felt from just not having to deal all day was enormous. And it wasn't nearly as hard to get out of the house and do the things that I knew were good for me as a result.

That's not to say that a healthy lifestyle or talk therapy aren't helpful- they're crucial. But sometimes they're not enough, or they're not available (or frigging expensive), or can't be accessed when you're incapacitated with what you're dealing with. And articles like these are *not helpful* for people who are looking for relief from very real and serious problems.

That said, I'm going to check out The Age of Anxiety, because it sounds like an interesting read.
planetariium 11th-Apr-2012 01:38 pm (UTC)
Seriously, this. All of this. I don't think people realize just how dangerous the rhetoric in this article can be. It's not enough to say, "oh and also some people do really need these drugs because they have actual mental illnesses" but then continue to focus on the people who misuse/abuse the drugs. Because that just further pounds into everyone's heads that psychiatry is a joke and psychiatric treatment is for those who are weak and lazy. That idea is internalized by everybody, because that message is everywhere, meaning that people with mental illness - the people that need these treatments - believe it about themselves, or just end up not even getting treatment because of what they think it would say about themselves. It's such a dangerous message.
pseudovirus 11th-Apr-2012 02:52 pm (UTC)
i would probably be agoraphobic without my benzos. anxiety's been a life-long battle for me and it got worse when i was 18-19... panic attacks are the worst. i'm in treatment, have done CBT, read a kajillion books, but idek, nothing will calm me down like benzos do, or even better: cannabis, but that's an entirely different article... and SSRIs have never worked for my anxiety, but they never helped with my depression either (finally had a breakthrough their with the enSAM patch; i was manic and had insomnia for a month and a half but now i think i've leveled out and am like "normal" and possibly not even dysthymic for once in my life).

i just wish they didn't have the tolerance problems that they do, and the abuse. i know waaaay too many college-aged people who take xanax or whatever they can get their hands on just to relax. and a lot of them mix it with alcohol, and i'm just...dumbfounded.

but i was on 2mg of generic time-released xanax for a couple years and then i hit a wall, and my psychiatrist wouldn't up it... i wasn't able to freaking get out of my car and go to work or school, and i had to freaking suggest to him to give me a different benzo and we settled on klonopin because it stays in the system longer blahblah. i'm at a different place now because he was completely incompetent, he had me on freaking lithium and i've never shown any signs of being bipolar, and all it did was give me daily suicidal thoughts for half a year.. ugh.

i like klonopin tho because it takes away my appetite, as opposed to the xanax that just made me eat everything always. but i'm up to 3mg of klonopin now--- i don't take it every day, but there are some days where i need more than the 3mg just to calm down enough to get out of the house. i.hate.anxiety. but i am so thankful that these medications exist. yes, they're abused, but so many people wouldn't be functional without them..
mycenaes brief mention of blood & needles (figured I'd warn just in case)11th-Apr-2012 04:32 pm (UTC)
I'm prescribed Ativan because when I go to get my blood tests, I faint and then have a seizure, womp (having a seizure after fainting is apparently more common than one would think? Idk, that's what I was told). I haven't taken it yet (my blood test--for the Abilify I also take--is on the 21st of this month), but I really hope it works, because fainting sucks.

And yeah, the fainting/seizures definitely is linked to my phobia of blood and needles, bleh. I'm glad that anti-anxiety meds exist, at least for me and my issue, not to mention what other people have said about their anxiety/panic attacks.
spiffynamehere 11th-Apr-2012 09:25 pm (UTC)
I hate hate hate articles that are about how ~people overprescribe meds~ and that's such a huuuuge problem, because is that seriously worse than perpetuating the idea that most people taking them don't need them? -_-

(it doesn't help that I'm going to my doctor tomorrow and have been having mood problems despite a recent increase in medication, and I'm kind of scared that he'll give up on me because before he decided to try Lexapro, he was kind of going "well, we've tried SSRIs and an anti-anxiety and they're not really working, maybe this is just situational" and D:)
kaowolfie 12th-Apr-2012 08:08 am (UTC)
..."just situational"? Why didn't he just ask you if you were hysterical while he was at it? Jesus. Situational depression has made me suicidal before. "Just" situational?
paulnolan 12th-Apr-2012 12:03 am (UTC)
Never been on Xanax, but when I decided I could go sans-meds last year (lol I never learn...) and ended up in a pretty bad state I got a short-term script for Valium. It did wonders for me the short time I was on it but the doctor's reticent to give it to me long-term because of the whole addictive thing (as if that even matters - I'm going to be medicated for the rest of my damn life anyway). -_-
saiita 12th-Apr-2012 01:35 am (UTC)
I was prescribed Xanax (Panic Disorder/Agoraphobia & Depression) for a 2 week trial after Klonopin (1 mg split into .5 tablets) because the latter makes me feel rather drowsy, but Xanax didn't do a thing for me. Hell, I felt worse when on Xanax because it did nothing for my anxiety at all. If anything, I'm kinda thankful for that and being put back on Klonopin, after hearing the horror stories surrounding Xanax. :/
chicklet22 12th-Apr-2012 08:25 am (UTC)
I think it depends what country you are in. I live in New Zealand and although Xanax is on the pharmaceutical schedule, nobody seems to take it. I know lots of people on all sorts of psych meds, but I've never met anyone in this country on Xanax. Its considered too addictive. The medical boards here say that nobody is supposed to be on benzos for more than three weeks at a time.

But I know lots of people in the states who are on benzos every day for years at a time...
bleakwinters TW: depression, anxiety, suicide, sexual assault12th-Apr-2012 02:07 pm (UTC)
I have had depression for the last 12 years of my life. Partly brought on by my relationship with my mother and the constant pressure of having to do well in school. It has triggered anxiety in me and the fact that I survived several sexual assaults hasn't done anything good for it.

I'm in the UK, and I'm prescribed Fluoxetine (which I'm told is the same as Prozac). I have to up my dose last year, from 20mg/day to 40. I don't take it daily, because 40mg makes my brain fill with cotton, but it helps my depression. My anxiety, however, is at an all time high. I fear leaving the house. Going to interviews makes me sweat and gives me nightmares. I am constantly worrying, to the point of not eating and contemplating suicide. I am booked for some CBT soon, but I may bring up the topic of benzos with my counsellor. I am done feeling like this and I want to be able to have a job that doesn't make me ill all the time.
sammet 19th-Apr-2012 12:46 am (UTC)
I suffer from Generalized Anxiety Disorder and I eat something called paroxetine to help with that and social phobia. It worked pretty well in the beginning, but after 7 months or so I had to double the dose since it was completely wearing off. Not-so-surprisingly, it started working again and now I'm once more at an all-time low. I've been in contact with my doctor lately, so we're working on getting me something else soon, but I don't think medication on its own will help me and I've had really scarce counselling. :s
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