Benzodiazepine withdrawal (frequently shortened to benzo withdrawal) is a group of symptoms that emerge when a patient decreases or stops their use of these medications. Whether prescribed or used recreationally, once tolerance has developed and physical and psychological dependence has been established, the patient will most likely experience some of these symptoms, some of which may last longer than others and vary in intensity depending on the patient’s length of use and the amount they have been using. One of the most common symptoms is rebound anxiety, which means that their anxiety feels much worse than it did prior to starting the medication. So, why does detox from benzos make you more anxious?
How do Benzos Work?
Benzos work by “amping up” the patient’s GABA, a brain chemical that blocks certain communication between nerve cells and the brain. Because low GABA levels are linked to anxiety and mood disorders, many people start using benzos for anxiety relief. In fact, about 5% of adults have been prescribed benzos in the last year, usually as a short-term bandaid during a stressful life event (death of a loved one, divorce, or other traumatic occurrences). Benzos are also often prescribed in people with chronic anxiety for short periods (generally a couple of weeks) while the patient undergoes therapy to learn healthy ways to cope with their symptoms.
However, they also produce compelling “feel-good” and sedative effects that are very appealing to many people, particularly those who struggle with anxiety. Additionally, benzos create tolerance very quickly, especially shorter-acting benzos like Xanax, the result of which is the need to take increasingly higher doses to produce these same effects. This combination creates a perfect storm for dependence to develop.
What Happens During Benzo Withdrawal?
Most benzo withdrawal symptoms begin to manifest within 24 hours of the last dose. They can last from a few days to several months, depending on the strength and quantity of the drug and the length of time it has been used. Early withdrawal symptoms, experienced within a few hours of cessation of the drug, include the swift return of anxiety.
As time away from the drug increases, more symptoms appear, including:
- intense anxiety
- muscle spasms or tension
- nausea, vomiting, and other gastric upset
- mood swings, trouble concentrating, and cloudy thinking
This list is by no means all-inclusive, and every patient is different. However, because of the uncertainty and unpredictability of the number and severity of withdrawal symptoms, it is important to seek treatment when making the decision to stop using benzos.
What is Rebound Anxiety?
During the early stages of benzo withdrawal, the patient can experience any number and combination of the symptoms listed. Even those who have been taking benzos as prescribed can, and often will, suffer from rebound anxiety along with other symptoms.
The “rebound effect” in benzo withdrawal occurs when a medication that had an effect on the symptoms it was being used to treat (whether diagnosed by a physician or as a form of self-soothing or self-medicating) is discontinued. It is characterized by intense waves of anxiety, irritability, panic, insomnia, and other mood disturbances. It can be frightening for patients who have been taking benzos for anxiety, even as exactly prescribed, to be overcome with anxiety and panic. Indeed, rebound anxiety during benzo withdrawal can lead to relapse very quickly. This is why it is important that the patient gets proper treatment and support during withdrawal.
The good news is that help is available, along with support. The need for support and healthy coping skills cannot be stressed enough when it comes to combatting dependence on benzos. As with any other recovery process, the knowledge that they are not alone, that there are people who understand and are willing and able to help, is pivotal to a successful detox and long-term recovery. There are many different treatment options available, and even the most hopeless-seeming cases can and do have successful recoveries. Life after benzos is not only possible, it can be fulfilling and rewarding.
If you’re ready to make a start, you can reach a counselor 24-hours a day by calling 800-737-0933. We’re ready to provide you with the knowledge you need to take the first steps on your path to recovery.