If you have anxiety, there’s a chance you’ve taken a medication like Xanax or Klonopin at some point, in order to better manage your symptoms. And that’s fine. These drugs, which are classified as benzodiazepines, can help relieve symptoms of anxiety by suppressing your nervous system, so that you can calm down and go about your day.
It is important to keep in mind, though, that Xanax and other drugs have side effects — even if you just take them occasionally. The thing is, many people get a prescription and keep a bottle in their pocket for moments when they feel too anxious. But even if you just take a pill "every now and again," you can still experience side effects. And, in many cases, it’s all too easy to become carried away, take too many, and even become dependent on the drug over time.
If you’re going to take drugs like Xanax, it’s important to do so carefully and mindfully — and supplement your anxiety treatment with other things like therapy, healthy amounts of exercise, and plenty of sleep. "The best way to use these medications is definitely under the supervision of your doctor, and being honest with all of your doctors about your prescriptions," Erin Parisi, LMHC, CAP, a licensed mental health counselor and certified addictions professional, tells Bustle. That way, they can plan ahead and make sure you aren’t mixing things that shouldn’t be mixed.
It’s also important to pay attention to how often you’re truly taking these pills. "In my mind, an ‘occasional’ user is someone who gets a couple prescribed before they get on a plane, not someone who takes [pills a few] days a week (or more)," Parisi says. Discuss with your doctor what the correct dosage might be for you, and then stick with it. If you experience any of the symptoms below, or feel like you might be using Xanax or Klonopin in an unhealthy way, definitely tell your doctor or therapist, so they can help you ween off in a healthy way.
Even if you’re just taking benzodiazepines occasionally, it’s easy to start relying on them more and more, and eventually developing a dependence. "Clinically speaking, dependence describes the physical body’s need for a substance… that happens with many different substances — nicotine, caffeine, sugar, alcohol, painkillers, marijuana, cough syrup, Adderall, and yes Xanax, and all of its cousins (Klonopin, Ativan, Valium, Librium, and all of their generics, alprazolam, lorazepam, clonazepam, diazepam, etc.)," Parisi says.
When you’re dependent, you might feel like you need these drugs in order to overcome withdrawal symptoms. But it’s also possible to rely on them, mentally. "From a therapist’s perspective, part of what I don’t like about anxiety medications is that they’re often prescribed on an ‘as-needed’ basis," Parisi says. "What that means for a lot of people is this pattern of ‘I feel anxious, so I take a pill’ over and over, and then it becomes more frequent, and then some people start taking it because they think they’re going to be anxious, or they carry one in their pocket just in case they’re anxious." Once you go down that road, you may need to speak with a therapist about other forms of treatment.
Again, it’s certainly OK to take an anxiety medication when you truly need it, such as during a panic attack or when boarding a plane. But going along with what was said above, if you’re popping a pill each and every time you feel stressed, it’s not only possible to become dependent, but your body may actually forget how to cope with stress all on its own.
When you take Xanax or a similar drug, your "nervous system is being shut off instead of slowing down like normal," yoga therapist Carli Shipley tells Bustle. "Over time this will make [you] even less resilient to anxiety/stress because [you] no longer have the tools to calm down on [your] own."
So, instead of taking a pill every time you feel uncomfortable, it can help to learn how to slow your breathing and relax your body naturally, possibly by walking outside, meditating, or talking to a friend. That way, you won’t need the medication to relax; it’ll just be a supplement for truly tough times.
It’s not unusual to feel foggy-headed when taking benzodiazepines, like Xanax. But they can also cause memory problems — and even may lead to some symptoms that are severe. "Many clients report ‘blackouts’ or ‘losing time’ after taking Xanax," Parisi says.
Of course, extreme situations like these don’t happen to everyone, and won’t happen when taking a small, recommended dose, which is usually around 0.25 to 0.5 milligrams three times daily. But memory problems and brain fog is certainly something to consider before choosing to take an anxiety medication. Always consider your dosage, and make sure that your doctor knows how much you take, so that you aren’t combining the drug with things it shouldn’t be combined with.
Drugs like Xanax or Klonopin can certainly be helpful and safe when taken properly, but it’s important to keep in mind that sedatives don’t combine well with other drugs or alcohol. So, whatever you do, don’t take it before driving a car, or if you plan to have a drink.
"Mixing these medications with other medications or alcohol is … very dangerous because of the synergistic effect," Parisi says. "That means that each substance intensifies the effect of the other. Taking a Xanax with a glass of wine means you’re getting much more intoxicated than either the Xanax or the wine alone, [which can affect your coordination and raise] the risk of falls and injuries, and because both depress the central nervous system." So please, be careful.
Let’s say you take a Xanax or Klonopin once a year when you fly home for the holidays because you hate to fly, and have panic attacks in the airport. That’s fine. As Parisi mentioned above, taking anxiety medication occasionally for anxiety-producing moments in your life is OK, and will not lead to dependence.
But if you take Xanax a few times a week, you can start to build up a tolerance, where you now need 0.5 milligrams, or one milligram to have the same effects. "Even if you’re taking the medications as prescribed, it’s possible to develop a tolerance," Parisi says.
Withdrawal symptoms are different for everyone, and depends on your body and how much Xanax you take. For some people who take benzodiazepines, it’s possible to experience symptoms months later, even after stopping taking the medication.
As Parisi says, "…there’s a ‘post-acute’ withdrawal that can last for months, and includes chronic anxiety, depression, and problems with sleep." So if you’re feeling "out of it" months after the last time you took Xanax, this may explain why.
You might think you’re just taking Xanax "occasionally," but it’s easy to fall into the habit of taking it more and more often — especially since it can make you feel so good.
"The problem arises here because patients have to use their own discretion, which differs from person to person," Dr. Sal Raichbach, PsyD, LCSW, of Ambrosia Treatment Center, tells Bustle. In other words, once you get that bottle in your hands, it might be tough to only use it "occasionally."
And this is especially true if you aren’t taking other measures to cope with your anxiety, such as seeing a therapist. "If [your] anxiety gets worse, it opens the door for overuse and potential misuse," Dr. Raichbach says. "Dependence on drugs like Xanax, Klonopin, or Valium can develop quicker than most people think."
Since many anxiety medications have dizziness as a side effects, it’s important to take it easy until you know how your body will react. "Benzodiazepines, such as Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), or Valium (diazepam), have the potential side effects of … dizziness, [and] ataxia and dysarthria (difficulty with movement and speech)," Danielle J. Johnson, MD, of the Lindner Center of HOPE, tells Bustle. "Side effects can occur with occasional usage … so caution needs to be taken with activities such as driving."
Anxiety medication is helpful in that it eases you out of a worried states, and helps you relax. And that’s wonderful. But if you aren’t used to the drug, or you happen to take more than prescribed, it can lead to feelings of disinhibition — which is exactly what happens when you get drunk.
"Disinhibition is a potential side effect of medications like Xanax or Klonopin," board-certified psychiatrist Nicole B. Washington, DO, MPH, tells Bustle. "The brain reacts to these medications just as it would to alcohol so if you are a person who is disinhibited with alcohol, you might have a similar reaction with one of these drugs."
This is just something to keep in mind before taking this type of drug, so you can keep yourself safe. You might, for example, want to take it right before a job interview, if you want to be on your game.
If you’re taking a benzodiazepine in order to relieve anxiety and get through your day, do keep in mind it has the power to knock you out. "If you take a benzodiazepine occasionally, and you are not used to it, the most likely thing that will happen is you will feel tired or very drowsy, because it is a sedating drug," Kimberly Miller, PhD, a neuropsychologist and director of Healthy Mind Sacramento, tells Bustle. Some people feel so drowsy and relaxed that they fall asleep, which is obviously not what you want when out and about in the world.
Believe it or not, taking a benzodiazepine can actually make you feel more anxious. "Benzodiazepines can have a paradoxical reaction in [less than one percent] of all people who take them," Miller says. "This can include: feeling more anxious, getting very talkative, feeling restless, having excess energy or movements, feeling agitated, getting hostile, and in very rare occasions psychosis. In general, the risk of paradoxical reactions is upped if you are mixing the drug with alcohol, [or] taking a high dose."
If you need to take a drug like Xanax, don’t worry — it’s usually safe, and if taken correctly, will not lead to unwanted side effects. But it may not be the first thing you want to take when it comes to treating anxiety. "Overall, [benzodiazepines] are not considered a great first-line medication for anxiety anymore because they are physiologically addictive," Miller says. "You can take them for a week or two in a crisis situation, but they should not be taken long-term. Most people with long-term anxiety are prescribed a class of medications called SSRIs, which are much safer." And can be taken every day, long-term, without these same side effects.
So if you’re feeling anxious, and it’s impacting your life, definitely speak with your doctor to find out which course of treatment is right for you. They might suggest you take something like Xanax for short-term, something for long-term, such as an SSRI, or that you simply need to go to therapy. As long as you follow their instructions, you’ll be a-OK.
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