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Mental Health (Expert Forum)
Concern about Xanax Use
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
Concern about Xanax Use
by befille, Oct 11, 2005 12:00AM
I'm a 40 year old female, and I take anti-anxiety meds on an as-needed basis. I recently switched to Xanax .5 mg from Klonopin 1 mg. My doctor made the change because I didn't find the Klonopin as helpful as Xanax, which I'd taken briefly about a year ago. Much of what I've read about Xanax is... scary. But I find it very helpful. I mainly want to know if I should worry about becoming dependent and what steps I can take to make sure that doesn't happen.
On average I would say I take one or two of the pills maybe 2 or 3 times per week. Sometimes a week or more will go by without my taking them at all. Other times, if things are bad, I may take them two or three days in a row.
I'm not sure if my issues with anxiety are genetic or environmental (or even whether that matters). My mother was on anti-anxiety meds for about as long as I can remember. The last several years of her life she was taking Ativan and Paxil. Her sisters have also had long histories of anxiety problems and anxiety meds as well. As for environmental factors, I have dealt with a series of traumas over the course of my life that I'm guessing might have taken a toll. During one stretch of 6 years, my sister and her daughter were killed in a car wreck, my father died of a heart attack, my brother was paralyzed in an accident, my mother attempted suicide and we lost our family home to foreclosure. That all happened before I was twenty (ages 13-19). Three years ago, my mother suffered a heart attack and stroke and was unable to care for herself because of physical limitations and dementia. I moved her into a nursing home and was her primary caregiver. She died last year after a protracted hospital stay. My brother, who is a paraplegic, lives with me. He doesn't need me to physically care for him, but I am his sole financial provider.
It has only been in the last two years that I've needed anti-anxiety meds. Before then, I had tried a number of anti-depressants (Prozac, Effexor, Lexapro, Wellbutrin). I started taking anti-depressants because I have so much trouble staying focused and concentrating on my work but I either felt no better on them or felt like I was in a fog. Eventually I gave them up. In the last couple of years anxiety has become a real issue. Things knock me for a loop more easily now. Often there is no real trigger for my anxiety. I just suddenly feel like my stomach is in knots and have this awful pervasive feeling that something is very wrong, like something bad is about to happen. During these times, I'm unable to concentrate on my work and it's difficult for me to deal with people. I avoid the phone (it startles me just to hear it ring) and generally avoid dealing with anything. Taking the meds really helps take the edge off and allows me to calm down and work.
Like I said, my real question is whether my Xanax use (a couple of times a week) sounds reasonable and/or healthy, or if I need to be concerned about addiction.
Thank you for any help/advice.
On average I would say I take one or two of the pills maybe 2 or 3 times per week. Sometimes a week or more will go by without my taking them at all. Other times, if things are bad, I may take them two or three days in a row.
I'm not sure if my issues with anxiety are genetic or environmental (or even whether that matters). My mother was on anti-anxiety meds for about as long as I can remember. The last several years of her life she was taking Ativan and Paxil. Her sisters have also had long histories of anxiety problems and anxiety meds as well. As for environmental factors, I have dealt with a series of traumas over the course of my life that I'm guessing might have taken a toll. During one stretch of 6 years, my sister and her daughter were killed in a car wreck, my father died of a heart attack, my brother was paralyzed in an accident, my mother attempted suicide and we lost our family home to foreclosure. That all happened before I was twenty (ages 13-19). Three years ago, my mother suffered a heart attack and stroke and was unable to care for herself because of physical limitations and dementia. I moved her into a nursing home and was her primary caregiver. She died last year after a protracted hospital stay. My brother, who is a paraplegic, lives with me. He doesn't need me to physically care for him, but I am his sole financial provider.
It has only been in the last two years that I've needed anti-anxiety meds. Before then, I had tried a number of anti-depressants (Prozac, Effexor, Lexapro, Wellbutrin). I started taking anti-depressants because I have so much trouble staying focused and concentrating on my work but I either felt no better on them or felt like I was in a fog. Eventually I gave them up. In the last couple of years anxiety has become a real issue. Things knock me for a loop more easily now. Often there is no real trigger for my anxiety. I just suddenly feel like my stomach is in knots and have this awful pervasive feeling that something is very wrong, like something bad is about to happen. During these times, I'm unable to concentrate on my work and it's difficult for me to deal with people. I avoid the phone (it startles me just to hear it ring) and generally avoid dealing with anything. Taking the meds really helps take the edge off and allows me to calm down and work.
Like I said, my real question is whether my Xanax use (a couple of times a week) sounds reasonable and/or healthy, or if I need to be concerned about addiction.
Thank you for any help/advice.
Doctor's Answer
by Roger Gould, M.D., Oct 16, 2005 12:00AM
, Oct 16, 2005 12:00AM
At the level of usage you described, you will have no problem. but if you rely on it every day, and increase the dose, you are in the trouble zone, and xanax is a nasty addiction, so monitor yourself closely.
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Just to be sure you aren't missing anything...have your thyroid antibodies checked which will indicate whether you have autoimune thyroid disease (Hashimoto's).
This is what caused my anxiety and it was gone within two weeks after starting thyroid hormone.
Thyroid disorder is well known to cause psychiatric disorder...and often Hashimoto's presents with psychiatric symptoms even before thyroid labs go out of range.
I'm always on the alert for missed cases of this - because of my own situation...and also because both my mother and cousin's suicide autopsy's indicated they had thyroid disease. Undiagnosed in both cases. Autoimmune thyroid disease has a genetic component and will lead to things like heart failure and severe memory and cognitive disorder if not detected and treated.
Don't be too hard on yourself. I think you need to give yourself time to heal from it all. Who wouldn't be depressed and/or anxious given everything you have been through?
At one point in my life I was diagnosed with post traumatic stress disorder, and I too, used to be very startled with any type of sudden noise and the phone ringing as well. Perhaps you may have some of that, too. I am fine now, and I'm sure that you will be, too.
Check with your doctor and I'm sure that he/she can guide you with the appropriate dosage of your medication.
Best of luck to you.
I think what is most often missing is utilizing meds and psychological treatment at the same time. Studies have shown that one without the other usually only ends up being a bandaid to the problem..but using both results in a much more quick ability to deal with problems and function normally in society.
I read where Debbie is not happy feeling like a dud and that your husband calls here Debbie Dud and that hurt her feelings. Understand that your husband probably has not idea what you're going through...no matter how much you may or may not tell him he can never understand...it's just impossible...I know at one time I would have never guessed I couldn't control every facet of my life...particularly my mind, but it's best to know that sometimes your life gets the best of you. You need to learn to cope and overcome and that's not always easy.
Debbie, don't let someone's not understanding your problems bring you down or make lose your selfworth. No matter what it is important to understand and find the goodness in yourself. We don't need to be the center of attention or be Robin Williams to impress people...but we do need to love ourselves and find peace with ourself. I think talking to someone qualified to help will give you the fastest results you could imagine in conjuction with meds if needed...eventually you won't need them but possibly the ears of a friend who is willing to listen.
I really hope you are all able to see past these feelings and realize how important you are to those that love you...how important you are to yourself. Life doesn't always feel great...but let me tell you, it can always get better, no matter how dark it appears.