Can Benzos Cause Anxiety?

woman wearing a mask looking out of a window

Millions of these drugs are prescribed each year. Classified as sedative-hypnotics, they have an effect on the central nervous system very similar to alcohol.  The withdrawal symptoms and side-effects of benzos are similar to those found with alcohol and barbiturates. The potential for abuse and dependence is very high.

For the past 50 years, benzodiazepines (AKA benzos) have been the premier treatment used for anxiety disorders. Popular benzos include:

• Alprazolam (Xanax)
• Lorazepam (Ativan)
• Clonazepam (Klonopin)
• Diazepam (Valium)
• Temazepam (Restoril)
• Chlordiazepoxide (Librium)
• Clorazepate (Tranxene)
• Flunitrazepam (Rohypnol)

How Benzos Work

In the simplest terms, benzodiazepines stop the brain from producing fear. They do this by interfering with the gamma-aminobutyric acid (GABA) system. This system is a set of chemical receptors in the brain which absorb GABA. When GABA locks into these receptors, they inhibit the ability of the amygdala to generate flight or fight responses. This, in turn, reduces anxiety, creating a sense of calm.

While drugs that interact with the GABA system are very effective at treating problems like anxiety, insomnia, panic and seizures, they also have a wide range of side-effects.

The Dangers of Benzodiazepines

Increased anxiety is one of the long-term problems that come with benzo use. Because these drugs inhibit anxiety in the short-term, they alter the natural brain chemistry of the user. The brain then becomes reliant on the drug to stop the fear reactions, and produces less GABA on its own. With GABA levels reduced, the person needs the drug to regulate their mood, since the brain is no longer able to do it without chemical assistance. The result is a person who requires increasing amounts of the drug to achieve the same effect. Without it, their natural fear levels become overwhelming.

Besides the increase in anxiety, benzos also carry a host of other problems, particularly when abused. They can cause depression, lack of motivation, delirium, aggression, amnesia, hallucinations and paranoia. By inhibiting brain function these drugs also slow reaction times, reduce the ability to think rationally and cause slurred speech. When combined with alcohol or opioids they can suppress the ability to breathe, quickly leading to death.

Dependence, reliance and abuse are also common with benzos, particularly among individuals who already have a tendency to misuse substances. Because the euphoric effects are so similar to alcohol, the allure to use these drugs recreationally is profound.

Withdrawal from benzodiazepines is also extremely difficult. Since the drug reduces fear, fits of extreme panic, terror and hostility are common because the fight or flight response is overactive. Sleeplessness, physical discomfort, agitation and a sense of impending doom frequently plague users.

Getting Off Benzos

There are severe emotional aspects of withdrawal. Therefore, quitting benzodiazepines without assistance is not recommended. It is strongly suggested to have a therapist, along with other major sources of support. Medication-assisted treatments (MATs) can help reduce or eliminate withdrawal symptoms. Anti-depressants are nearly as effective at reducing anxiety, with far fewer difficulties and risks. Consulting with a doctor on the best path to quitting is always helpful.

Anyone who is fighting with benzo addiction should consider a structured environment, such as Partial Hospitalization (PHP) or an Intensive Outpatient (IOP) program. These can help manage the painful mood swings and downright dread that come with stopping. Support and structure are paramount in recovery from benzo addiction. It is impossible to overstate their importance. Don’t try to do it alone.

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