ANTI-ANXIETY MEDICATIONS
Be aware that this is information only. I am not a psychiatrist, medical doctor or pharmacist. All of this information is taken from several websites and is here simply for you to familiarize yourself with them if you so desire.
Anti-anxiety medications are a lot more complex than antidepressants, partly because there are a number of different anxiety disorders requiring some different types of medications and partly because addiction to some anti-anxiety medications is a very important issue. So I’m going to do this posting in four parts as outlined below.
What is anxiety?
Anxiety Disorders – a brief description
What does an anti-anxiety medication do?
Do I need an anti-anxiety medication?
PART II:
Types of anti-anxiety medicationsTypes of anti-anxiety medications for specific disorders
PART III:
Side effects of anti-anxiety medicationsParadoxical effects of anti-anxiety medications
Safety concerns
Addiction problems
Drug interactions and overdose
People more at risk
What to do once you have started taking an anti-anxiety medication
PART IV:
Other options for relief of anxietyRelated links
Today I’ll start with defining anxiety, giving brief descriptions of the different anxiety disorders, talking about what anti-anxiety medications can do and the questions to ask both yourself and your prescribing doctor in order to decide if medication is the avenue you want to take.
WHAT IS ANXIETY?
First of all, anxiety can be a very unpleasant emotional state where we anticipate some kind of danger to ourself, whether it’s realistic or not. We feel that something bad is about to happen and it wreaks havoc with our emotions and our physical body. We may feel nauseous, sweat more than usual, feel shaky or weak, our muscles tense up as if ready for a fight or a quick escape (called the “fight or flight response”) and our heart might begin to beat very fast. We might think there’s no way we can cope with whatever lies ahead.
Although, I can think of some instances where the anxiety is rather pleasant for some of us. That would be when we are about to go on a rollercoaster or some other frightening but thrilling ride. It could be bungee jumping or skydiving, hang-gliding or jumping from the highest diving board at the pool. Then the anxiety is part and parcel of the thrill.
But the rest of the time most of us would probably rather not feel such fear. However, we manage. We meet whatever the challenge is and move on. We might even feel proud of ourself for doing what we feared. If nothing else we might feel a great relief that it’s all over.
So when does it become an actual disorder. When does it all slip over the edge into a terrible abyss that leaves us crippled with fear and feeling very unable to cope? Well, mostly when it renders us fairly dysfunctional. When anxiety leads us to excessive worry, compulsive rituals or obsessive thoughts, when it causes us to avoid people, places or situations or when it leads to possibly one of the worst symptoms of anxiety – a panic attack.
When these things happen over and over, on a regular basis and we can no longer manage the symptoms, when it causes us a lot of distress then it might be an anxiety disorder. When we see danger where there really is no danger, at least not from other people’s perspective, when we feel powerless to escape a situation or cope with it we may well be experiencing an anxiety disorder. When our anxiety becomes so bad that it interferes with our work or school performance, with our relationships with family and friends, or with our social activities and recreation so that we cannot enjoy them anymore we may have an anxiety disorder.
A note before I talk about the specific disorders. It’s very important for us to understand and not beat ourself up about what we are experiencing as well. This is not easy however. We tend to criticize ourself for these “stupid” fears. We may think that we are just trying to opt out of things. We may think we are simply making excuses and should just smarten up. We may think “Everyone else can do this. What’s the matter with you. This is no big deal.”
But that’s a huge error in thinking. It’s a very big deal for us. IT’S AN ILLNESS AND ... IT’S NOT OUR FAULT. Usually these fears are based either on some kind of conflict that is going on within us or they are based on experiences in the past that were dangerous to us. Many people who suffer PTSD (Post Traumatic Stress Disorder) experience this over and over as they relive in their mind the traumatic event or events that happened to them when they were younger. Usually there was no escape from those situations.
So, we may have come to a point where we go to see our doctor and he or she diagnoses us with an anxiety disorder of some kind. Below is a brief description of each type of disorder.
Generalized Anxiety Disorder
Generalized Anxiety Disorder, or GAD, is when our anxiety and worry about a number of events or activities is excessive and keeps happening for more days than not for over a period of at least six months. It also comes with symptoms such as fatigue and poor concentration.
Panic Disorder
Panic Disorder is the formal name for re-occurring panic attacks as well as persistent worry about having more attacks, worry about the implication or consequences of the attacks or any significant change in our behaviour related to the attacks. These attacks usually begin quite suddenly and may seem to come from nowhere. We may not be able to figure out what triggered them. When an attack comes on our heart begins to beat rapidly, we may experience a very tight chest or actual chest pain. Some people believe they are having a heart attack at this point and will even go to emergency. We may also experience a shortness of breath and feel dizzy as we are not getting enough oxygen to our brain. We may also feel like we are choking, have nausea or some kind of stomach distress, feel as if everything is very unreal (called derealization), and/or have chills or hot flashes. Possibly the worst of all these feelings is that we fear we are losing control or that we are going crazy.
Panic attacks can be absolutely terrifying and we may feel as if we are going to die.
Agoraphobia
Many people think agoraphobia is simply the fear of leaving home or of being in wide open places but it’s more than that. It is the fear of being in a place or situation when a panic attack occurs and there is either no escape or it’s at least embarrassing. It’s also the fear that there will be no help available at the time of the attack.
Often the fear is about being outside of home alone, being in a crowd, standing in a line, being on a bridge, or travelling in a bus, train or car.
Post Traumatic Stress Disorder (PTSD)
This disorder happens some degree of time, months or even years, after we have experienced a traumatic event or events such as assault, terrorism, war, a natural disaster or childhood or domestic abuse. Some of the symptoms we might experience are what’s called “emotional numbing” where we don’t feel like we care about anything, or feel detached from everything around us. Often we can’t remember the details of the traumatic event(s) for months or years. Many people experience depression as well. And many of us go out of our way to avoid people, places or events that might remind us of the trauma.
People with PTSD may also feel hypervigilant, as if constantly on alert and watching for any signs of the trauma to re-occur even if it may never happen again. Some get startled quite easily and seem very jumpy. Some may seem quite agitated and experience many of the symptoms of Generalized Anxiety Disorder such as rapid heartbeat, dizziness and faintness.
Acute Stress Disorder
This disorder is very similar to Post Traumatic Stress Disorder and is evoked by the same types of stressors. The cause is trauma for both disorders but the symptoms of Acute Stress Disorder show up much more quickly. They may be experienced right at the time of the traumatic event or immediately following whereas those of PTSD happen months or often years after the situation. Usually the symptoms of Acute Stress Disorder last a minimum of two days and a maximum of four weeks.
Social Anxiety Disorder
Or Social Phobia
Some of us have an extreme fear of social situations such as conversations with others, parties, or meetings. We may go out of our way to avoid any of these situations. Many of us are absolutely terrified of public speaking, afraid of being embarrassed, humiliated or observed by others. Some studies have shown that some people are less afraid of death than they are of public speaking. This fear may or may not be a disorder, depending on how extreme and excessive the fear is and to what point it interferes with having a normal life.
Obsessive Compulsive Disorder
Like the title says, this disorder is made up of two distinct characteristics – obsessions and compulsions. Obsessions are when we have very intrusive thoughts, or images that seem senseless, inappropriate or even repugnant to us and they cause us a lot of anxiety and distress. For example, every time I drive I think about going over into the oncoming lane and having a collision. No matter what I do I cannot stop thinking this whenever I get into the car and it causes me no end of distress and fear, and thinking I might just do it sometime.
Compulsions are things we do that are usually repetitive but may seem senseless to us. We usually don’t feel any pleasure from doing these things but they give us a sense of relief. Often we may be doing these things to counteract the obsessive thoughts that bother us so much.
The repetitive behaviours might be very frequent hand-washing, constantly putting everything in order or checking things. It could also be mental acts such as praying, counting or repeating words. In the above example where I have obsessive thoughts while driving I might open and close the car door three times before getting in to counteract my obsession. Or I might do something that seems unconnected to the obsessive thoughts such as checking five times that I have locked the doors every time I leave my home. I may not even connect the obsessive thoughts while driving and the compulsion to check my locks as part of the same illness. But it’s all part of a deep-seated fear about something.
WHAT DOES AN ANTI-ANXIETY
MEDICATION DO?
So how can a medication help? Unlike antidepressants, anti-anxiety medication is really only meant for short-term relief. We need to do other things in order to resolve such distressing fears and, thankfully, there are quite a few options. I will be discussing those in Part IV. However, medication can definitely help some of us in the short-term. It may help get us back on our feet to some extent and then be able to deal with the underlying problem.
One other thing. Medication may not be the answer for everyone. It may not be the best option for treating our anxiety. We need to do our homework when it comes to these medications especially. We need to do the research, talk to our doctor or pharmacist, and ask a lot of questions.
While we need to understand the risks and side effects of any medication we especially need to do this when deciding whether to take an anti-anxiety medication. Some drugs can lead to a strong dependence and to a chronic addiction. Some may lead, though very rarely, to mania (extreme excitability, possible unsound judgement, lack of sleep and other symptoms of Bipolar Disorder), or aggression and rage. Worst of all maybe, some may actually increase our anxiety rather than lessen it.
DO I NEED AN ANTI-
ANXIETY MEDICATION?
As I have said before, medication for anxiety is only a temporary solution and it may not even be the right solution for you. Talk to your doctor and do the research if you can. Weigh the benefits of the medication against the drawbacks and side effects. Know that there are other options and tools for you to use that can also help anxiety, especially if it is not too severe. In Part IV I will talk about those options a bit but for now, they include cognitive-behavioural therapy (CBT), talk therapy, meditation, biofeedback, hypnosis, acupuncture, relaxation techniques as well as addressing your lifestyle and possibly making some changes to it.
> How soon will it work?
> How long will I need to take it and is there a risk of taking it for too long?
> Is there a risk of me becoming addicted to it? (This is an especially important question to ask yourself if you have a history of addiction and substance abuse problems. You are more at risk of becoming addicted to other substances and medications.)
> Will withdrawing from it be difficult and what possible side effects might I have from withdrawal?
> Will the anxiety return as soon as I stop taking the medication?
> What are the side effects and other dangers of taking the medication and am I willing to put up with them?
> Are there any possible interactions with other medications I presently take or even with any foods or beverage (e.g., alcohol, caffeine) that I consume
> What else can I do to relieve my anxiety? Am I willing to try other things instead of taking medication or alongside with my medication for a period of time?
HOW LONG WILL IT TAKE
TO BEGIN WORKING?
Some anti-anxiety medications take a very short time to work, especially the Benzodiazepines. They can work as quickly as within 30 minutes to 1 hour but most take more time to reach their full therapeutic effect. You will need to be patient, just as with antidepressants, and have realistic expectations. Find out from your doctor or pharmacist about the medication and how long it takes to work. You will probably have to work closely with your prescribing doctor to find exactly the right dosage for you and to monitor its effects on you.
In the meantime, do try to find out about other options for relieving some of your anxiety. Even deep breathing in the moment can help in the short term. Know that there is help out there and that many people have suffered like you and found ways to deal with their anxiety. Many have been able to move on with their life. Don’t give up.
NEXT TIME
Next time Part II – the different types of anti-anxiety medications. This is for those of you who really want to know what your options are in terms of medications. The more you know often means the more you feel in control of things. 
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