A Hard Year: Benzos

There are a lot of things to say about psychiatric medication. But for the first few weeks out of the hospital my primary experience was with lorazepam which also has the brand name Ativan. And it's part of a class of drugs called benzodiazepines which are fascinating as well. The way they work is something I'll write about in the future.

But for the first days and weeks out of the hospital, I'd been prescribed to stay on lorazepam almost constantly. Essentially this was to prevent a relapse while I found a long term solution to the generalized anxiety that put me in the hospital. Since that characterized my experience at the time, this will look at what the experience of taking benzodiazepines is like.

Lorazepam is considered an essential medicine by the World Health Organization and that's because it is incredibly effective. It stops dead panic attacks and, relatedly, seizures by slowing down neurotransmission. So any information your brain is sending and receiving goes from a shouting match to a predictable conversation. That's how I described it most coherently on March 2, 2016.

"The adivan [sic] provides a high degree of clarity. But it doesn't solve my problems. It just makes it possible to work on them. In particular I can work on the kinds of personal level shit. I can work on myself. I can work by myself and be with others. That's really nice. "Sitting here, thinking clearly, thinking a few sentences ahead is really nice. Maybe it makes movies less interesting? I'm not sure. I really can't turn down the noise there. Yikes. But I can think about, maybe, particularly my films on it." March 2, 2016

"The adivan [sic] provides a high degree of clarity. But it doesn't solve my problems. It just makes it possible to work on them. In particular I can work on the kinds of personal level shit. I can work on myself. I can work by myself and be with others. That's really nice.

"Sitting here, thinking clearly, thinking a few sentences ahead is really nice. Maybe it makes movies less interesting? I'm not sure. I really can't turn down the noise there. Yikes. But I can think about, maybe, particularly my films on it." March 2, 2016

Lorazepam takes effect in under ten minutes and the effects last for six to eight hours. That's critical, it really does stop a problem in it's tracks. I remember one time heading out of the house feeling the anxiety growing in me. I took an Ativan and started walking. For about a block I was waiting for it to kick in and then a block later I was waiting for a light to change and I realized that I was calm. Taking benzodiazepines is relief. They bring clarity and they cut out noise--the chatter of all your nerves firing at once, thoughts and sensations coming all the time.

Lorazepam is sort of unique in how powerfully it cuts the noise out and how quickly. It hits hard and leaves you glass eyed and motions feel automatic. I sort of wonder how that looks on the outside, because when I was taking lorazepam just to get through a day it let me make eye contact. Sometimes, in fast paced environments, I could feel myself start to shake as it wore off as well.

The effects are dramatic and actually it has a potential for abuse because of that feature. It seems like the easiest compromise to make in the thick of things. The first time I was prescribed lorazepam it was for two weeks and that's about all they'll give you to avoid abuse. But I did get a second prescription for 20 tabs of it after meeting with a GP, but the idea at that point was to only take as needed.

Taking lorazepam as needed, being serious about your need for it, introduces a completely different problem though for generalized anxiety. Suddenly I had to judge when it was appropriate to take this drug and that introduces questions and uncertainty. Which I could tell was the case even when I was taking it regularly.

"I don't know what happened here or why, but everything is just running too hot. I can't handle so much of the emtal energy going on right now. It hurts. Often. "Right now I know I should take this pill because it will put me at ease. I might get a moment's peace and not have to be thinking about everything in the universe at once. That's really what it's like." February 18, 2016

"I don't know what happened here or why, but everything is just running too hot. I can't handle so much of the emtal energy going on right now. It hurts. Often.

"Right now I know I should take this pill because it will put me at ease. I might get a moment's peace and not have to be thinking about everything in the universe at once. That's really what it's like." February 18, 2016

So there were a few times, when I couldn't make this judgement and I just wound up on the floor of my room for up to an hour waiting, all my muscles tense, for the anxiety to pass. First I wouldn't be sure if I needed the lorazepam, then I wouldn't be able to reach it. So taking it as needed inclined me to hoard it out of fear of a really disastrous attack. But those came and went and I wouldn't take medication. There are so many times I should've taken this drug and didn't or couldn't.

The long term solutions are gentler and more subtle. They have the same effects, basically, but they can take hours to come up on and land you in weird spaces of not knowing if the drug or yourself or your lifestyle is making you able to just move forward. I found that experience to be disarming particularly at a bar or in a social setting.

But the main thing about being on benzodiazepines and other medications is discovering the new norm. The concept of the new norm just muddles medication, motivation, and lifestyle together. That fact points to an important thing to really understand about these kinds of medications; doctors don't know what they're doing here. Benzos treat the symptoms of anxiety very well, but not the causes, and chemically they do things that are similar to drinking but without the drunkenness. So who's in the driver's seat?