“Will I be able to have a drink again with friends?”
“What about weed?”
“How about coffee? I really miss my morning coffee…”
“Do you eat lots of refined sugar now? I miss desert and sugary snacks. I miss chocolate!”
“How about violent or horror movies—or do you get overstimulated?”
“Can you take an aspirin? What about cold medicine?”
“Can you push yourself super-hard exercising? Or work really long days without repercussions?”
“Could you ever take another benzo, say if you had to for a surgical procedure? What about pain medication?”
“What about cigarettes? Are those ‘off limits’?”
Over the years, I’ve had people going through psychiatric-medicine tapers, washout, or withdrawal ask me these and similar questions. Some of these are certainly questions I’ve had for myself as I’ve fought my way back to normal life — back to that delicious calm and ease of living we in good health take for granted. After losing my way for many years due to psychiatric drugging and chemical addictions, I’ve come to believe that the big issue with med withdrawal is that it causes a light-years-beyond-“discomfort”, horror-movie overexcitation that won’t, not for one instant, let you forget your existence. Your second-to-second reality comprises a seemingly unending hell with no pause button, only the occasional relief of sleep. You are in so much pain on every possible level that you simply cannot escape yourself, and so the pain looms larger like for it.
In the withdrawal/healing state, the symptoms are often so strong, and the fear, racing, obsessive, and tortured thoughts, and inner torment so great, that you are unable to enter that frictionless state — aka plain old life — in which you are simply acting, moving freely about the world as need and desire dictate without the ball-and-chain of dread-infused self-awareness dragging you into the abyss.
Without being so persistently aware of your existence that you also can’t stop from ruminating about its antithesis, death.
Distraction helps a little, but only for so long. I often felt like my very shadow was chasing me, leaving nowhere to run. As soon as I paused, even for a microsecond, the withdrawal storm was back on me like pack of snarling dogs. Worse yet, insomnia and fatigue had sapped my energy stores, yet if I tried to “rest” because I simply could not take another step, the symptoms crowded in to fill the stillness. I felt like a shark that must always keep swimming, or it will drown. The experience was in every sense an existential trap.
You look at other people not tormented as you are and wonder how they live so casually, so fluently. What secret do they know that I don’t? Their world seems alien, a realm of the gods and superheroes, a paradise unobtainable. Just to go grocery shopping or throw a Frisbee in the park or smile at a child would take more energy and courage than you could ever imagine conjuring. Occasionally, you hit one of those rare windows of calm, and you can, in the contrast, see how withdrawal has warped your picture of the world. Then, discouragingly, the symptoms return to push you back into a terrified and frenzied thought-storm.
Oh shit, not this again.
Yet life goes on and you must keep moving as best you can, so you learn to operate by a new physics. It often takes force of will and sometimes literally physically maneuvering yourself in some unnatural way to accomplish even the simplest task. You dwell in inertia. In florid benzo/SSRI/mood stabilizer withdrawal, my thoughts oozed like molasses, thick, clotted, unnatural, foreign, frightening. I often couldn’t breathe properly due to what felt like a bloated belly and iron straitjacket sheathing my torso; an electrical current surged through my gut and spine, and my muscles were on fire from the crown of my head to the tips of my fingers and toes. I could neither cry nor laugh, so bound up was I with hyperventilating rigidity, so frozen were the muscles of my face.
Amidst this near-paralysis, when I needed to access a thought — say, “I need to take out the garbage” — and convert it into action, a sluggish disconnect stalled the message’s transfer between brain and body. I would have to actively conjure instructions for myself, as if using the manual to put together an Ikea dresser: “OK, I’m going to reach down to this little pail, bring into the kitchen, turn it upside-down over the big trash can, and then take the liner out of the bin and carry it out to the alley.” Step-by-step, I would accomplish each task, slowly, unsurely, my body stiff and sweaty. Instead of enchaining these actions as one continuous flow, I moved like a robot, staccato, pondering every movement then taking seconds to actualize what once used to occur unconsciously in a fraction of that time.
Completely conscious, at every turn, of my existence. But never in a reassuring, mindful way, as with the grounding of your body to the earth through your feet while meditating, or stopping to savor the sweetness of an apple. More like, the awareness of each in-breath a man has while being waterboarded.
There is no peace. That is the heart of the matter: there will be no peace until you pass a certain threshold with your healing.
Now, I did get better from all this—almost entirely, and enough so that I didn’t have to think about it anymore. It was mostly not on my radar. The dread, the existential panic, the body dipped in cement disappeared. I have enjoyed, for many years, the luxury of taking my existence for granted because it has not been a torment to me. But there have been setbacks, bad decisions or unforeseen stressors or just the randomness of neuronal healing that have plunged me back into the aforementioned state. Which, as you might gather, sucks. If you’re like me, when you have a setback, your first thought is probably going to be, “What if this time it’s permanent?”
And: “I don’t know if I have the strength to deal with this again.”
And: “FUCK this…”
As I write this, I’m after two long and toxic months gradually (yet also erratically—blergh!) on the mend from a setback that began in late July. Oddly enough, it had occurred to me over this past year as I’ve been writing these essays for Mad in America that maybe I was “too healthy” to speak to the withdrawal experience with authenticity, to have street cred. Maybe too much time had passed since I’d been at the crux to recall what it was like; to put these essays into their proper context, to have the proper empathy for people early in their healing, their wounds still raw. To shuffle a mile in their shoes—usually as quickly as possible from their psychiatric tormentors. Perhaps I’d had too many good years in a row, my body strong again, taking normal life for granted, to have an honest recollection.
However, it’s now a moot point. I’ve (hey, lucky me) had a chance to live with full-bore 100% benzo/antidepressant/mood-stabilizer withdrawal symptoms again, seven years after taking my last psychotropic. It sucks — it sucks big time — but that’s just how it is, a reality I’ve somewhat been able to accept. I write this not to scare people, but to point out some mistakes I made along the way that contributed to this setback, so that others might avoid them. And also to emphasize that I have been healing in a matter of months this time, instead of years, as grim as the experience has been.
This was, I now see, all very predictable.
I’d been drinking way too much coffee, and my consumption had been escalating for years despite my best efforts to rein it in. The deadline-driven nature of the editorial work I do often means brief periods of epic, 12- and 14-hour days, for which you need to remain “up” and alert. By this summer, each morning began with a quad espresso, moved to a Dr. Pepper or Double Shot at lunch, and whenever I needed a “bump” I’d turn to chocolate-covered espresso beans or dark chocolate. I could drink a Double Shot at 5 p.m. and still sleep eight hours that night. (I know, I know — don’t say it. This was excessive.) Paradoxically, only the morning caffeine woke me up; the other infusions were oddly sedating, and I ended up nodding off by afternoon. Something very strange was going on . . . I was also eating way too much refined sugar. The only fruit I’d have was the occasional handful of blueberries with my son.
I had the nutrition of a jacked-up Red Bull teenager . . . in my forties.
Meanwhile, I was continuing to push myself rock climbing in high summer, even though heat has been a trigger for past setbacks. It didn’t matter, I figured. I’m seven years out. I’ll be fine. It’s over. I also had a shoulder injury, a flaming-red flag that should have been a clear signal to take time off. But I didn’t. I couldn’t. I wouldn’t. I’d lost too many years flat on my back or writhing on the floor in benzo agony to sit on the sidelines ever again, so I pushed through. I took a small dose of painkillers at night for about ten days just to sleep on my injured limb, and then abruptly stopped. I’d taken opiates as prescribed on a couple occasions post-benzos for knee pain without any major adverse issues, despite a past history of addiction with these pills. But this time, for whatever reason, was different.
This time I fucked myself . . . hard.
All hell broke loose on a short trip to South Dakota, climbing two days in the swampy Midwestern heat with a friend. On day two, on the hike up out of the little limestone canyon, the symptoms, which had been building, came rushing back in a giant tsunami. I couldn’t breathe; it was like I’d walked into an invisible wall. On the six-hour drive home, I felt like I’d been dosed with acid, and fought back panic and tried to appear as normal as possible in front of my buddy as I clutched the steering wheel with desperate force. The symptoms have ranged from jitters to insomnia to the “iron sheath” to trouble breathing to anxiety to panic to derealization to a rigid neck and throat to fatigue to rubbery legs to a black, black depression, and of course the hopelessness that comes from being plunged back into hell having thought you’d finally escaped, never to return.
This wasn’t anxiety; this wasn’t depression. I felt like I’d been dosed with speed and LSD, assaulted by a pack of bat-wielding thugs, shot full of flu virus, contracted MS. There have been perhaps some elements of adrenal exhaustion or general stress/fatigue contributing, but the root problem has felt like the return of benzo withdrawal, even all these years later. It had lain dormant like a sleeping bear, then came roaring out of its cave after I so stupidly bumbled along and poked it with a stick. Clearly, I was treating my body like crap, and clearly even without a sensitized nervous system I was headed for a blowout. And having endured setbacks before, I should have been smarter.
But I wasn’t.
The first month I was down to three hours of sleep a night, had to go up the stairs on hands and knees, and on a good day could only walk around the reservoir by our house, a 0.75-mile loop, twice, shuffling, gasping, a far cry from my daily five-mile walks with the dog. I had adrenaline spikes, panic attacks, sobbing fits, heavy legs, looping death and suicide thoughts, and bouts of fatigue that left me glued to the mattress. I often despaired over how my world had exploded, the pieces seemingly scattered too far and wide to ever be picked back up again and reassembled.
I’ve often told people that I’m not sure if I’d have the strength to go through benzo withdrawal again. I believed this to be true until, once again, I’ve had no choice but to face the monster, and realize I’d been wrong: It was just something I was saying. I actually do have the strength, because just like before, I will not give in. Just like before, I will not end my life to end my suffering, and I will not, even at my most desperate, darkest hour, craving some quick fix for the pain, give back in to the “meds” or “doctors” that have taken so much already. Even if I spend the rest of my days a shuddering wreck, they are my days to spend here on Earth. I am not going to let this thing or the heartless, broken “mental-health” system win. Not before, not now, and not ever.
If the only way through before was forward, then forward I shall go again.
The good news is, I’m slowly getting better thanks to the balm of time, to meditation, and to cleaning up my diet and getting off caffeine, which IMO has a profoundly horrible and way understated withdrawal syndrome. I believe that all along, caffeine had been inflaming the underlying stuff until this final breaking point. (Caffeine interacts with GABA receptors, the ones affected by benzos, so perhaps my body was relying on it in some bizarre way. It also releases dopamine—as well as the fight-or-flight hormones adrenaline and cortisol. It is a stimulant and a psychotropic.) But this has been the scariest setback of all, because I was so far out time-wise. In my first few years off benzos, there were heat-induced summer funks that lasted two to three weeks, but at that point I could rationalize that I was still early in my healing. At other times, life or work stress conspired to lay me low. Or I’d go a few too many nights with poor sleep and the symptoms would return. But in all these cases, I could point to a single discernible cause. In the past three or four years, I have considered myself mostly healed, almost impervious to setbacks save those few weeks in summer, and even then I’d experience symptoms at only about 50 percent intensity. There simply hadn’t been any of the random bad spells, the waves, I experienced during the first three years.
Each time that I’ve experienced a setback I have healed, and felt stronger than before. I expect this time to be no different. In fact, I expect it to be my last major setback, as I now plan to take better care of my health. To, like the early days in benzo withdrawal, scrutinize every last thing I eat, to listen to my body and not push too hard with exercise or stress, and to monitor my psychic output (eliminate negative thoughts) and input (avoid negative people and negative media) so that my thinking is more centered.
And to avoid caffeine and sugar.
Let us hope this is the last of it.
I write this not to scare people, but to present a reality. This reality has been difficult to accept, but the fact remains that my nervous system is more sensitive than before and might always be so, at least to some degree. I’m not the same man I once was, though this isn’t necessarily a bad thing. As an integral person, I’m much tougher and more resilient, having survived psychiatric oppression. If something or someone smacks of control or manipulation or disingenuousness, I don’t give it or them the time of day. However, on the level of pure neuronal function, there is a lingering sensitivity I’d do well to monitor.
So perhaps you’re wondering, once a year, or two, or three go by off benzos or antidepressants or antipsychotics or whatever chemicals have been foisted on you, will you still have to be vigilant or can you dive fully back into your “old life” again? Can you pound coffee or smoke weed or drink socially, or have a stressful job or commute, or eat foods with lots of MSG and not blow out, not have a setback? Can you overextend yourself physically or mentally or emotionally without incurring “the wrath”?
I don’t pretend to have the answer: you do. I mean, how important are certain of these things, that you need to reintroduce them into your life to try to reclaim the “old you”? Are they important enough to risk a setback? Why not embrace the new you and make more judicious decisions that accommodate who you are now? Why not proceed slowly and with great caution back into any activity that’s a potential trigger? Isn’t this how life should work? Shouldn’t we live according to who we are today?
Psych-med damage or not, we’re all changing in one way or another up until the day we die — all aging and sagging and slouching toward our graves, battered this way and that by happenstance and fate, made more fragile with each step, each breath, each passing second. This is both the most wondrous and most terrifying thing about being human: we are simultaneously self-conscious and aware of our mortality, whether we live this truth accordingly or not.
I once thought I had good, reliable answers to what happens as we heal, to how to live “after benzos” in a way that cultivates long-lasting health. But clearly I didn’t; clearly I was wrong. Clearly I’d let myself see only one part of the picture. As each day goes by, however, and I clutch and claw my way back to health, reclaiming the hard-fought gains already made, I think I’m coming closer to one version of the truth.
Of further interest:
Rock climber, author, and MIA Blogger Matt Samet discusses his experience becoming addicted to, and subsequently coming off of, benzodiazepines.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.