Date: Tue May 30, 2000 5:12 am

Subject: TRANX Newsletter

ANXIETY

Anxiety is, as one would expect, an extremely common withdrawal symptom, from benzodiazepines. This withdrawal anxiety is similar to other withdrawal symptoms in that it comes and goes for no reason, and does not seem to be related to life events. Often, the anxioety peaks to become a panic attack. Many people experience panic attacks in withdrawal. What the best way to manage Panic & Anxiety attacks in withdrawal? As the anxiety is DIRECTLY related to withdrawal of the drug from the body, there is no point going into therapy to treat it!

It is important, however, not to get caught up in the anxiety and fear, as this could generate a secondary anxiety which was started by the experience of withdrawal.

Therefore:- · remind yourslef that the anxiety/panic attack is a withdrawal symptom and like all withdrawal symptoms will pass

· do not feed into the anxiety with fearful thoughts of "what if"......

· treat the symptoms of anxiety by practising a relaxtion techniuque TWICE a day

· when experiencing the anxiety, SLOW the breathing and gradually DEEPEN each breath until the breath starts from the ABDOMEN and NOT the chest. Focus on the flow of breath in and out of the body. On each exhalation, say to yourself, RELAX and Let Go

· Have a warm bath · vigorous exercise works well for SOME people (it didnt work for me), if one is not feeling too unwell in withdrawal. Go for a run, have a brisk game of tennis/squash or even a fast walk.

· Sit or lie quietly and listen to a beautiful piece of music. Really focus on the music and not on your symptoms. Make sure you are really warm and comfortable

· If the anxiety feels really bad and does not seem to be responding to the strategies listed above, you can try distracting yourself from the feelings by watching television, listening to a tape, reading a book, going out and being with other people as musch as possible or ANY activity that requirs you to focus, such as doing a jugsaw or even colouring in or drawing. (COlouring in and drawing worked for me)

Management of Panic Attacks in Withdrwal

1. Learn to recognise the first signs of over breathing

2. If possible, stop what yu are doing and sit down or lean against something. If you are driving, pull over to the side of the road. If you are in company, excuse yourself for a monent, but make sure you return.

3. Hold yuor breath and count to 10. (Dont take a deep breath, just hold your breath)

4. When you get to 10, breath ou and through yur nose and say the word "Relax" or "Let Go" to yourself in a calm and soothing manner.

5. Breather in and out slowly in the 6 second cycle. (in for 3 seconds and out for 3 seconds). Sy the word "Relax" top yourself each time you breathe out.

6. After 10 breaths, hold your breath again for the count of 10. After you have done this, continue again with the 6 second breath cycle

7. Continue breathing in this way until all the symptoms of over-breathing have disappeared. If you follow the breathing cycle as soon as you notice the first signs of ovr breathing or panic attack, your symptoms will subside within a minute or two. (Much faster than swallowing a tranquiliser) The more you practice the breathing technique the better you will become at using it to stop panic attacks. If you are unable to start the breathing cycle as soon as you would wish, you might find it useful to breathe first into your cupped hands (to breathe in the carbon dioxide) and then to start the slow breathing cycle.

Also:-

· close your eyes or lower your gaze

· remind yourself that these feelings are normal and they cannot hurt you

What if the anxiety is not due to withdrawal but is anxiety experienced bewfire starting the benzodiazepines? Deciding if the anxiety is withdrawal related or not, can be difficult. If a range of symptoms are being experienced in addition to anxiety once the benzodiazepines have been stopped, then it is safest to assume that the anxiety is still withdrawal. If you are feeling ONLY anxiety and no other symptoms then it is probably not related to withdrawal.

In this instance professional help for management of the anxiety is necessary. A professional assessment should be carried out. What are the main symptoms of anxiety? Sometimes the cause of anxiety is unclear, or there are mony causes. Often we are not even willing to admit to ourselves that something in our ives is unsatisfactory. Un resolved problems result in a constant low level feeling of anxiety Anxious people feel irritable and uneasy. They find it hard to relax. Hard to concentrate and hard to sleep. Some people fear that something dreadful is going to happen. These fears and feelings can be accompanied by physical sympptoms such as heart palpitations, tension and muscle pains, sweating, hyperventilation, dizziness, faintness, headaches, nausea, indigestion, bowel disturbances and loss of sexual pleasure.

Kathy