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Delilah backs out of the driveway and waves goodbye to her parents. High school is over, the goodbyes have ended, and the only thing that stands between her and college is a five hour drive. She now has some free time. Plenty of time. Too much time. Radio is her only distraction, but it's not enough. And the thoughts begin. So many new people. So many new experiences. So many new fears. The "what if" scenarios cycle in her head like a military drill. What if she chose the wrong major? What if she fails her first classes? What if her roommate hates her and she can't find any friends? What if she gets sick so far from home? What if she can't get a job after graduation and can't pay back her loans? So much time, so many fears. College is going to be a complete and utter disaster — she is sure of it — and no one can convince her otherwise. The one adventure that Delilah had dreamed about her entire life — now fills her with fear. The Evolution of Anxiety Delilah's story is familiar to many of us. Life is overwhelming. Period. No caveats. No conditions. Unless you're a monk, or nun, or hermit, or someone completely isolated from the outside world — modern life will overtake you like a Sherman tank. And how do we respond to it? Well, if you're anything like Delilah, with a five-alarm blaze of stress and anxiety. It sucks. But, it wasn't always that way. There was a day when a human being's primary concern was simply, not to get eaten. If we made it through the day alive, it was a good day. Survival occupied much of our thought. We didn't have time to worry about "lesser things." It was simpler times. Not better, just simpler. If we could eat, sleep, and reproduce — life was good. Then came language. Societies. Laws. Currency. Businesses. Buildings. Computers. MTV. Social Media. The Kardashians. And Toaster Strudel (I may have been hungry when I wrote this). Life got better in many, many ways. But simpler? I don't think so. In the past, changes in the ancient world affected our evolution slowly. Very, very slowly. About a million years appears to be the best guess. While some "rapid evolution" has taken place over shorter periods of time, these changes are rarely sustained throughout human history. True, lasting evolutionary change takes a very long time. But the world around us, the world we created, it doesn't have the same degree of patience. Comparatively speaking, our technological and societal changes happen at lightening speed. We try and adapt — with some success — but the gap continues to widen. While our physical and behavioral traits remain very similar to those of hunter/gatherer days, our society is ages ahead in some futuristic Brave New World. And there are few places where this gap is more obvious, then in our reaction to stress and anxiety. In particular, fight-or-flight. Fight-or-Flight Response — Excerpt from "Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal" The fight-or-flight response is a physiological response to perceived danger. This process prepares the body for either fighting or fleeing. When triggered, the body releases a cascade of epinephrine, norepinephrine, estrogen, testosterone, dopamine, and other stress hormones. These trigger reactions in the body including increased heart rate, breathing rate, muscle tension, and an increase in oxygenated blood to the larger muscle groups. Now the body is prepared. It's prepared to survive. The only problem is, we don't experience true risk-of-life situations as much as we used to. The amygdala part of our brains, which triggers this fight-or-flight response, can't always identify a real threat from a perceived threat. And this response is often triggered when we really don't need it. When the human race was in its infancy, our lives were simpler — but also more dangerous. We spent most of our days seeking food, water, shelter, and warmth. We also spent time eluding danger. But things have changed. Few of us must face off a wild hippo just to get to the office in the morning. Even in our modern world today, anxiety is still a regular part of life. You might have felt it when that car almost hit you on 25th Street. Or perhaps when you wanted to ask that boy out to the dance. Or maybe when you were in the waiting room for your first acting audition or when that sudden turbulence hit mid-flight somewhere over Ohio. We experience some level of anxiety every day. For most people, it's a normal part of life, and it doesn't cause any long-term complications. It becomes a problem when it becomes excessive. It becomes a problem when it becomes chronic, when it interferes with a healthy life or keeps you from doing things you want to do. For some, anxiety includes excessive worry, insomnia, chronic nervousness, panic attacks, stomach distress, muscle tics and tremors, heart palpitations, hot and cold flushes, depression, and even suicidal ideation. For some, anxiety is a life-altering condition. One, from which, they want nothing more than to escape. Anxiety kills relatively few people, but many more would welcome death as an alternative to the paralysis and suffering resulting from anxiety in its severest forms. — David H. Barlow, Anxiety and Its Disorders (2002) What Can We Do? Delilah wants to escape, but doesn't know how. She can't directly change her physiology. She can't just think "stop releasing the neurochemicals that make me anxious," and expect everything to be better. We wish it worked that way, but wishing doesn't make it so. She can't isolate herself entirely from the outside world. Many have tried this — and while it may have a few short-term benefits, it is far from a realistic solution. She can't take anxiety medications like Xanax, Ativan, Valium, and Klonopin and expect her problem to improve. Most people who have visited our site know that these cause far more problems than they cure (visit our website for more info). But, there are many options that do work — and have been proven to do so. She can learn proven anxiety management tools and techniques. She can take up mindfulness, meditation, or yoga. Or try breathing exercises and spend time in nature with the animals. She can exercise, eat healthy, visit a therapist, or explore a daily practice of gratitudes. The list is endless. Now, most of these do take work. There are no easy fixes here. But still, every little bit does help. And eventually, the little bits add up. There is one more thing, though. One more tool that I forgot to mention. And that is the technique of changing the story you tell yourself. Changing the Story Jess is driving down the highway — the same highway as Delilah. She is also heading to her first day at college. New people, new events, all the same stuff awaits her as Delilah. But, there is one significant different between the two. Jess is smiling — arm out the window, head bobbing to the music, her jet black hair blowing in the wind. To look at her, you'd think she doesn't have a care in the world. She does care, though. She has some of the same fears and worries about college as Delilah. The difference between the two, are the stories they tell themselves. The core of Jess's story is excitement. The core of Delilah's, is fear. "We are what we think." — Buddha Jess's story is one of adventure. She is still as clueless as Delilah about what lies ahead, and yet she is eager to find out what happens. There will be some failures, but there will also be successes. There will be some painful relationships, but there will also be new loves and friendships. But most of all, it's something new, and she can't wait to experience it. Unfortunately, this way of thinking is foreign to Delilah. How can she be excited about something, when so many things could go wrong? Her mind is filled with chronic anxiety, ruminations, obsessive thinking, and looping thoughts. When something happens in her life, she jumps to the worst case scenario, and her fears overwhelm her. It's not really her fault. Perhaps it was genetics, perhaps it was her childhood, perhaps it was the result of brain injury or medication. Or more likely, perhaps it is a combination of all the above. It may not be her fault — but it is her responsibility. No one else is going to change Delilah's story — but Delilah. Most anxiety stems from self-fabricated stories based on speculation and assumption. We tell ourselves fictional stories about the people in our lives or the circumstances that befall us. We do it all the time. Seldom do we notice what we're doing. Even more rarely do we see the connection between our incorrect assumptions about others and our internal anxiety level. — R. Scott Gornto, Psychology Today Changing her thoughts, her story, is not going to be easy. But, she can change. Delilah can modify the messages she tells herself. She can tear down the false assumptions she has focused on, and replace them with more optimistic, more realistic thoughts. And it doesn't have to be some massive change. In fact, it's better to start small. The first step in this process is simply learning to notice your internal messages and emotions. Here are eight tips from a Psychology Today article titled, "The Anxious Stories We Tell Ourselves." Please visit the article for more background and information. 8 Tips to Help Change the Story You Tell Yourself Notice your body and emotions Breathe deeply Connect with your environment Control what you can control Let go of what you can't control Talk to yourself in a positive manner Do something life-giving in the moment Repeat steps 1 through 7 as necessary Delilah Arrives at College Now, I know I couldn't end this article without telling you what happened to Delilah. So, here it goes. A tear sliding down her cheek, Delilah stands at the closed door of her dorm room staring at the door knob — frozen. It's been almost five minutes now. She is seconds from turning around and driving back home. All her fears were correct — she can't handle this. Then she hears a soft voice next to her, "It's just a door." She turns to see a woman with jet black hair and the warmest smile she has seen in years. It's her new roommate — Jess. Delilah grins quietly, wipes away her tears, and turns the knob. Yes, this story may be a bit campy. And yes, it is quite predictable. And yet, it still made me feel warm inside as I wrote it. I can't help it — I'm an old sap. I don't really know what happened to Delilah at college — since she only exists in my mind. But, I like to think that with time, with the help of a good friend, and with some therapy and a little guidance, that she thrived. I like to think that, because I have seen it time and time again. Life moves fast. Too fast. And many of us can't keep up. And we find ourselves trapped in our own minds occupied by nothing other than worry and fear. But, it's not hopeless. Not by a long shot. Anxiety is a loop. It's a vicious cycle. Stress causes anxiety which causes symptoms and pain and fear which causes stress which causes anxiety which... get the picture? But that cycle also works in reverse. Easing stress eases anxiety which eases symptoms and pain and fear, etc., etc. Next time the looping thoughts start, step back. Observe the voices in your head and see where they are taking you. Then edit your story, just a bit. Change it up. Turn a horror flick into an adventure pic. You wrote the movie in your head, and only you can change the ending. Try it out. You're worth it. See ya next time. References Barlow, David. Anxiety and Its Disorders. 2nd ed. New York: The Guilford Press, 2002. Challenging the Negative Stories We Tell Ourselves. PsychCentral. Accessed May 31, 2023. https://psychcentral.com/blog/challenging-the-negative-stories-we-tell-ourselves. Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, CO: Denim Mountain Press, 2018. https://www.benzofree.org/book. Gornto, R. Scott. The Anxious Stories We Tell Ourselves. Psychology Today. July 15, 2015. Accessed May 31, 2023. https://www.psychologytoday.com/us/blog/the-stories-we-tell-ourselves/201507/the-anxious-stories-we-tell-ourselves. Lawton, Graham. "How long does evolution take? It happens on two different timescales." New Scientist. June 15, 2022. Accessed May 29, 2023. https://www.newscientist.com/article/mg25433910-900-how-long-does-evolution-take-it-happens-on-two-different-timescales/. Uyeda, Josef. Lasting evolutionary change takes about one million years. Oregon State University. August 22, 2011. Accessed May 29 2023. https://today.oregonstate.edu/archives/2011/aug/lasting-evolutionary-change-takes-about-one-million-years. Disclaimer This post is for informational purposes only, and should never be considered medical or professional advice of any kind. Please visit our disclaimer page for more info.

A recent article in Forbes Health discusses medication classes commonly prescribed for anxiety. As with so many articles on benzodiazepines and antidepressants, this one includes some valuable information — but it also falls far short when it comes to dependence and withdrawal. In the May 18th Forbes Health article, "Anxiety Medication: Types and Side Effects," contributing author Becca Stanek explores four classes of psychiatric medication. These are selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and benzodiazepines. While the author does present the information on these medication classes in an organized and easily accessible format, repeated errors and shallow research may leave readers with inaccurate conclusions. Withdrawal Complications The primary concern that I have with this article is the same issue I have with most articles on benzodiazepines — the lack of accurate information regarding dependence and withdrawal. And that goes for the antidepressants listed here too. While my background is primarily focused on benzodiazepines and their long-term effects, the absence of caution regarding antidepressants is also alarming, especially considering that they are listed as first-line treatments. But, for now, let's focus on benzos. "This category [benzodiazepines] of anxiety medications has a high potential for misuse and dependence, and is generally not recommended for people who have a history of substance use." — Becca Stanek, Forbes Health In the above quote from the article, the author's primary focus is on substance use disorder (SUD), or addiction. Unfortunately, while some individuals do suffer from SUD with benzodiazepines, the majority have taken the drugs as prescribed by a physician and are dealing with the complications of physical dependence and withdrawal — not SUD. Abuse is not a factor for these individuals. While the author does define tolerance in the following paragraph, there is no mention of withdrawal or any long-term consequences. What is missing in this article — and what most of us in the benzodiazepine community would dearly like to see — is an effective warning about dependence and withdrawal. Something to inform individuals before they start taking a benzodiazepine, so they know the possible consequences of this drug. Here's a sample of what I would like to see in these articles. Perhaps one of the authors might include it one day: Benzodiazepines are not recommended for longer than 2-4 weeks of continuous use. Physical dependence is common, and withdrawal can be severe. Some individuals experience a protracted state known as benzodiazepine-induced neurological dysfunction (BIND) which can last for months, even years after discontinuation. If you choose to withdraw from benzodiazepines, please consult with a licensed physician. Abrupt cessation can be very dangerous, even fatal in some cases. A slow taper under doctor's supervision is the most frequently recommended method. Summary It is clear when reading this article — and many others like it — that the author was not very knowledgeable of the subject and didn't spend much time researching and crafting her message. I understand the pressure to produce content at lightening-speed for these publication houses, but that mindset also leads to poorly worded articles causing misleading interpretations. I hope that with time, we can help educate journalists and improve the messages that they provide. Disclaimer This post is for informational purposes only, and should never be considered medical or professional advice of any kind. Information provided here should never be substituted for medical advice. Do not disregard or delay in seeking medical advice. Do not change the dosage of any prescription medication without consulting with a licensed physician. Visit our disclaimer page for more info. References Basics of BIND. Easing Anxiety. September 30, 2021. https://www.easinganxiety.com/post/basics-of-bind. FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. U.S Food & Drug Administration. September 23, 2020. Accessed May 19, 2023. https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class. Stanek, Becca. Anxiety Medication: Types and Side Effects. Forbes Health. May 18, 2023. Accessed May 19, 2023. https://www.forbes.com/health/mind/anxiety-medication/.

I have to confess something right here from the start. I've let myself go. It's so easy to talk the good talk on a blog or podcast. But, to also put those suggestions into practice and maintain them for years — that is where I have fallen short. The past few years of my life have been extreme, and during that time I lost focus of what got me through my recovery from anxiety medication (benzodiazepines). I was so focused on caring for my parents in another state, that I neglected my own health an self-care. And, I paid the price for it. I keep hearing the age-old cliché in my head, "dance with the one that brought ya." I got busy and started feeling better and let my anxiety tools and healthy habits slip away. My recent wave of benzo withdrawal (BIND) symptoms was a slap in the face — and I needed it. So, I'm returning to the basics. I'm improving my diet, getting more exercise, and re-focusing on yoga and meditation. In fact, I just subscribed to a meditation app for the very first time. There was a discount for a year membership and I went for it. And so far, I'm grateful that I did. I had no idea how much content some of these apps have. I even found a series specifically for my ADHD. And all of that got me thinking that this could be a good blog post. So, here I am. I researched a few of the top therapy and meditation apps available and listed six of them below. All of the apps in this list are available on both iOS and Android. Maybe you can find one that will help you. I hope it helps. ANXIETY APPS Better Help (Therapy) Services: Counseling (CBT, DBT, EMDR, etc.) / stress, grief & anger management / self-esteem / mental health Pricing: Costs range from $60 - $150 / week Website: www.betterhelp.com Review: Google Rating 4.6 2023 Best Meditation App (NYT Wirecutter) Best Anxiety App for Therapy (verywellmind.com) For many, online therapy options are the perfect fit. Founded in 2013, Better Help is the largest supplier of online therapy services with over four million subscribers. They provide 24/7 services from licensed therapists and other accredited professionals via a variety of communication options including phone call, video chat, live chat, or text message. They also offer group support via weekly online seminars and online journaling. If you've thought about getting some therapy support for your anxiety but haven't had the time to find a local counselor, this might be a good alternative. Calm (Meditation/Sleep) Services: Meditation / sleep / stress / body & movement / classes / music & nature / well-being monitor Pricing: Monthly $14.99 / Annual $69.99 / 7-day free trial Website: www.calm.com Reviews: Google Rating 4.5 App of the Year 2017 (Apple) Google Play Editor's Choice 2018 Best Anxiety App Overall (verywellmind.com) Calm is usually at the top of lists for best meditation apps, alongside Headspace (see below). This is the app that I signed up for last week, and I must admit I'm quite impressed so far. Over 100 million people have Calm on their smartphone, so I would guess they are doing something right. In an article in The Atlantic on Calm, the author said there is evidence to back the success of meditation apps stating, "Meditation apps really do undercut the stresses of modern life. Studies also show that app-based meditation seems to have many of the same effects as in-person meditation." Headspace (Meditation/Sleep) Services: Meditation / sleep / stress / articles Pricing: Monthly $12.99 / Annual $69.99 / 14-day free trial (on annual plan) Website: www.headspace.com Reviews: Google Rating 4.6 / Best Anxiety App for Adults (verywellmind.com) Headspace is the primary competitor to Calm in the meditation app category and has millions of users in more than 190 countries. According to Headspace, an Oxford study found that "eight weeks of using the [Headspace] app (for 10-20 minute sessions) resulted in a 31% decrease in symptoms of anxiety and a 46% decrease in depression symptoms." Whether you choose Calm, Headspace, or a different app, there is growing evidence that this technological intervention appears to have benefits for those of us struggling with anxiety. Healthy Minds Program App (Meditation/Sleep) Services: Meditation / sleep / courses (podcast-style) / well-being monitor Pricing: FREE Website: www.hminnovations.org/meditation-app Review: Top 3 Meditation Apps in 2023 (New York Times Wirecutter) Healthyminds innovations provides this app — completely free. Perfect for beginners to mediation who want to "give it a go." According to the New York Times, Healthy Minds Programs is "unburdened by bells and whistles [and] it offers a well-structured, clear sequence of courses. It’s a great option for anyone who wants to see if meditation is right for them." Tide (Meditation/Sleep) Services: Sleep / Meditation / Nature / Quotes Pricing: Monthly $11.99 / Annual $59.99 / Free Version Available Website: www.tide.fm Review: Apple Store Rating 4.8 / Apple Store Best of 2017 The Tide App focuses on four key essentials: sleep, meditation, relaxation, and focus. Tide, at its core, is physical and mental care inspired by traveling, nature, and meditation. It's about getting away from the stressors for life. Tide excels at helping individuals with insomnia by offering sleep analysis, light wake-up alarms, nap modes, and calming nature sounds. Basic meditations are available in a free version. Breathwrk (Meditation/Breathing) Services: Sleep / Meditation / Nature / Quotes Pricing: Monthly $7.99-$11.99 / Annual $59.99-$76.99 / Free version available Website: www.breathwrk.com Review: Google Rating 4.5 Breathwrk is Apple's #1 breathing app. It's key focus is on breathing exercise programs that promote calm, relaxation, and even pain management. Each program is designed to help specific health issues such as anxiety, cardiovascular health, pain, and insomnia. The app isn't just focused on relaxation, but also has energizing exercises to improve performance. According to Breathwrk's description, studies show that "slow, voluntarily regulated breathing practices are non-invasive, easy to learn, and generally safe for treating patients with symptoms of anxiety, insomnia, depression, stress- and trauma-related disorders, ADHD, schizophrenia, and substance abuse." Disclaimer This post is for informational purposes only, and should never be considered medical or professional advice of any kind. The resources listed here are provided as a courtesy only. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. EA receives no compensation for listing any resource on this site. Please make sure you read the privacy guidelines before you sign up for any online service. Some sites are not HIPAA-compliant and may share private information with third parties. Visit our disclaimer page for more info. References Best Apps for Anxiety. verywellmind. Accessed May 17, 2023. https://www.verywellmind.com/best-apps-for-anxiety-3575736. BetterHelp Online Therapy: A 2023 Review. Healthline. Accessed May 17, 2023. https://www.healthline.com/health/mental-health/betterhelp-review. Blackwell, Caira. The Best Meditation Apps. New Yok Times: Wirecutter. Updated January 18, 2023. Accessed May 17, 2023. https://www.nytimes.com/wirecutter/reviews/best-meditation-apps/. Lowrey, Annie. The App That Monetized Doing Nothing. The Atlantic. June 4, 2021. Accessed May 17, 2023. https://www.theatlantic.com/technology/archive/2021/06/do-meditation-apps-work/619046/. Patricia L. Gerbarg MD, Richard P. Brown MD. Neurobiology and neurophysiology of breath practices in psychiatric care. Psychiatric Times. 2016;33(11). https://www.psychiatrictimes.com/view/neurobiology-and-neurophysiology-breath-practices-psychiatric-care.

Personality changes. Loss of ability. Loss of confidence. Loss of self. These are common in benzo withdrawal and BIND, and yet we rarely talk about them. What does this look like? What are its causes? And most of all, what can we do about it? In today’s episode, we explore the loss of self during benzo withdrawal. We also respond to a question on tinnitus, share a comment on the benefits of nature, and hear a benzo story from New Zealand. Video ID: BFP122 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 INTRODUCTION 01:28 Back from Vacation 03:36 Benzo Work Updates 04:57 Still Have Some Symptoms 07:00 Today’s Format 08:11 MAILBAG 08:17 Benzos and Tinnitus 12:58 Nature and Connection 15:39 BENZO STORY 16:29 Eta’s Mum’s Story / New Zealand 22:04 Medical Communication Failures 25:40 FEATURE 26:59 BIND Refresher 27:43 Our Lives Have Changed 28:29 Benzo Life Effects Data 30:41 Loss of Confidence 35:00 Humility vs. Egoism 35:54 Symptoms that Affect Confidence 38:23 What Can We Do? 38:42 Making Use of the Extra Time 40:35 Finding Acceptance 42:59 Six Tips for Improving Self-Esteem 47:22 MOMENT OF PEACE Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. — Ackerman, Courtney E. “What Is Self-Confidence? (+9 Proven Ways to Increase It).” Positive Psychology. July 9, 2018. Accessed May 11, 2023. https://positivepsychology.com/self-confidence/. — Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. https://easinganxiety.com/ashton. — Finlayson, AJ Reid, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. — Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, CO: Denim Mountain Press, 2018. https://www.benzofree.org/book. — Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. — Ravenscraft, Eric. “Practical Ways to Improve Your Confidence (and Why You Should).” New York Times. June 3, 2019. Accessed May 11, 2023. https://www.nytimes.com/2019/06/03/smarter-living/how-to-improve-self-confidence.html. — Tinnitus. Mayo Clinic Patient Care & Health Information. Accessed May 11, 2023. https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156. — “Top 10 Tips for Overcoming Low Self-Esteem.” Ditch the Label. September 26, 2022. Accessed May 11, 2023. https://www.ditchthelabel.org/overcoming-low-self-esteem/. The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

A recent article in Pharmacy Times highlights the concern of benzodiazepine use in medical settings, especially with older adults. In a May 11 article by Richard P. Dutton, MD, the author states that "minimizing unnecessary benzodiazepine use has become an important principle for patients and anesthesiologists hoping to have the clearest, quickest emergence from anesthesia, with the lowest risk for delirium or any other cognitive dysfunction." Alternatives for treating anxiety related to medical procedures are available, "including clear prep instructions and good communication." Mark D. Neuman, MD, MSc, at the University of Pennsylvania leads a collaboration focused on reducing unnecessary use of preoperative midazolam in patients 65 years of age or older scheduled for anesthesia. "The DROP-Benzo trial (De-adopting Routine Preoperative Benzodiazepines for Older Surgical Patients) consists of a year-long sequence of educational efforts followed by block-randomized deployment of 2 behavioral nudges designed to increase mindfulness about the risks and benefits of benzodiazepine administration." Minimizing unnecessary benzodiazepine use has become an important principle... — Richard P. Dutton, MD One of the interventions utilized is a 20-page, easy-to-read guide to anesthesia care: https://online.flippingbook.com/view/728110703/6/. This guide was developed by US Anesthesia Partners (USAP) and is routinely distributed to its providers and patients. Read the full article here: https://www.pharmacytimes.com/view/deprescribing-benzodiazepines-in-older-adults-an-anesthesiology-quality-initiative References Dutton, Richard P. "Deprescribing Benzodiazepines in Older Adults: An Anesthesiology Quality Initiative." Pharmacy Times. May 11, 2023. Accessed May 12, 2023. https://www.pharmacytimes.com/view/deprescribing-benzodiazepines-in-older-adults-an-anesthesiology-quality-initiative. "Preparing for Your Procedure." Digital Flipbook. US Anesthesia Partners. Accessed May 12, 2023. https://online.flippingbook.com/view/728110703/.

According to a recently updated article in AARP, antianxiety drugs (benzodiazepines) top the list of memory-robbing medications. Benzodiazepines include drugs such as alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), clonazepam (Klonopin), and many others. In the article, Dr. Armon B. Neel, Jr. stated that "benzodiazepines dampen activity in key parts of the brain, including those involved with the transfer of events from short-term to long-term memory." He cautioned that benzodiazepines should be "prescribed only rarely in older adults, and then only for short periods of time." Benzodiazepines not only can cause memory issues in this population, but also contribute to falls, fractures, and motor vehicle accidents, among other complications. Benzodiazepines dampen activity in key parts of the brain... — Dr. Armon B. Neel Jr., AARP Health The author also cautioned against abrupt cessation and advised patients to consult with a physician before stopping or reducing their prescription. Stopping benzodiazepines abruptly can lead to hallucinations, seizures, and even death. Patients are advised to work with a physician familiar with benzodiazepine withdrawal if they choose to reduce their medication. Most experts recommend a slow taper under doctor supervision. Nonbenzodiazepines (Z-drugs), which have similar effects to benzodiazepines, are number five on this list. This class of drugs includes eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien). While Z-drugs have a completely different chemical structure to benzodiazepines, they do have similar effects and withdrawal complications. The author cautioned that Z-drugs "also can cause amnesia and sometimes trigger dangerous or strange behaviors, such as cooking a meal or driving a car with no recollection of the event upon awakening." The list of medications that can cause memory loss includes: Antianxiety drugs (benzodiazepines) Antiseizure drugs Tricyclic antidepressants Narcotic painkillers Sleeping aids (nonbenzodiazepine sedative-hypnotics) Incontinence drugs (anticholinergics) Antihistamines (first generation) Other medications of concern include corticosteroids, heartburn medications, and cannabinoids. It is important to remember that while memory loss can be an effect of benzodiazepine and nonbenzodiazepine (Z-drug) use, and that long-term use has been associated with an increased risk of dementia in some studies, the return of memory and cognitive function after discontinuation is also quite common. This process may take some time for some individuals, but most accounts of benzodiazepine withdrawal include gradual improvement after the drug and its effects are removed from the body. If you are concerned about benzodiazepines or Z-drugs and their effects, please consult with a licensed physician. Do not attempt to reduce or discontinue any prescription without professional medical guidance. References Foster, D E. "5 Dangers of Benzodiazepine Use in the Elderly." Easing Anxiety. April 26, 2019. https://www.easinganxiety.com/post/5-dangers-of-benzodiazepine-use-in-the-elderly. Benzodiazepine Deprescribing Guidance. Benzodiazepine Action Work Group at the Colorado Consortium for Prescription Drug Abuse Prevention. https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf. Neel Jr., Armon B. "Caution! These Drugs Can Cause Memory Loss." AARP Health. February 9, 2016. Updated April 14, 2023. https://www.aarp.org/health/drugs-supplements/info-2017/caution-these-10-drugs-can-cause-memory-loss.html. Disclaimer Easing Anxiety is for informational purposes only and should never be considered medical advice. Please see our disclaimer for more information.

One of the promises I often make on the podcast is that "I will keep this brief." If you've listened to the podcast for any length of time, you probably know that I often struggle to deliver on that promise. Well, this time I am going to hold true to it. So, here it goes... I'm back from vacation. It was good. Podcast episode coming this week. Excited to get back to work. Hope you are well. Talk soon. There... how was that? Take it easy, D :)

When was the last time you took a vacation? Have you ever postponed, or cancelled a vacation? Have you done this repeatedly? We all need to take some time away. This is essential for everyone — and even more so for those of us dealing with anxiety, benzo withdrawal (BIND), and other psychological and neurological issues. In an article from Forbes magazine titled "Why Taking Vacation Time Could Save your Life," the author refers to a study that found 26% of respondents had never taken two weeks of vacation at one time. In a separate article, a World Health Organization (WHO) study found that working 55 hours or more a week was associated with a 35% higher risk of stroke and a 17% higher risk of dying from heart disease than a workweek of 35 to 40 hours. And on top of that, many who do take vacations often take work with them and rarely, truly relax. One of the benefits of vacation time is that it increases mindfulness. It also can help you catch up on sleep, develop new perspectives, relieve stress, and increase productivity. Metabolically speaking, vacation time helps to reduce high blood pressure, high blood sugar, excess belly fat, and abnormal cholesterol levels. Vacation and Benzos Some of you may be asking, but what does that have to do with me? How can I take a vacation during benzo withdrawal and BIND? A vacation doesn't have to be two weeks long. It can be a weekend, a day, even a few hours. Dealing with withdrawal and BIND is a form of work, hard work, intense work much of the time. And we need a break from that work. Doing this isn't always easy, but there are ways. Here are a few ideas that might help: Utilize Your Windows — When you get a window from you symptoms, make use of it. Try and get your mind off your condition. Get out into nature and get away from your home if you can. Make use of this time to reset your mindset. It's so easy to ruminate on the state of your life, but that helps no one. Break away from the pattern, if even just for a couple of hours. Try Some Mindfulness and Meditation — Meditation and mindfulness are very valuable tools in BIND. Even if you can't get out of the house, or escape your symptoms, you can encourage your mind to take a break — without having to go anywhere. Here are some meditation ideas from our site. Change Your Environment — It is common for us to attribute our home with suffering during withdrawal and BIND. This is where many of us spend our time — so our house, apartment, office, whatever, can be linked to negative emotions and imagery. When you can, get away. See new things. Explore new areas. Give your mind and your emotions something else to work on, at least for a little while. Give Your Caregiver a Break — Encourage your caregiver to take a break too. This is critical. Benzo caregivers are often overworked, stressed, and need a break just as much as we do, if not more. Encourage them to take a break away from you, when they can. My Time to Get Away And that brings me to... well, me. I'm leaving tomorrow morning to the great states of Ohio and Pennsylvania. My wife has family in that area and I've never really toured either state, so it's about time. Yes, this is a road trip. Not a surprise to many of you who know me. And guess what, I'm not recording any of it for the podcast. That is a surprise to many of you. That's right, this is a vacation and it's going to stay that way. The truth is, I've reached my limit. I do that sometimes. Then again, don't we all? And I need to take some time away to allow myself to rest, heal, and maybe even process a few emotions and some grief that I've been avoiding for some time now. This is a cycle for me, and I know when it's time to take a break. I wish you all well and hope that you can also find some time to escape in the coming weeks. I'll be back around the second week of May and look forward to catching up with you then. Take care my friends, D :) References Castrillon, Caroline. "Why Taking Vacation Time Could Save Your Life." Forbes. May 23, 2021. https://www.forbes.com/sites/carolinecastrillon/2021/05/23/why-taking-vacation-time-could-save-your-life. Foster, D E. "10 Tips for the Benzo Caregiver." Easing Anxiety. April 5, 2019. https://www.easinganxiety.com/post/10-tips-for-the-benzo-caregiver. "Long working hours killing 745,000 people a year, study finds." BBC News. May 17, 2021. https://www.bbc.com/news/business-57139434. Easing Anxiety is for informational purposes only, and should never be considered medical advice. Please visit our disclaimer for more information.

Road Trip to the Rx Summit in Atlanta (Final) / Presentation Cancellation, Vacation Reschedule, Benzo Community Activity, Social Media Effects, and Rollin’ with the Changes Video ID: BFP121 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 Which Day Is It? 00:19 Presentation / Vacation 04:59 What to Talk About? 05:48 Benzo Community Activity 06:15 Social Media Effects 08:30 Promoting Others’ Sites 10:12 Rollin’ with the Changes 12:23 Closing Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. Rx and Illicit Drug Summit Rx Summit: https://rx-summit.com Rx Summit Agenda (Benzo Presentation Tuesday 8:00am): https://www.eventscribe.net/2023/RxSummit/agenda.asp?startdate=4/11/2023&enddate=4/11/2023&BCFO=&pfp=FullSchedule&mode=&fa=&fb=&fc=&fd= The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

Road Trip to the Rx Summit in Atlanta (Day 5-6) / 1st Day of Rx Summit, Small Victories, Managing Benzo Limitations, BIND, Pelvic Floor Dysfunction and Urinary Difficulties, Fear of Heights, and Finding Ways to Do Things Video ID: BFP120 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 Welcome to Days 5-6 00:28 Day 5 Recap 01:31 First Day of Conference 04:15 Benzo Morning Obsessions 06:50 Small Victories 07:13 Managing Limitations 07:47 Pelvic Floor Dysfunction 10:45 Managing PFD 14:57 Symptom Management 15:50 Fear of Heights 17:40 Finding Ways to Do Things 19:06 Thought Train Derailment 2 20:30 Closing Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. Rx and Illicit Drug Summit Rx Summit: https://rx-summit.com Rx Summit Agenda (Benzo Presentation Tuesday 8:00am): https://www.eventscribe.net/2023/RxSummit/agenda.asp?startdate=4/11/2023&enddate=4/11/2023&BCFO=&pfp=FullSchedule&mode=&fa=&fb=&fc=&fd= The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

Road Trip to the Rx Summit in Atlanta (Day 4) / Nashville, TN to Alpharetta, GA / Driving and Flying Working Around Limitations, Emotions and Social Media, Setting Boundaries Video ID: BFP119 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 Welcome to Georgia 02:16 Managing My Symptoms 1 02:46 Hotel Room Tour 04:51 Driving in the Rai 05:42 Managing My Symptoms 2 06:24 Driving and Flying 07:47 Work Around Limitations 08:48 Emotions and Social Media 11:59 Setting Boundaries 12:52 Train of Thought Derailment 13:20 Back to Boundaries 14:53 Care for Our Caregivers 15:37 Closing Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. Rx and Illicit Drug Summit Rx Summit: https://rx-summit.com Rx Summit Agenda (Benzo Presentation Tuesday 8:00am): https://www.eventscribe.net/2023/RxSummit/agenda.asp?startdate=4/11/2023&enddate=4/11/2023&BCFO=&pfp=FullSchedule&mode=&fa=&fb=&fc=&fd= The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

Road Trip to the Rx Summit in Atlanta (Day 3) / Branson, MO to Nashville, TN / Back Home in Missouri, People with Crosses on the Roadside, Getting Out There and Doing Things Video ID: BFP118 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 00:00 Welcome to Opryland 01:11 Back Home in Missouri 03:27 Roadside Crosses: Preface 07:29 Roadside Crosses: Interview 09:24 Roadside Crosses: Follow Up 12:54 Getting Out There and Doing Things 14:31 Closing Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. Rx and Illicit Drug Summit Rx Summit: https://rx-summit.com Rx Summit Agenda (Benzo Presentation Tuesday 8:00am): https://www.eventscribe.net/2023/RxSummit/agenda.asp?startdate=4/11/2023&enddate=4/11/2023&BCFO=&pfp=FullSchedule&mode=&fa=&fb=&fc=&fd= The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved