I have a son with Duchenne’s Muscular Dystrophy, a slow, progressive terminal illness. He is now 10. I struggle daily with trying desperately to keep my precious family in balance. I have a husband (43), a daughter (14), a career and a home. I am taking Xanax daily for stress, about 1.0 to 1.5mg a day, and it seems to help. I have heard conflicting reports about this medication and I was wondering what your thoughts are. Should I get off it completely or would you suggest something else to help the anxiety and stress?
It sounds like you are, indeed, faced with a challenging path ahead; and you are already doing many things to safeguard your physical, mental and spiritual health. I have a few additional thoughts.
You are right to question the use of Xanax (alprazolam), a benzodiazepine or anti-anxiety agent that is quite potent and has a short half-life. Other benzodiazepines include Librium (chlordiazepoxide), Valium (diazepam) and Ativan (lorazepam). Because of these qualities of high potency and short half-life, alprazolam offers a sense of relief very quickly, but it also comes out of your body rapidly, often leaving a person feeling more jittery and wanting more medication. For this reason, it tends to be rather “addicting.”
In addition, as a person gets used to the action of the benzodiazpines, suddenly stopping them can bring on a withdrawal syndrome characterized by rebound anxiety, shakiness, and even changes in blood pressure, heart rate, and in the worst cases, seizures. All of the benzodiazepines can induce tolerance (the use of higher and higher doses) and withdrawal symptoms. However, in certain circumstances, and when used in a judicious and informed manner, they are highly effective and useful medications.
For the pharmacological treatment of anxiety, other medications to consider, and to discuss with your physician, include:
- antidepressants, which are often very helpful for people with chronic anxiety and which are not “addicting”
- a medication called buspirone (Buspar), which is an anti-anxiety medication that is not sedating or “addicting”
- benzodiazepines that are not so potent and that do not have such a short half-life (such as lorazepam or clonazepam)
In terms of non-pharmacological treatments for anxiety and stress, and in order to maintain yourself in the best possible physical and mental condition, you may want to consider the following:
- Make sure you are getting enough omega-3 essential fatty acids in your diet.
- Make sure you have adequate intake of important vitamins and minerals. Anecdotal reports suggest that the following nutrients are helpful in people with mood and anxiety symptoms and for energy level in general: B vitamins (especially B6), calcium, magnesium, selenium, zinc, vitamin E.
- Consider the use of St. John’s wort (300 mg up to 3 times a day), or SAM-e (200-800 mg per day) — butn only if there is no history of bipolar disorder in yourself or your family.
- Add a relaxation or meditative mind-body practice to your exercise regimen (yoga, tai-chi, qi gong). Look for a practice that emphasizes breathing techniques and quiet “centeredness.”
Because you are 41, it is also important to know that you are entering a stage of your life where you might begin to experience peri-menopausal symptoms, and for many women this includes increased anxiety and a sense of stress. You may want to begin to educate yourself about this and about nutritional guidelines you can follow to help minimize such symptoms.