In these highly polarized times, family gatherings like Thanksgiving and Christmas can be stressful. Many people may worry about interacting with relatives whose political views differ. Just thinking about family fights over the dinner table can be enough to trigger anxiety.
What to Do about Uncle Charlie?
Some people have a hard time restraining themselves no matter what the occasion. They seem to relish poking people who have a different perspective. No matter how much family members try to placate Uncle Charlie, he just wants to argue. Family fights can turn the most delicious meal into a war zone. Of course, Uncle Charlie is a metaphor for any argumentative family member. We have nothing against your Uncle Charlie, we promise.
High Anxiety During the Holidays:
As if family fights weren’t enough, just imagine holiday shopping and fighting the crowds that descend on malls and big box discount stores. Then there’s the traffic. People become irrational on the roads. Everyone seems to be in a hurry. That means they take short cuts with safety, cutting off other drivers, speeding and making unexpected turns. Finding a parking place at the mall can turn into a never-ending nightmare. We have witnessed near fights over who arrived first at an empty parking slot.
Clearly, the holidays can be challenging times for all sorts of reasons. How can you prepare for the hostility, stress and anxiety of the next several weeks?
Are Drugs the Answer to Anxiety?
Barbiturates for the Brain?
It you tell your doctor that you aren’t sleeping well and are feeling anxious, tense or overwhelmed because of the holidays, you may be offered a prescription. Fifty years ago doctors prescribed barbiturates for anxiety or “nerves.”
Sedatives like pentobarbital or phenobarbital may have taken the edge off, but they were easily abused. In overdose or combined with alcohol, they could be lethal. People who accidentally died because of barbiturate overdose or a deadly interaction include Marilyn Monroe, Judy Garland and Margaux Hemingway.
Benzodiazepines Remain Popular:
If you tell your health professional that you are freaked out because of family fights during the holidays, you may be offered a benzodiazepine. “Benzos” like chlordiazepoxide (Librium) and diazepam (Valium) became very popular after barbiturates fell into disfavor. Doctors may have felt like wizards with a magic prescribing wand. Benzos seemingly made cares and worries vanish without the risk of unintentional suicide.
The stresses of daily life were less intrusive when a benzo was on board. Politics and the fear of family fights might have seemed less threatening. Shorter-acting compounds such as alprazolam (Xanax) and lorazepam (Ativan) became hugely popular. Clonazepam (Klonopin) is prescribed for anxiety, panic attacks and insomnia.
Driving on Benzos Can Be Disastrous:
It took years before health professionals realized that these medications also had some serious drawbacks. Driving is hazardous for people taking such drugs (Journal of Studies on Alcohol and Drugs, online, Oct. 31, 2017). Patients are not always warned about this danger.
Benzos and Confusion:
Few health professionals are aware that benzodiazepines and other “Z” drugs for insomnia may impact cognitive function.
Mary shared this story about her mother:
“When my mother was in her late 80’s, she was prescribed lorazepam for anxiety by her general practitioner. Over the next few years, she became increasingly confused and agitated. She told the neighbors that my father had kidnapped her and was holding her hostage. She no longer recognized my brother. Eventually, she could no longer do even simple tasks.
“She experienced numerous panic attacks and was convinced there were two of my father. One lived upstairs and one lived downstairs.
“When my brother and I finally got her to a geriatric psychiatrist at the University of Chicago, he diagnosed her with Alzheimer’s disease. He also changed her anxiety medication. Within a month, she was back to her pre-lorazepam clarity. Mom and was amazed at what we told her had been going on with her for the past several years. She passed away at 97 with complete mental clarity.”
A study published in the BMJ (online, Sept. 9, 2014) reported a link between long-term use of benzodiazepines and dementia. The authors concluded:
“This case-control study based on 8980 individuals representative of elderly people living in the community in Quebec showed that the risk of Alzheimer’s disease was increased by 43-51 percent among those who had used benzodiazepines in the past.”
Benzo Side Effects:
- Drowsiness, dizziness
- Fatigue, lethargy
- Clumsiness, impaired coordination (not good for older people)
- Dry mouth, constipation
- Memory problems, amnesia
- Cognitive impairment, difficulty concentrating, confusion, irritability
- Sexual difficulties
- Low blood pressure
- Depression, suicidality
- Difficulty stopping the drug
Getting Off Benzos:
Stopping benzodiazepines suddenly can lead to scary withdrawal symptoms. They may include anxiety and jitteriness, sensations of panic, trouble sleeping, difficulty concentrating, extreme sensitivity to sound or light, headache, digestive distress and sweating.
Peggy in Williamsburg, KY had a hard time with withdrawal:
“I was taking Xanax (alprazolam) for 14+ yrs. I stopped taking them because my doctor left. The flood gates of HELL opened up. I’m doing good now except I’ve been having high heart rate and flutters I am 5 months out. I just hope and pray my heart rate returns to normal one day.”
Victoria in California reported:
“I am off Klonopin (clonazepam) after taking it for 30 years. The anxiety rebound I handle with meditation; however the physical symptoms are horrible. With a doctor’s assistance I tapered off for one year until off the medication. I have bloating in my stomach and what people in England call a Benzo Belly, though I am at my perfect weight.
“I am writing to let people know it is possible to be free of Benzos. I must tell myself that this will not last forever and right now I am very calm. Taking this medication for many years when older can cause: serious fall risks and dementia. I have numerous physical symptoms which can be researched online but do not want to dwell on them.”
Anthony in Santa Fe, NM has had long-lasting symptoms:
“I was prescribed a low dose of Klonopin for anxiety and insomnia. My physician never warned me about dependence. I was probably on this drug for 18 months. Long story short, the side effects of benzos mirror the problems for which they were prescribed so there is a tendency for physicians to up the dosage.
“I resisted that (fortunately) but with time my side effects were so uncomfortable that I was barely able to function. I educated myself and learned that benzo addiction is extremely common in a certain percentage of patients. Some can get off the drug by weaning themselves with decreasing doses over a period of a month or two–others, such as myself, are much less fortunate.
“The weaning only made me more and more miserable until one day I just quit cold turkey. The next 6 months were pretty much a living hell and I wasn’t finally free of the withdrawal symptoms for two years. I am still far from right. In England this drug is virtually never prescribed for longer than two weeks. In the US it’s as if nobody has a clue about how dangerous prescribing these drugs is.”
Antidepressants for Anxiety:
Just the thought of the holiday season makes some people extremely anxious. It’s not just family fights. The shopping, busted budget and commercialism drive many people to seek medication. Some doctors now prescribe SSRI- or SNRI-type antidepressants for anxiety. Drugs such as duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and venlafaxine (Effexor) are being prescribed to ease anxiety.
Withdrawal from Antidepressants:
Like benzodiazepines, however, these drugs can trigger distressing withdrawal symptoms if they are stopped too swiftly. One reader wrote:
“I was on duloxetine for eight months to ease my anxiety and panic attacks. The drug made me moody, argumentative and zoned out.
“I asked the doctor about coming off and was told to wean off it gradually. Although I have followed that advice, I have been experiencing terrible dizzy spells as if I am going to faint. I ache all over and am exhausted all the time. I’ve had hot flashes, dry mouth and dreadful mood swings. My head aches and I cannot seem to find the right words when I want them. I cry a lot and have been very emotional.”
Symptoms of Benzodiazepine Withdrawal:
- Anxiety, restlessness, jitteriness, agitation
- Impaired concentration
- Faulty memory
- Irritability, sensitivity to sound, light and touch
- Muscle cramps
- Muscle twitching
- Blurred vision
- Decreased appetite
No Magic Wands for Anxiety:
Such reports remind us that there are no perfect drug treatments for anxiety. Even non-drug treatments may fall short. Nevertheless, some people find that valerian root supplements can be helpful in dealing with stress.
Ashwagandha is an ancient Indian herb that also seems to take the edge off anxiety or worry. This can be helpful for people who are tired but wired, worrying themselves awake at night.
You can learn more about ashwagandha at this link:
A meta-analysis of previous studies found that people who lift weights or do other types of resistance training were less anxious than those who did no exercise (Sports Medicine, online Aug. 17, 2017).
Cognitive behavioral therapy is also a proven way to address anxiety without drugs.
Another option for family get-togethers this holiday season would be to ban political discussions over the dinner table. Life is too short to engage in family fights over the holidays.
How do you cope with family discord? Share your story below in the comment section.