As an online expert in Anxiety Disorders, I get asked this question frequently. Today, I got asked by a pharmacy student about his doctor prescribing him Valium (diazepam) for Generalized Anxiety Disorder (GAD). First off, let me be clear about benzodiazepines:
BENZODIAZEPINES ARE CONTRAINDICATED FOR LONG TERM USE.
I get it that benzodiazepines work for anxiety, and are effective, but the real problem with them is their addictive potential. So when you take them for longer than a few weeks, you start to need more and more of the benzodiazepine to get the same effect. This is called tolerance…you need ever-increasing amounts of the drug to get the same effect. And after you have been taking benzodiazepines for a long time, you start to get withdrawal symptoms when you stop taking it or go on a lower dose…this is called dependence. Withdrawal symptoms include agitation, tremors, sweating, anxiety, restlessness, fatigue, and poor concentration.
So with the tolerance and dependence that can occur after chronic use, you start to use higher and higher doses of the benzodiazepine, and you end up with a bigger problem than the one that you started with. So instead of just having anxiety, you now also have a substance abuse disorder to benzodiazepines.
Sure, there are some who swear that they can take benzodiazepines for the long term without getting addicted to it. But the problem is that they depend solely on the drug, and it keeps them disabled, as they forego other treatments which would help over the long term in eradicating their anxiety. Sure, there are some who can take benzodiazepines for long term and may not become addicted to it- but these are the rare exceptions. For most other people, like the other 99%, you should not use benzodiazepines for longer than a few weeks, to decrease the risk for addiction and other treatment emergent side effects, such as in-coordination, fatigue, tremors, and altered mental states.
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I like that you talked about benzodiazepines and their abuse potential. My friend struggles with anxiety, so I’ll have to mention this to her. Hopefully, she can use meditation and exercise to manage her emotions instead of pharmaceuticals. I know that she will be very happy to hear this, as it has been on her mind of late. Thanks so much for the help!
Thank you for visiting, and glad it was helpful.
I completely agree with the addictive potential and that benzodiazepines are really a medication that should be used in emergency situations and temporarily. Benzodiazepines work very well, but that is the problem, they do not allow the brain to develop real coping skills to deal and manage anxiety, they actually make your anxiety worse and worse over time. The best route is to only use benzodiazepines in emergency situations and I do not believe doctors should prescribe to manage any type of mental health condition.
It is a myth to think any psychotropic medication can bring back mental health- it requires the coping skills that you mention, and the environmental and familial supports to get someone better from mental illness. Psychotropic medications are just a part of the overall treatment plan.