For the 20 million Americans who suffer from depression, I explained last week how antidepressant medication is wonderful. It helps relieve some of the symptoms of depression without creating any, and it even relieves one of the causes.

Whereas antidepressants have no inflated street value because they give you no buzz or addictions, most medicines for anxiety are just the opposite. They are sold on the street at a profit, because they do provide a short-term habit-forming buzz.

Well over twice as many Americans suffer from anxiety problems as from depression, but here the most popular medicines in many cases end up doing more harm than good. For too many, a pill relieves some anxiety symptoms, quickly but not for long, so that they come back as strong or stronger after the pill wears off. Instead of relieving any of the causes of anxiety, a nerve pill creates the discomfort of withdrawal, which becomes a new source of anxiety.

Because its onset is gradual and felt all over the body, withdrawal discomfort is subtle and yet bothersome. Another anxiety-producing side effect of tranquilizers and sedatives is equally insidious: to some extent users learn to monitor their nerve and muscle tension closely for signs that they might be ready for another pill. In scanning for stress, they have in effect gone on psychosomatic alert.

Too many of my friends and clients have abused these pills and become dependent on them. After that, they’ve not been much good to themselves or others, except for the few fortunate ones who found recovery.

Sure, there’s research that says there’s not much risk of abuse or dependence with the milder sedatives ("nerve pills" like Valium, Xanax, Librium, Tranxene, and Ativan), or the heavier sedatives ("sleeping pills" like Tylenol PM, Ambien, Lunesta, Sonata, ProSom, Restoril, Halcion, and Dalmane).

But these studies have usually been sponsored by the companies who make these drugs, and the same was done and said in the old days when barbiturates and morphine came out. All of us who have had special training in treating drug abuse have seen the overwhelming research evidence that these meds carry a significantly greater risk for abuse and dependency.

This risk is especially great for the approximately 30 % of Americans who have had a parent get dependent upon alcohol or drugs. Because of genetics, modeling and the added likelihood of being born into a chaotic or detached family, they are almost twice as likely as everyone else to develop drug abuse or dependency in their own lives. The extra 10 or 15% who have had both parents to be drug abusers are three times more at risk with these medications.

Now I’m certainly not saying that no one should be taking medication for pain, anxiety or insomnia. I’m only suggesting as I did last week that alongside these medicines we take measures to resolve the underlying causes of our anxiety, and to avoid abuse of these pills. All this generally requires some form of counseling to pull off.

Counseling may also be needed to work through the denial that comes with any chemical dependency or abuse. So what might drug abusers be denying? Here are some common tendencies:

1. They deny there are other, better ways to relax, get to sleep or get through the day.

2. Before and after medication, they deny that withdrawal makes them tense, and act short or mean toward anyone that questions their drug use.

3. During medication, they deny how physically and emotionally unavailable they are to their loved ones, and how much their loved ones need them.

They deny how much they are hurting themselves with these drugs, given the medical and psychological side effects. They deny how their lives have gone downhill during their years of drug abuse. They forget how close they used to be to family, friends and God. They forget when they used to have self-esteem and self-confidence. They forget the hopes and dreams of their youth, which were more noble than what they long for now--calm nerves, pain relief and a good night’s sleep.

Once they begin to see the harm being done to themselves or others, they deny how bogus are their finger-pointing excuses for using the drugs anyway: "If you had my (wife, husband, kids, parents, boss, job, pain, life, whatever), you would need help relaxing, sleeping and coping with pain too."

So remember that an ounce of prevention for anxiety is worth a pound of cure. And realize that if you’re not careful with these pills, the cure you’re counting on for tension, pain or insomnia too often becomes a contributing cause.


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Dr. Paul F. Schmidt