My first panic attack sent me to the hospital. Like many people experiencing profound physical anxiety for the first time, I couldn’t be convinced of any explanation other than that I was definitely dying. A friend brought me to the emergency room where staff conducted an EKG and hurried me away with a Valium, a bill and a strong urging to consider treatment for anxiety.
A year later, I sat in my GP’s office, shaking and sweaty and scared and weak. My doctor wasn’t available, but her partner had agreed to see me when I told him I was on my way and an ambulance should meet there if they couldn’t fit me in. I’ve never felt worse, I told them. Everything hurts. I can’t sleep. I can’t be awake. I can’t move. I can’t stop moving. I feel crazy. I think it’s my kidneys, or my brain stem, or maybe a real blood clot this time.
Everyone else ― urgent care doctors, psychiatrists, family and friends ― had told me I was just anxious. I had been feeling more nervous than usual, but I’d recently stopped taking the Klonopin I’d been prescribed as needed when I noticed I was taking them almost every day. I’d had concerns about their long-term impact and about developing physical dependency. That explained the anxiety, I thought, but not the unyielding panic and physical discomfort I’d felt for the past seven days and on and off for months before. Someone would have warned me about that.
The doctor examined me and confessed, with apparent contrition, that he couldn’t find anything medically wrong.
“Have you ever taken Klonopin for panic?” he asked me, ostensibly to suggest some for his diagnosis of Anxious Woman Wasting My Time. Yes, I told him. I’d been taking it a few times a week, at that rate for about a year. “When was the last time you took any?” About a week ago, I said. His jaw dropped. I was in the throes of serious benzo withdrawal, he told me. He was surprised I was even standing.
I was reminded of this period in my life earlier this week when Lena Dunham revealed she’d been “sober” for six months after “misusing” the anti-anxiety drug, in her words. Like Dunham, I’m an anxious millennial woman steeped in a high-pressure environment and with privileged access to health care. During a particularly difficult period of amplified anxiety and frequent panic attacks, my doctor also sent me off with a cheap script for benzodiazepines, promising a salve in my time of need and failing to mention how quickly my mind and body could become dependent.
Physical tolerance to benzodiazepines can develop even when users take them in “therapeutic doses,” or as the medication is prescribed. When taking the drug regularly, users can develop physical dependence in less than four weeks and experience unpleasant symptoms when they try to stop. Often, these symptoms mimic those of anxiety ― the same symptoms patients might have originally taken the drug to eliminate. If someone has taken the medication for longer, between one and six months, sudden cessation can cause more extreme side effects, including seizures.
“I didn’t have any trouble getting a doctor to tell me, ‘No, you have serious anxiety issues, you should be taking this. This is how you should be existing,’” Dunham said of her doctor’s approach to her Klonopin use.
She also said she believed her use gave way to misuse under her doctor’s supervision, yet without her doctor’s intervention. I had the same experience, and while I don’t blame my doctor for what happened to me, I do wonder how many women complaining of anxiety, or something worse, are sent away with a prescription ― one casually vaunted in our society ― and have no idea that, in a few months, they might not be able to live without it, and how dreadful they might feel if they try.
“Only people “addicted to drugs” felt unwell when they stopped using them, I thought. People “dependent” on things like Klonopin or Xanax just didn’t feel as happy or calm without them, I thought.”
Following my first panic attack, which seemed to hitch a ride from the general psychic discomfort that characterized my mid-20s, my doctor prescribed a common antidepressant, which I took. I asked if she could also prescribe something for the panic ― just one pill I could carry around in my purse. She prescribed me 30 small doses of clonazepam, the generic for Klonopin, so I wouldn’t have to call and refill it for a while. I never intended to take it unless my untreated anxiety launched me into extreme physical or emotional distress.
Suddenly, that was all the time. Like Dunham’s, my standard for “extreme distress” requiring medicinal intervention seemed to creep lower and lower. I was an anxious person, everyone insisted on telling me. Friends and colleagues wielded benzos casually to avoid airplane jitters or smooth out a tough day at work. If I could extinguish existential dread and get to bed at a decent hour, why wouldn’t I? I’m taking care of myself, I thought.
Klonopin, like Xanax, is a benzodiazepine, a class of drugs that bind to GABA receptors in the brain that decrease nervousness. Some people experience pleasant feelings approximating a “high” when they take it, but I never really thought I did. The pill just shuttered the part of my brain that insisted on living in anguish. I thought Klonopin just made me feel like a person who isn’t anxious.
I also I can’t deny that, as Dunham put it, Klonopin did help me “feel like the person I was supposed to be.” It soothed the hangover anxiety that terrorized early weekend mornings and threatened my brunch plans. And at least in the beginning, it removed theretofore intractable barriers to sleep and social ease, hushing the self-consciousness that gnawed at my productivity and self-esteem.
My Klonopin use had transitioned from “in case of emergency” to “as needed,” and I felt like I needed it most days. I was still fresh off my panic streak and wanted to avoid another one. But for some reason, I was experiencing more physical anxiety than ever. To this day, I can’t fully explain how I didn’t know what I was doing ― how I didn’t know that by taking Klonopin regularly, I could no longer stop abruptly.
But my doctor’s failure to intervene or notify me that I was taking the pill regularly enough to experience withdrawal effects if I stopped, paired with my blind certainty that I would never let myself to get in too deep with any type of drug given a family history of substance abuse, steered me swiftly toward the very worst months of my life.
About a year after I was originally prescribed, I began to worry about the frequency of my Klonopin use. I decided that if I was going to feel this anxious all the time, I needed to find a healthier solution. After about a month straight of near-daily use, I didn’t refill my prescription.
I had no idea that by this point, my brain and body had become dependent on the drug to function properly. My exposure to illicit drug addiction had distorted my understanding of “dependence” ― only people “addicted to drugs” felt unwell when they stopped using them, I thought. People “dependent” on things like Klonopin or Xanax just didn’t feel as happy or calm without them. But a day or two after my last dose, my brain was begging for the chemicals I’d provided a steady supply of for several months, sending painful signals to every other part of my body.
“Waves of panic crashed into a pulsing sea of pain whose current dragged sleep further and further away.”
People experience and describe benzo withdrawal differently, but sufferers and medical professionals agree that symptoms can rival those expected when heavy opioid and intravenous drug users quit cold turkey. Dunham describes hers as “most hellacious acid trip you’ve ever had where you’re fucking clutching the walls and the hair is blowing off your head.”
For me, it mostly felt like a torch was taken to my brain, exposing its soft tissue to frigid air that scraped at the raw recess left behind. It felt like my eyes were missing, but wherever they were, they hurt. Waves of panic crashed into a pulsing sea of pain whose current dragged sleep further and further away. My body ached from busying itself to avoid a pain that hit hardest at rest. I spent early mornings researching my symptoms and the horrifying diseases and freak medical prognoses they suggested. I never encountered “Klonopin withdrawal symptoms” in my search.
I’d felt this way before, in the weeks or days between filling my Klonopin script in the past. Symptoms went away when I started taking it and came back when I stopped, but for reasons I still don’t understand, I never connected the two. I simply thought my natural state was to be so anxious that I needed to medicate daily. It never occurred to me I needed to take Klonopin almost every day because I’d been taking Klonopin almost every day.
I went to urgent care half a dozen times. They told me I was just anxious. I went to a very expensive psychiatrist who told me I was bipolar (subsequent mental health professionals have told me this diagnosis was inaccurate) and prescribed high doses of stimulants and a migraine medication that bedded me for a week and permanently altered my vision.
I had never experienced suicidal ideation, but the night before my withdrawal was properly diagnosed, I thought to myself: If I can’t figure out what’s wrong, I’m not sure how much longer I can live like this.
When the doctor discovered my symptoms were a result of withdrawal, I had to resume taking Klonopin immediately. I was put on a taper plan so I could come off the drug slowly to mitigate unpleasant symptoms and avoid the kind of extreme mental health event I’d just experienced. I had never felt more relieved in my entire life. And then I felt unbelievably angry. I sometimes still do.
When people tell you enough times you are an anxious person, and react negatively when you suggest your symptoms might be related to anything else, you eventually have no choice but to believe that these are just the facts of your existence ― even when there might actually be something else going on. Though my symptoms at the time were caused by chemical withdrawal, my original diagnosis of anxiety was accurate. But women are routinely dismissed as anxious when they express symptoms of a serious medical event. Some of them even die because of it.
All told, it took months for anyone to consider seriously that anything other than my anxiety-riddled mind was causing my physical anguish. It took even longer to taper off the medication permanently, during which time I still experienced withdrawal symptoms that affected my personal and professional life.
Like Dunham, I was prescribed a medication that a doctor sincerely believed would help me. But I was never informed of the pain that relief might ultimately cause.
Millions of people diagnosed with anxiety or panic find life-changing relief with medicines like benzodiazepines, have no problems with misuse or dependency and can stop taking them safely and under medical supervision if and when they choose to. But when they were offered to me, I do wish someone could have anticipated my blind spots and told me what I was in for when I wanted to stop.