Jump to content

A Theory of What's Happening to our Bodies/Minds in WD


[30...]

Recommended Posts

I am headed into my second year of having been "bit" by benzos.  While I am not a biochemist, I have certainly had a lot of time on my hands to research and think about what is potentially going on with me/us - especially those of us who experience a great deal of emotional/mental symptoms such as fear, dread, doom, gloom, terror, depression, etc.  Please just take from this what makes sense, it's not meant to be scientific --- just my own ponderings and thought I would share!

 

1) With any psychiatric medication there is a certain level of neuro-adaptation that happens....how the brain and nervous system adapt to what you are putting in it.  For each of us, it is slightly different due to genetic and biological differences.  That said, let's start by thinking about the neurotransmitters amino acids - GABA and glutamate.  As many of us know, GABA are the natural inhibitors in our system (the brakes) and it is the MOST COMMON neurotransmitter in the body. Glutamate is an excitatory neurotransmitter and it serves as  (the gas).  The goal is for GABA and glutamate (as well as many other things like dopamine, serotonin, norepinephrine, acetocholine, glycine and hormones like progesterone, estrogen, testosterone, oxytocin and our stress hormones like adrenaline and cortisol) to all work to be in balance to create a sense of homeostasis. 

 

So, when we are NOT on a benzo, the natural GABA in our bodies binds to the millions of gaba receptors that exist throughout our bodies - sort of like a lock and a key.  the GABA is the key and the GABA receptor is the lock.  when we take a BENZO, over time, the benzo now binds to that same receptor and the lock slightly changes shape.  As we take the benzo away, it's not that we don't have enough GABA in our bodies, it is that our natural GABA doesn't have the exact same shape that the benzo did --- the key isn't exact -- and so as our natural GABA tries to bind and fit into that lock to create a sense of calm -- it doesn't work.    It takes time, and sometimes lots of time, for that lock to re-adapt for our natural GABA to fit neatly back into that lock and create a sense of calm and peace.

 

So, when people think they need to just flood themselves with GABA supplements, that isn't the issue.  We aren't deficient in GABA in withdrawal, it's simply a matter of our natural GABA (the key) no longer fits nicely into the lock (the GABA receptor) thus it cannot do its function of calming us down.

 

Also, because we have less ability for our brakes to work for a period of time, it also throws our GABA/glutamate balance out of whack.  So, we feel like we have TOO MUCH GLUTAMATE -- that's not the case, its that we don't have enough GABA binding to is receptor to produce the brakes to balance out the glutamate in our system.

 

Think about it like as if you were making a vodka tonic.  If you are supposed to use one part vodka, and three parts tonic but you only have enough tonic to add in one part --- you will drink that drink and think "Oh my God, there is too much alcohol in this -- its terrible!" --- there isn't more alcohol in it, there is just not enough of the tonic to dilute it.  same thing with our gaba and glutamate. 

 

2) Okay, so there are literally hundreds of millions of GABA receptors all over our body -- and we just figured out that our GABA is not able to properly bind to it for a period of time when we are in withdrawal.  There are high numbers of these receptors (the now slightly disfigured locks) all over our gut and limbic system.  So, let's start with our limbic system:  our limbic system in our brains is our most primitive part.  It was the part that hasn't evolved much over time and it was what kept us safe when we had to sleep out in the open and be on the look out for saber tooth tigers.

 

So, let's look at how it works:  your amygdala’s job is to alert you to danger.  It takes a perceived threat and sounds a distress signal.  Let's call it a fire alarm.  It perceives danger ( a fire) and sends off an alarm to the hypothalamus.  Now the hypothalamus is basically our command center.  It takes this raw data from the amygdala and decides whether it is a false alarm or a real threat.  Now if our limbic system ISN’T  injured (which ours IS in benzo withdrawal) -- typically the command center says "thanks for the warning but all is well" and our parasympathetic nervous system is alerted that we are fine and we feel calm and often we never even really feel this process...it happens in nanoseconds.  (for example:  standing on a corner you aren't looking and thinking fully "is that car going the right speed limit, what about that one, what about that one? -- its happening almost automatically).........but the amygdala's job is to keep you safe and so it would rather throw up 100 false alarms and keep you from being eaten by the tiger or hit by the car then to get lazy and you get eaten or hit.

 

anyway, in our injured limbic system our amygdala is throwing up constant alarms - it is not working properly and it is trying to keep us safe --- but our command center is not working either and so it is AGREEING WITH our amygdala and saying "yep, that could be dangerous" and activates our sympathetic nervous system and alerts the adrenal glands to shoot off adrenaline.  Now keep in mind all of this is happening in nano-seconds.  So in a non benzo-injured person - they are standing on a curb, they step off, a car comes barreling around the corner at 90 mph, the alarm is sounded, the control center says "danger", adrenaline is released and BOOM before you know it and can even think about it -- you have jumped back on the curb out of harms way.  then you feel that rush and it takes a minute or so to calm down.

 

BUT for us -- we are constantly getting bombarded with floods of adrenaline which creates all sorts of physiological changes (heart rate, breathing, and we certainly are unable to think rational, calm thoughts).    teddy bears look like grizzly bears --- our limbic system is highly populated with these GABA receptors that are now temporarily not working and so the entire system keeps us in a dysregulated state and in fight/flight or freeze. 

 

If that wasn't bad enough, the control center that has signaled the adrenals to shoot off adrenaline has now alerted the HPA axis (hypothalamus, pituitary and adrenals) to react and this basically keeps the gas pedal down with each of the three parts shooting off hormones -- including the adrenals shooting off cortisol. 

 

So, our main two stress hormones are adrenaline (epinephrine) and cortisol.  One way to think about them is adrenaline is like Xanax (short and potent) - adrenaline is meant to come on fast, do its job and leave.  Cortisol is more like valium.  It comes on slower and sticks around a while and allows us to remain on high alert for longer periods of time.  Because our limbic systems are malfunctioning - we are experiencing more consistent bursts of adrenaline as well as the longer term doses of cortisol due to the chronic stress on our systems.  Adrenaline and cortisol affect different organs.  Adrenaline tends to affect our muscles and respiratory system while cortisol can affect our digestive, reproductive and immune systems.  Together high levels of these stress hormones over extended periods of time lead to an array of symptoms -- both physical and mental.  It explains not only why so many of us feel so much fear and terror.

 

3)  The state of our nervous system drives our story.  What do I mean by this? Our overly sensitized and taxed nervous system that is now being over run with stress hormones creates a background of fear, terror, unease, dread, and doom.  And since we are meaning making machines --- we automatically work to answer the question "why am I feeling so terrified or awful" by creating stories.  This is how intrusive thoughts, phobias and other symptoms come to be.  We may feel terror and think “I don’t feel safe, why?”  and we answer by assigning a fear value to a store, driving, the outside world, being alone, afraid we are going to die, going to have a heart attack, etc.  We are constantly scanning to make meaning of our emotions and sensations, our thoughts and our feelings.  Also, we tend to see a bad day, week or month as a sign that we are back at ground zero or will never heal.  I like the idea of “regression for the sake of progression” – sometimes our symptoms increasing or re-emerging are not a sign we are going backwards, but a sling shot of sorts to move us forward. 

 

Unfortunately, as humans we have a built in negativity bias.  This has been an adaptive function in our evolution as it kept us from getting too cumfy and getting eaten by a saber tooth tiger.  If our negativity bias was we might not be safe, we were more apt to be on alert to protect our families from bears and tigers.  Fortunately most of us don’t have to worry about bears or tigers but our negativity bias continues to be a part of our human psychology.  In benzo withdrawal, multiply that x 1000.  In fact, I have found that any of my worst traits, existing fears, vulnerabilities, etc are super exaggerated in withdrawal.  Why?  I think because we are basically a walking raw nerve and everything hits us with more force.  It’s kind of like Claire Weekes talks about – we are and have a super sensitized nervous system.  So, everything has a propensity to have a greater impact on us. 

 

For example, many women in withdrawal experience heightened symptoms during ovulation or PMS or during menstruation.  Is this because suddenly my estrogen is rising and dropping at higher rates – not necessarily.  It’s that we are feeling it due to our highly sensitized system.  It’s like taking a penny and dropping it into a tin can – it will make a loud noise.  Drop that same penny on a soft bed – hardly a sound.  Has the penny changed?  No.  The system it has interfaced with is different.  We are like the tin can.  Any fluctuation in hormones, any change in our routine, food, vitamins, supplements, exercise, stress, illness—can all hit our highly sensitized system and have a much greater impact than it normally would. 

 

4) I think its important to think of our body’s as a soup.  We are made up of all sorts of neurotransmitters, hormones, vitamins, chemicals, bones, blood, tissues, organs, genetic coding.  And when we put something in our big pot of soup – LIKE A BENZO – its like adding salt to our soup.  Once you add that salt to soup, you can’t reach in and just take it back out.  It has now intermingled with the broth, the vegetable, the meat.  Just like we would like to believe we can simply take a medication like a benzo and then reach in and take it out – it usually doesn’t work like that.  There are consequences as this med (the salt) has now intermingled and affected every other part of our soup. 

 

That said, I do believe we heal.  I am banking on it.  Our bodies and minds are resilient.  However, unfortunately healing doesn’t happen on our time frames.  What can we do in the meantime – what do we actually have control over?  Well, we don’t have control over our random, automatic thoughts, our feelings, our emotions, our sensations – but we do have control over our attitude towards them.  Sometimes just knowing and being able to say “Yep, I’m in withdrawal” rather than “Oh no” or “What if?”  is enough to keep us from going down the rabbit hole.  We get good at what we practice.  Our amygdala doesn’t respond to words – tha ‘s why we are often so not reassurable in this process.  We have to SHOW our amygdala the mailbox is not a grizzly bear, the phone or car or store is not a monster.  As hard as it is, if I am able, I try each day to just work to not be in complete potato mode where I am trapped in fear.  Someone once said to me “jen, step a bit outside of your comfort zone.”  I looked at them like they had four heads and said “what comfort zone?  I haven’t felt a comfort zone in two years.”  But I knew what they were saying – I had to speak the language of my primitive brain and SHOW IT that the world has not become dangerous overnight by taking little steps, not letting myself turn completely inward.  Learning a bit about the mechanics of what MIGHT be going on with this has been helpful to me -- doesn't take away the symptoms but makes them a tad less scary.

Link to comment
Share on other sites

Thanks pamster!  I hope its helpful to some -- it has been helpful to me as I researched and broke it down to have a sort of conceptualization to all of the awfulness!  Take care!
Link to comment
Share on other sites

Nice post but what I really wonder about why we develop things like severe anxiety, panic, and depression in the first place that becomes so bad until we feel compelled to seek out medical treatment. That is how most of us are 1st introduced to benzos and other psychoactive Rx drugs. My personal suspicion is a lot of stress experienced over a long period of time, coupled with probably a hereditary component is what precipitates most anxiety disorders.

 

Benzos are palliative. They only mask bothersome sxs. They cure nothing, but they do cause the underlying disorder to become worse over time due to drug tolerance. Now, you have got a horrible addiction to overcome just to get back to baseline before you ever started taking the drug.

 

edit: grammar correction 3/30/22  3:55AM US EST

Link to comment
Share on other sites

Hi Jen - this is so clear - thanks so much for this - has really helped me.

It really fits well with a meditation  I do called ‘Feeling Safe’.

 

Hope your journey is getting easier.

Link to comment
Share on other sites

Hi Jen

 

i wondered if you know why we get muscle pain, I can’t work this out, but know it is very common, and unpleasant.

 

Many thanks for any thoughts.

Link to comment
Share on other sites

Anti - its a great question and I would imagine there are probably numerous answers people would come up with.  I like and tend to agree with the idea of chronic stressors ---- seen and unseen, "felt" and unfelt and the build up over time that can lead to all sorts of manifestations of anxiety ranging from panic to depression (depletion).

 

P - I wonder if the muscle tension has something to do with the adrenals and the fact that adrenaline highly affects our musculature system.  In fact, its probably the system that is affected the most in bursts of adrenaline, as the body prepares to fight or flee.  And because, many of us are having consistent bursts of both -- adrenaline and cortisol -- the muscles, like other parts tend to wear out/down.  The effects on the muscles can range from extreme cramping and contracting to general fatigue.  Just a thought. 

 

 

Link to comment
Share on other sites

Also, the job of cortisol is to increase glucose to basically continue to 'feed' the systems that the adrenaline uses to keep us safe (keeping us ready to fight or flee) ---- so, I have wondered if it is cortisol that has a few of my friends going through this really grappling with blood sugar issues ---- often they have to eat every few hours, sometimes they have surges of adrenaline after a meal.  Again, I think its all so interconnected-- the benzos create the limbic injury which in turn creates the adrenaline/cortisol misfirings which in turn affect every system of our body -- including our blood sugar.  Unbelievable.  And yet the docs keep saying, take this and now come off.  As if we've applied a superficial band-aid and can simply remove it when desired.  The massive neuro-adaptations as well as physiology that is affected by this class of meds is no joke!
Link to comment
Share on other sites

Interesting - thanks 30..

And I’ve read that muscle pain is sometimes the last to heal - maybe tying into the adrenals/cortisol being the last to get into homeostasis.

 

With the anxiety/panic/depression issues I do I think it is invaluable to healing that we do all recognise, accept and really address the underlying issues that we all have to be on these drugs in the first place. Yes it’s hard, but has to be done.

Link to comment
Share on other sites

I just received a private message with a couple questions and so I thought I would make those questions public, as maybe others might have them as well. 

 

1) What do you mean by our amygdala doesn't understand words?   

 

I am not saying all structures of our brains don't respond to words -- in fact, our more advanced aspects of our minds certainly respond to what we feed it -- what we take in, what we tell it.  However, our more primitive aspects of our brain -- specifically the parts I was referring to -- the amygdala, etc -- don't respond to words -- that is why we are so often not re-assurable in this process.  We keep asking 'are we ok?"  "am I going to heal?" -- we will often ask anyone and everyone that and many times! 

 

Our amygdala and command center that decide "am I in danger?"  needs to be SHOWN that it isn't in danger.  That is why we need to alter our behavior.  Now altering our behavior can be practicing going for drives as a passenger if we are afraid of driving, then taking the wheel eventually ourselves and driving around the Block, maybe a week later driving a bit further, etc.  David Powers, a benzo coach, spoke about in one his podcasts that he became so agoraphobic in his withdrawal, that he needed to practice walking to the mailbox, then doing it several times a day, then going into a store and walking around a few minutes a day.  The goal isn't to throw ourselves head first into what feels like the lions den - but it is to begin to take steps to show our limbic system ---- THIS IS DISCOMFORT, EXTREME DISCOMFORT - BUT NOT DANGER!

 

2) Should we try to go on with our normal activities?  I can't seem to find anything that will stop the adrenaline surges. 

 

I do think that if we can maintain some normalcy to our routine, as much as possible, it can be helpful.  I know when I had to stop working, although it was a necessary step, I began to sink down and pull away from many other normal routines in my life (getting up and out of the bed, showering, talking to people)....and our worlds can become small very quickly.  That said, we have very sensitized nervous systems and have to be careful and discerning about where we put what energy and capacity we have. 

 

The goal isn't to stop the adrenaline surge --- that would be ideal, but often trying to stop something only makes it come back with a vengeance.  Imagine pushing a beach ball under the water, it pops back up with greater force and hits you in the face.  Imagine letting that beach ball (of adrenaline, pain, symptom, intrusive thoughts, fear, dread, depression, palpitations, dizziness, head pressure) just float along next to you in the pool.  It's still there but you keep swimming.  it bumps into you, its never out of site -- but you continue to try to engage as much life as you can.

 

We tend to try to do things to GET RID OF our distress.  who wouldn't want to do that?  but, unfortunately, its not the way the nervous system works -- there is a lot of truth in what we resist persists.  so a byproduct of our trying to engage in life alongside the distress is that over time -- and for many of us - its a LONG TIME -- the symptoms are still there but aren't being magnified x 1000 as we get stuck staring at them and wishing or willing them away. 

 

again, just my ponderings - but hope they help!

 

 

Link to comment
Share on other sites

Thank you Jennifer these posts have been so informative.  I had that same question about the amygdala that was a great explanation thank you.

 

Hope you are having a good day. 😊

Link to comment
Share on other sites

Hi Jen thanks for your videos! Do you think mental fatigue, brain fog, getting exhausted just taking a walk and light sensitivity especially with artificial lights could be a sign of high cortisol and low dopamine? Because that has been my idea lately
Link to comment
Share on other sites

Thanks for this amazing post, it's very reassuring to understand all the mechanism behind this mess.  :)

 

My question is (apologies for my laymans analysis)- how come short-term users also experience prolonged withdrawals? Can GABA receptor sites really change their form within 2 weeks of use? And why do these receptors don't reverse at the same speed they changed once off?

 

I always saw as a glutamate overflow issue. Most people seem to develop what feels like an "allergy" to anything gabaergic after withdrawals as well, like magnesium, valerian, passionflower etc. I thought of this as our body's glutamate response being hyper sensitized and reacting to every single strong gabaergic due to that lack of "stasis". I think I read somewhere that glutamate can't down regulate and that really scared me.

 

If it's a purely GABA related then that's very comforting to know because I expect the body to eventually go back to a factory reset.

Link to comment
Share on other sites

You know, this is just my dime store two cents personal research but I think when things like dopamine is out of whack -- which actually any habit forming substance (as well as natural events that are pleasurable) affect our reward center.....so when things like dopamine or cortisol is out of whack -- I think its likely that all of our big chemical messengers (neurotransmitters, dopamine being a big one ) as well as hormones are disrupted.....which I think can lead to a host of symptoms.

 

If you look at each part of the limbic system and just do a google search on limbic system injury -- it will talk about abdominal pain, headaches, depression, anxiety, body pain, etc ---- our whole body is affected. 

 

I also wonder why some get hit after just a few weeks, some are able to walk off, others get hit after a longer period of time - I am sure genetics as well as other factors that can lead to central nervous system sensitization have to be factors.  For example, when Claire weekes was writing in the 70's about nervous suffering and discussing factors ranging from fear, phobia, strange body sensations, obsessions, loss of confidence, depression, etc -- she was talking about how we become naturally sensitized from acute and/or long term stressors.....and spoke about the condition as a sensitized nervous system.  So, I think there are all sorts of things that are possible explanations as to the vast differences of severity and when and how withdrawal hits -- from underlying conditions, to the state of our nervous system before benzos, to environment to genetics. 

 

In terms of the glutamate versus gaba -- I think there are various theories.  The one that I read about that seemed to make the most sense was having plenty of gaba but it being able to make use of the receptor.  that said, others have said they wonder if perhaps the body increases glutamate in order to try to balance out the increase in the gaba function provided by the benzo, so when we take it away there is an excess glutamate.  unfortunately, there doesn't seem to be any true robust good scientific studies to know exactly what mechanism is at play.  But for me, what seemed to make the most sense was that we didn't need to load up on Gaba supplements to offset the excess glutamate, we just need to let our receptors heal, to make use of the existing free floating gaba and because our brains and bodies are constantly trying to get into homeostasis, it will eventually even out.

 

if it were true that our bodies can't get rid of excess glutamate and excess glutamate was the reason behind why we feel so lousy in withdrawal -- it would never really go away --- we would remain in a "glutamate storm" forever.  the gaba lock and key idea seems to makes better sense to me overall.....

 

regardless, what is true is that our bodies want homeostasis and will EVENTUALLY get there -- we just don't know in what time frame and I for one have a struggle with the not knowing!  I am certainly learning patience in this process. 

 

I think that's part of why this is such a complicated thing to both struggle with and for our treaters to understand --- I think its a syndrome of sorts - -has so many manifestations and degrees of severity and follows no coherent pattern.  That said, the one pattern that does seem tried and true is that so many people, no matter how bad off they are, seem to circle back months or years later and describe healing and the extreme gratitude they have for their lives........that's what I'm counting on! 

Link to comment
Share on other sites

Hi Jennifer,

Somewhere here in BB you mentioned that you had cut out all processed foods, gluten along with dairy plus taking a probiotic.  If the benzos have messed up the GABA receptors in the gut how can you heal the gut if you are still tapering a benzo?  I am so confused...which doesn't take much.  Also has it helped cutting out the dairy and gluten?  I stay away from processed foods, I do drink 2% milk, cheese and eat some yogurt.  Seems like I have gas/bloating and discomfort no matter what I eat or don't eat. 🤷

 

Hope you have had a good evening. 🙂

Link to comment
Share on other sites

Hi Diane,

well, again just my armchair thoughts but I gave up dairy not because I read any evidence it would help us in benzo withdrawal but just because I realized I felt better when I cut out cheese.  In terms of gluten, I found the same.  Although there are varying opinions on this, I believe we heal as we taper.  So, as neuro-adaptation occurs the other way (meaning now because we are taking the med out versus putting it in), just like hopefully that fired up limbic system will hopefully calm down, so does our gut.  just like almost every other system in our body struggling to get into balance, our gut is also working to find homeostasis and find the right balance of good and bad bacteria, heal that leaky gut and be a strong breeding ground to generate that over 90% of serotonin that is generated in a healthy gut. 

 

I was just talking to someone the other day who was quite sick in her taper from Ativan.....had to stop and hold for a month or so, was very symptomatic, then eventually started a slow taper -- now she is about six months from completing her taper and is experiencing no symptoms.

 

to me that story and others are proof that we heal as we go ---

for me I was able to tolerate taking a probiotic, but I know many can't.  it's just like I can't tolerate taking vitamin D but many can.

 

that said, those Gaba receptors are all over our body and the influence of adaptation by putting benzos in as well as taking them out can disrupt most of our bodily symptoms as they highly affect our limbic system (which includes our hypothalamus that is responsible for our hormones as well as our autonomic nervous system -- that autonomic nervous system is both our sympathetic nervous system (the gas;  and the one that we tend to operate from often in benzo wd and at the parasympathetic which calms us down and allows us to rest and digest).......our nervous system is basically the star point guard on our basketball team -- and we can't win without him healthy.  He calls most of the plays, runs that court and our whole offense....we can still play with him limping, but we aren't going to thrive......that's how I think about it anyway. 

 

I think, unfortunately, even in neurology it seems there just isn't a ton of talk about the widespread problems that can be generated by a nervous system that is taxed and sensitized ---- and its certainly not discussed that this can be caused by benzos, both their use and discontinuance.

 

this is why I feel we all need to, once healthy, stick around and tell our stories if possible --- for example, many of us are in this disastrous boat because we are trying to come off these meds -- either voluntarily or by the will of our doctors.  Do you know for a medication to get FDA approval, they requite no discontinuation studies?  They have to prove they are safe to be on (for a prescribed period of time), but they do not have to prove that people can tolerate coming off of them......that blew me away.  Also, I think to get approval it only had to show an effectiveness in 50% of the people in the study.

 

These are the things we need to be aware of as we look to put other meds in our mouths as well as helping our loved ones make the best decisions regarding what they are ingesting. 

 

as always, just my ponderings - but given this med has turned my life upside down -- innocence has been lost in this process and I want to try to understand how so many of us landed in this position.  sorry, I took your thoughts about the gut health into a bit of a soapbox.  ha.  can you tell I'm a bit pissed off for myself and for all of us? 

Link to comment
Share on other sites

Hey Jennifer,

Thank you for explaining so well.  I just have to digest it now.  Its not been a good day so I'm kind of slow going.  Also trying something new I cut my dose for 4 days and now going to hold for 3...hope this works.

 

Hope you are having as good a day as possible.

 

Hugs❤

Link to comment
Share on other sites

Hi Diane,

I sure hope you get to feeling better soon and that dosing change works for you! 

I'm thinking about you and sending good vibes your way! 

We will make it through this!

Link to comment
Share on other sites

Hi Jennifer,

I just wanted to touch base with you and I had a question.  Have you been able to tell a difference since you started the slow taper?  Are you feeling a little better?  I hope you had a good weekend.  I was able to spend time outside in the sunshine and fresh air it was good medicine.

 

Hugs❤

Link to comment
Share on other sites

Hi Jennifer,

 

Thanks for posting this. It's helpful to have some idea of what is happening to all of us as we go through withdrawal and heal.

 

D. E. Foster says the muscle aches and pain are due to the muscles waking back up after being on a benzo, which is a muscle relaxant. I'm sure there are multiple reasons. The drug severely affects the nervous system and the pain receptors as well. I think it's multifaceted.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...