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There are certain events and dates that we always remember: Pearl Harbor, September 11, Sandy Hook, or the Parkland Shootings. What they all have in common is that we never imagined that these events could happen, and when they do they can change our fundamental reality and how we see the world. Recent news has brought this issue to the forefront again: One month ago today, Hamas militants attacked southern Israeli communities, killing more than 1,400 people and taking about 240 hostages. In Gaza, more than 10,000 people have been killed since Israeli airstrikes began, according to the Health Ministry there. — Suzanne Nuyen, Up First Briefing, NPR It doesn’t matter where you stand politically or ideologically on the issues. These are events which can affect us in deep and significant ways. Learning how to process such world events in healthy manner, can help us move forward. Events such as these can initiate a tsunami of feelings, especially when anxiety is no stranger to us. But, some events happen at such a global scale that they become the great equalizer. That is, there are few individuals on this planet who are left unaffected and the need for support and management tools is universal. Collective Trauma: Making sense of catastrophic events When you try to understand the notion of collective trauma or secondary traumatic reaction, there is a flood of information. Collective trauma is a cataclysmic event that shatters the basic fabric of society. Aside from the horrific loss of life, collective trauma is also a crisis of meaning. — Gilad Hirschberger, Collective Trauma and the Social Construction of Meaning, 2018 I Googled this concept and found 42 entries just on page one. They describe the feelings that are engendered including: A sense of helplessness Guilt that you survived or are not directly challenged in your day-to-day life Shame over feelings you cannot control Rage and fear Fear for the future Hopelessness for a solution Seeing increased security in buildings can both allay anxiety and increase concern. Overall, events like these shatter a fundamental sense of security, which can lead to overwhelming emotions. For people of some communities there are compounding effects. For Jewish people, not only is peace and security an issue in Israel, but there are also upticks of anti-Semitism in the United States. And as for Palestinians, in addition to ongoing violence in Gaza, unrest in the states leaves many fearful for their own freedom and safety. On October 11, 2023, the American Psychological Association (APA) released a statement warning that consuming violent and traumatic news can, in and of itself, negatively affect our mental health. Some people are more vulnerable than others to developing an acute stress reaction or even post-traumatic stress disorder with the constant stream of images and stories. People who are in closer proximity to the actual events – obviously, if you’re there or your family’s there or this touches you in some more direct way. But even people who are ripples out from this can develop [deeper issues], particularly people who either have a prior mental health issue, like an anxiety disorder or a mood disorder, and people who have suffered [any kind of] trauma in their past. — Dr Gail Saltz, Clinical Associate Professor of Psychiatry at the New York Presbyterian Hospital and Weill Cornell Medical College Catastrophic events are real and distressing — but our resilience to deal with them, enhanced by helpful advice, can steer us through the troubled waters. Here are a few tips that may help: Understand that distress is normal, and shared by many others. There is no wrong or right way to feel. You feel how you feel. Don’t ignore your feelings. Recognize them. You are not alone. Talk about your feelings and connect with others. Stop doomsday scrolling. Limit social media, Only go to credible sources. Give yourself some space from the issues. Reach out to a higher power and use prayer if it is helpful to you. Reestablish daily routines. Take action Do something to help Reach out to support others Donate to causes that help In an opinion piece in USA Today, Douglas Yeung summed it up this way: Trauma is often described as a shattering of one’s assumptions or worldviews. That is, when events collide with our expectations, beliefs or hopes, we are forced to reconsider what is truly possible. This latest war – set in a world still emerging from the COVID-19 pandemic, grappling with social isolation and mental health crises – has provided plenty of traumatizing developments, with the grim promise of more to come. It certainly requires making hard choices and doing the work to forge community bonds that prioritize everyone’s well-being. And much of that work starts with knowing the spillover effects of trauma, and how it affects us all. — Douglas Yeung, USA Today Opinion Let us know if you have dealt with the effects of October 7 and the recent war. We want to hear from you. References APA warns of psychological impacts of violence in Middle East. American Psychological Association (APA). October 11, 2023. https://www.apa.org/news/press/releases/2023/10/middle-east-violence-statement. Kane, Andrea. How to protect your mental health while keeping tabs on the Israel-Hamas war. CNN Health. October 17, 2023. https://www.cnn.com/2023/10/14/health/mental-health-israel-hamas-wellness/index.html. Hirschberger G. Collective Trauma and the Social Construction of Meaning. Front Psychol. 2018 Aug 10;9:1441. doi: 10.3389/fpsyg.2018.01441. PMID: 30147669; PMCID: PMC6095989. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095989/. Moench, Mallory. Where to Seek Help if the Israel-Hamas War Is Impacting Your Mental Health. Time. October 22, 2023. https://time.com/6327064/israel-hamas-war-mental-health-services/. Nuyen, Suzanne. Up First Briefing: 1 month since Hamas attacked Israel; Supreme Court gun control case. NPR/CPR News. November 7, 2023. https://www.npr.org/2023/11/07/1211150085/up-first-briefing-1-month-since-hamas-attacked-israel-supreme-court-gun-control-. Yeung, Douglas. I can't help but follow graphic images from Israel-Hamas war. I should know better. USA Today. November 3, 2023. https://www.usatoday.com/story/opinion/voices/2023/11/03/israel-hamas-war-images-trauma-mental-health/71334176007/. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing human. Please read our site disclaimer for more information.

The Benzodiazepine Action Work Group (BAWG) has announced six newly scheduled classes for the course "Recovering from Benzodiazepines for Peer Support" starting this November. While four of these initial classes are limited to Colorado residents, two non-Colorado classes have also been announced. We plan to offer a total of 10 new classes between now and July 2024. To register and learn more about this training please visit: BenzoPeerTraining.org About the Class This 12-hour training course is designed to educate peers, counselors, caregivers and providers on specialized information regarding benzodiazepine use, its associated complications such as withdrawal and benzodiazepine-induced neurological dysfunction (BIND) , and how to support the individual as they taper, heal, and find wellness. This course was developed by the Benzodiazepine Action Work Group (BAWG) in conjunction with members of Easing Anxiety, the Alliance for Benzodiazepine Best Practices, Benzodiazepine Information Coalition, the Schreiber Research Group, and Benzo Warrior. It is certified for 12 CE credits with COPA/CPFS in Colorado and is designed to meet state certification requirements for peer support professionals across the nation. The cost for these classes is kept low via support from BAWG and the Colorado Consortium for Prescription Drug Abuse Prevention. Standard course fee is $125, but a discounted registration fee of $90 is available for those registering early. Schedule There are currently six scheduled classes on the calendar as follows. Each will be held virtually. More classes will be added over the coming months. CURRENTLY SCHEDULED CLASSES 2023 Colorado - November 7 & 14 - SOLD OUT! Instructors: D E Foster (Easing Anxiety) / Ginger Roos (Choices Training) 2024 Colorado - January 23 & 30 - Registration Now Open Instructors: Terri Schreiber (The Schreiber Research Group) / TBD (Choices Training) New Hampshire - February 20 & 27 NATIONAL (open to all) - March 12 & 19 Colorado - April 23 & 30 Colorado - June 4 & 11 For More Information For more information please visit: BenzoPeerTraining.org.

It’s 3:00am. Sleep is elusive. Collective thoughts converge on the manic mind. So, why not record a podcast? Join D as he ponders benzos and BIND, fatigue and fear, motivation, meditation, gratitude, and grace. All from the comfort of his own bed. Video ID: BFP127 Listen on YouTube... The Benzo Free Podcast is also available on... Apple Podcasts / Audible / iHeart / PodBean / Spotify / Stitcher Chapters 0:00:00 It’s 3:14 am 0:02:21 Struggling Lately 0:05:30 Podcast Delays 0:07:08 Benzo Peer Training 0:07:51 Overwhelm & Fatigue 0:09:02 New Content Coming… 0:10:35 Coping with Insomnia 0:13:38 Missed Y’all 0:14:34 Ruminations in a Dark Room 0:16:23 Finding Life Balance 0:19:10 Motivation to Change 0:24:00 Discipline As We Heal 0:26:00 Moving Forward 0:28:38 It Does Get Better 0:29:52 Advice for the Younger You? 0:32:54 Being OK with Yourself 0:38:35 Trying to Belong 0:40:14 A Calming Voice 0:42:26 BIND Frustration / Emotion 0:47:40 Talking in the Bathroom 0:48:56 Podcasts & Authenticity 0:51:24 Meditation & Perfectionism 0:53:53 Five Minute Meditation 0:54:38 Yin Yoga & BIND 0:56:19 Changing for the Better 0:58:56 Benefits of Gratitude 1:04:27 Three Gratitudes 1:06:08 Being Grateful for Others 1:13:27 CLOSING The Podcast The Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.com MAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMER All content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITS Music provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTION Easing Anxiety is produced by… Denim Mountain Press https://www.denimmountainpress.com ©2023 Denim Mountain Press – All Rights Reserved

Welcome back to the Easing Anxiety blog series, "What We Learned from the Benzo Survey," where we dive deep into the data from the Benzodiazepine Survey of 2018/2019 to learn more about benzos, BIND, and the individuals who have taken these medications. In our first posts in this series, we explored age groups, gender, country, drug type, and warnings. Today in our fifth installment, we look at how many respondents took different medications at the same time and whether or not they took their medications as prescribed by their doctor. Check out the findings below. *** Scroll to the end of this post for details about the survey and research team. *** CONCURRENT MEDICATIONS Most of the survey respondents (83.6%) took more than just a single benzodiazepine and over half (56.2%) took two or more medications at the same time. The most significant pairing was between benzodiazepines and antidepressants. 45% of those who had taken benzodiazepines also took some type of antidepressant. Since SSRIs and SNRIs are commonly prescribed to individuals in benzo withdrawal, this finding may not be surprising. If we look at the benzodiazepine class only, 52.4% (632) of the respondents only took one benzo, 23.0% (278) took two, 14.0% (169) took three, 5.7% (69) took four, and 3.5% (42) took five or more. One respondent even stated that they took 10 different benzodiazepines. Taking multiple psychiatric medications — what is commonly referred to as polydrugging — is not uncommon in mental health treatment and can create a nightmare scenario for individuals dealing with physical dependence and/or addiction (SUD). Question (n=1,207): Did you take different medications concurrently (at the same time) or sequentially (different ones at different times). TAKEN AS PRESCRIBED Over 90% of the respondents took their benzodiazepine mostly as prescribed. Only 8.7% definitely did not. This key finding backs the experience of most professionals in the benzo community. The majority of individuals we work with have taken their medication as prescribed by their doctors — and while substance use disorder (SUD) can happen with benzodiazepines, it is rare. Most complications we've seen have nothing to do with SUD or addiction, but instead are caused by physical dependence, withdrawal, and BIND. Question (n=1,207): Was your benzodiazepine med always taken 'as prescribed,' in the dose recommended by a doctor? References Survey papers are listed below. About the Benzodiazepine Survey About the Research The largest survey of its kind, "The Benzodiazepine Survey of 2018/2019" was created and administered by Jane Macoubrie, PhD and Christy Huff, MD. Over 1,600 individuals took the survey, resulting in 1,207 qualified respondents. The survey constituted 20 questions, including demographic inquires. Some of these questions had multiple sub-questions and/or allowed multiple answers. The survey generated three published research papers in scientific journals (as noted below) between April 25, 2022 and June 29, 2023. The research team is still together working on new benzodiazepine-related research projects. Special thanks to the Alliance for Benzodiazepine Best Practices for sponsoring and organizing this research. Published Papers PAPER 1 — April 25, 2022 Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. PAPER 2 — February 6, 2023 Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. PAPER 3 — June 29, 2023 Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, Martin PR. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Research Team Research Team / Authors (alphabetical) A. J. Reid Finlayson, MD, MMHC — Vanderbilt University Medical Center D E Foster — Benzodiazepine Action Work Group / Easing Anxiety Christy Huff, MD — Benzodiazepine Information Coalition Peter R. Martin, MD, MSc — Vanderbilt University Medical Center Alexis Ritvo, MD, MPH — University of Colorado Anschutz Medical Campus Bernard Silvernail — The Alliance for Benzodiazepine Best Practices Acknowledgements The Alliance for Benzodiazepine Best Practices — Sponsoring Organization Jane Macoubrie, Ph.D. — Survey originator Jo Ann LeQuang — Medical Writer Limitations SOURCE: Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey This study has several limitations. The study reported on ‘suicidal thoughts’, which can range from fleeting notions of self-harm to passive desperation, preparatory planning, and disinhibition. Suicidal thoughts may be underreported, even in an anonymous online survey, as respondents might hesitate or be embarrassed to report self-destructive thoughts. There was no control group. Much of the survey dealt with symptoms presented in multiple-choice lists, and it is possible that patients may have been suggestible to the list presented, may not have correctly remembered past symptoms, or may incorrectly attribute certain symptoms or feelings to benzodiazepines. We did not account for a nocebo effect. The large number of write-in comments suggests that many respondents felt the survey did not allow them to fully describe the extent of their experiences and emotions. Another limitation of our survey is that it recruited respondents from social media and online sources that deal with benzodiazepine use and withdrawal. Respondents were self-selected, forming a convenience sample that may not represent the population of benzodiazepine users as a whole because visitors may have sought sites such as these specifically because they have experienced problems. Moreover, those who use the Internet for health information tend to be younger, and those who join online support groups for medical conditions tend to be in generally worse health. Our results thus may not be generalizable to the population of all people taking benzodiazepines. Data Analysis A medical statistician produced the initial results of this survey utilizing SAS Software. Subsequent data analysis was performed in greater detail by an experienced data scientist who imported the survey data into a custom SQL Server data model. Customized queries were employed to obtain correlations among the data. In particular, this analysis examined conditions for which benzodiazepines were prescribed and compared them to symptoms and adverse life effects reported by patients who were tapering or had discontinued benzodiazepine use. All analyses were delivered via a structured reporting process and validated against the original SAS reports. The survey was made available online through websites and internet benzodiazepine support groups and general health and wellness groups. The data scientist mentioned above is D E Foster, who is also the author of this blog series and the founder of Easing Anxiety. D has been a member of the Benzodiazepine Survey Research Team since 2019, providing general benzodiazepine knowledge and lived-experience in addition to formal data analysis and reporting. Prior to his withdrawal from benzodiazepines, D worked as a database developer and data scientist for over 25 years. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

"[Xanax] may be less effective than clinicians and scientists have been led to believe, based on publications in medical journals," according to a recent article in Neuroscience News. The article was based on research originally published in Psychological Medicine titled, "Unpublished trials of alprazolam XR and their influence on its apparent efficacy for panic disorder." The study tested for publication bias with alprazolam (Xanax) by comparing efficacy for panic disorder using results from published literature and the U.S. Food and Drug Administration (FDA). Publication bias might have overstated the drug's effectiveness by over 40% — Erik Robinson, Neuroscience News The researchers reviewed publicly available FDA data from phase 2 and phase 3 clinical trials conducted for extended-release alprazolam (Xanax XR) for the treatment of panic disorder. Of the five trials that were conducted for the FDA review, only one showed a positive outcome. According to Robinson, "Of the four not-positive trials, two were published conveying a positive outcome; the other two were not published." Our study throws some cold water on the efficacy of this drug. It shows it may be less effective than people have assumed. — Erick Turner, MD, senior author of the study This article and study reveal the all too common practice of cherry-picking studies and massaging their conclusions to gain FDA approval for a new drug. A practice that has left millions dealing with the life-altering after effects of poorly tested medications. And a practice that continues to this day. References Ahn-Horst, R., & Turner, E. (2023). Unpublished trials of alprazolam XR and their influence on its apparent efficacy for panic disorder (Abstract Only). Psychological Medicine, 1-8. doi:10.1017/S0033291723002830. https://www.cambridge.org/core/journals/psychological-medicine/article/unpublished-trials-of-alprazolam-xr-and-their-influence-on-its-apparent-efficacy-for-panic-disorder/B118AF52F7402C1A081822CF57E424D9. Robinson, Erik. Xanax's Efficacy Questioned. Neuroscience News. October 19, 2023. Accessed October 21, 2023. https://neurosciencenews.com/xanaxs-efficacy-anxiety-24967/. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

I'd like to apologize. Big surprise, huh? Yes, I have heard it a hundred times from a hundred people: "stop apologizing." I do it a lot, and I'm sure it annoys some people. Sorry about that. Perhaps it's low self-esteem, or the coping mechanism of a chronic conflict-avoider, or even the desperate pleas of an eternal outsider just dying to fit in. Then again, maybe it's just an affectation of my conversational style. In the end, it all boils down to this. Two of the most common words from my mouth are, "I'm sorry." And I'm guessing I'm not the only one. Apologizing and anxiety go hand in hand. When you worry about what you said or didn't say, or about what you did or didn't do, or about being late or early or rude or insensitive or selfish or inadequate or forgetful, those of us with anxiety, apologize. But those aren't the only reasons we do it, and that is why this topic is a bit more complex than it seems. I've beaten myself up about this many times. I've even had a few counselors try and help me change. But, it didn't do much good. Sometimes I say it to apologize, sometimes to comfort, and sometimes because I don't know how else to start a sentence. And maybe, just maybe, that's okay. The Problem with Apologizing Apologizing can be a good thing and can be a sign of empathy towards others. But over-apologizing can be harmful. In a Forbes article by Jay Rai, the author said that "Over-apologizing is a common symptom amongst individuals with low self-esteem, fear of conflict and a fear of what others think. He added that "this goes hand in hand with poor boundaries, perhaps accepting blame for things we didn’t do or couldn’t control." Leading off sentences with "I'm sorry..." often shows that "you're subconsciously seeking reassurance." He said that you are also "sending a message to those you're speaking to that often undermine the validity of your statements or implies lack of confidence in expressing yourself or asserting your own needs." Over-apologizing isn’t so different from over-complimenting: You may think you’re displaying yourself as a nice and caring person, but you’re actually sending the message that you lack confidence and are ineffectual. — Beverly Engel, Psychotherapist In the Forbes article, Rai suggests alternatives to leading off with "I'm sorry," such as: Thank you for your patience... Do you have a moment? I am unable to attend this meeting These are my initial thoughts... I have a different take that I'd love to share. According to the majority of articles that I found on over-apologizing, this is a common opinion, and working on reducing this is a positive step forward. But then again, not everyone agrees. Is Apologizing Really That Bad? A Washington Post article titled "Can you apologize too much?" contradicts some of the more commonly held beliefs around apologizing. Scientific evidence suggests that you should never have to say you’re sorry, for saying sorry. — Teddy Amenabar, Washington Post A study from researchers at Harvard Business School and the Wharton School at the University of Pennsylvania found that leading a conversation with "I'm sorry" may actually help to build trust. In this study, a man asked dozens of individuals waiting at a rainy train station to borrow their cellphone. Almost all of them — 91 percent — turned him down. But then he tried it again leading off each conversation with "I'm sorry about the rain..." Almost half of the responses were now positive, and they handed over their cell phones. Alison Wood Brooks, associate professor at Harvard Business School, explained why this might happen. “A superfluous apology isn’t about blame. It’s an acknowledgment of someone else’s suffering, essentially, even if it’s incredibly minor.” She suggested that it is far more common for individuals to not apologize enough, than over-apologize. Apologizing is a natural part of our language, and the idea of over-apologizing is subjective. — Deborah Tannen, Professor of Linguistics at Georgetown University People who apologize more often are usually less narcissistic and have more empathy to others. They are frequently seen by others as more friendly, even more moral. Do Women Apologize More Than Men? The simple answer is here is "yes." But the reasons of this — and results from it — may not be so straightforward. According to an article in Psychology Today, "research shows that women tend to say sorry more than men." Possible causes may include lack of self-confidence and socialization. Apologizing may be viewed as a a sign of inexperience, insincerity, and can be a hinderance in negotiating. Basically, over-apologizing has been viewed by many as a limitation to success in the workplace. This is why many articles have been written encouraging women to find alternatives to saying "I'm sorry." There's been a push in recent years, especially among women, to apologize less. — Kristin Wong, The New York Times But, this topic is also a bit more complex than it first seems. "Women do apologize slightly more than men on average," said Karina Schumann, associate professor of psychology at the University of Pittsburgh. "But that’s probably because women are more likely to notice that a given behavior may be offensive and, therefore, more deserving of an apology." Schumann went on to state that men apologize just as often as women when they perceive they've done something wrong and that the gender gap regarding apologizing is not nearly as large as people think it is. According to Dr. Schumann, men rated offenses as less severe and less deserving of an apology than women. "Men apologize less often because they are less likely to think they've offended anyone." And as we mentioned above, even though there are detrimental effects of apologizing often, there are also benefits. Women — and men — who apologize are seen as more friendly and less threatening, and thus included more often in business and social settings. They are also considered more trustworthy than their less apologetic colleagues. In addition, apologies can mean many things. According to a New York Times article by Kristin Wong, "words are defined in how they're used and an apology is used in many different ways." It can be used to help repair a relationship, to show respect, or even just to smooth out a conversation. Many times an "I'm sorry" doesn't really mean, "I'm sorry." Finding a Balance If over-apologizing is a hurdle for you and you wish to reduce how often you say "I'm sorry," then do so. But, don't get carried away. And don't let the stigma of over-apologizing affect how you feel about yourself. As almost everything in life, there are pros and cons to apologizing. Find the balance that is right for you. As for me, I'm learning to accept myself as I am. I'm 57 and even though I might use "I'm sorry" a bit less now and then, I'm going to stop apologizing for... well...apologizing. See you next time. References Amenabar, Teddy. Can you apologize too much? Sorry, but read this to find out. Washington Post. April 6, 2023. Accessed October 17, 2023. https://www.washingtonpost.com/wellness/2023/04/06/saying-sorry-apologize-too-much/. Rai, Jay. Why Over-Apologizing Can Destroy Your Confidence At Work (And How To Avoid It). Forbes. May 4, 2021. Accessed October 18, 2023. https://www.forbes.com/sites/forbescoachescouncil/2021/05/04/why-over-apologizing-can-destroy-your-confidence-at-work-and-how-to-avoid-it. Rettner, Rachael. Study Reveals Why Women Apologize So Much. Live Science. September 27, 2010. Accessed October 18, 2023. https://www.livescience.com/8698-study-reveals-women-apologize.html. Wilding, Melody. How to Stop Over-Apologizing. Psychology Today. October 7, 2021. Accessed October 18, 2023. https://www.psychologytoday.com/us/blog/trust-yourself/202110/how-stop-over-apologizing. Wong, Kristin. No, You Don't Have to Stop Apologizing. The New York Times. April 22, 2019. Accessed October 18, 2023. https://www.nytimes.com/2019/04/22/smarter-living/no-you-dont-have-to-stop-apologizing.html. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

Welcome back to the Easing Anxiety blog series, "What We Learned from the Benzo Survey," where we dive deep into the data from the Benzodiazepine Survey of 2018/2019 to learn more about benzos, BIND, and the individuals who have taken these medications. In our first few posts in this series, we explored age groups, gender, country, and drug type. Today, we look at a single, simple question from the survey: "Were you warned?" Were you warned about the dangers and complications associated with benzodiazepine use? The results of the survey are quite clear on this topic, and it backs what many of us have been saying for some time. *** Scroll to the end of this post for details about the survey and research team. *** WERE YOU WARNED? According to the survey, only 6.1% of respondents were clearly warned that benzodiazepines should be only taken for a short time, or that they are difficult to withdraw from? Another 7.9% were warned, but not sufficiently. More than 3 out of every 4 respondents (76.2%) were "definitely not warned" about the dangers of taking benzodiazepines. Question (n=1,207): Were you warned that benzodiazepines should only be taken for short times, or that they are difficult to withdraw from? This data backs the anecdotal experiences shared by most of us in the benzodiazepine support field. The most common complaints many of us hear from the individuals we work with is that they were not warned or were tapered too quickly. Many even claim that they were met with annoyance, disdain, and disbelief from their own doctors. Doctors love prescribing benzos because it's the most efficient way to get a complaining patient out of the office in the shortest possible time... 90 percent of benzo prescriptions are written, often carelessly, by primary care doctors, who can spend only seven minutes with the patient without giving serious thought to the considerable risk... — Dr. Allen Frances, Professor Emeritus at Duke University, Chairman of the DSM-IV Committee IN THEIR OWN WORDS This survey allowed respondents to provide additional feedback on any topic in an open-ended text box. Many of them took this opportunity to share their frustrations with the prescribing and deprescribing practices of their physicians and/or psychiatrists. Here is a small sample of those responses: My doctor never warned me of what benzodiazepines could do to my body. He's still trying to prescribe me more. I had been taking .5 mg of clonazepam for 4 years, completely unaware that it was a benzo and a very dangerous drug. I wish I knew more before I began the taper a year ago, but my doctor didn't warn me, and I had no reason to research it since I've gone off of medications before without difficulty. Am so frustrated and disappointed that we were not given correct warnings on these meds. From my first dose on a benzodiazepine, I had adverse effects. My doctors did not recognize the medication to be the cause and actually diagnosed me with anxiety because my seizures were non-epileptic. I wasn't warned about benzo use by my doctor until I was having difficulty discontinuing use. My doctor cut me off without warning. They don't have a clue how to treat the after effects. Also, went to emergency room within days of being discontinued and was "locked down" in mental health unit for 9 days... Was given gabapentin, phenobarbital, and finally 5 mgs of valium once nightly during last 3 days of stay. I went to 37 doctors looking for answers for my declining health. Even went to the Mayo Clinic. Not one doctor recognized that I had hit benzo tolerance. When I started tapering, not one recognized the withdrawal symptoms. Asked my doctor flat out if Xanax is addictive. He said no and continued to prescribe them at increased doses for 20 years. My doctor, a trusted psychiatrist, told me my body needed this, like a diabetic needs insulin, and promised me it was not addictive. I believed him, and never abused the RX, but hit tolerance in 2015, still struggling over 3 years later, no one has ever told me about tolerance, all Drs have told me I am mentally ill. Doctor had no knowledge how to detox me and never warned me that lorazepam was for short-term use and kept me on it for eight years and then stopped refills he said due to FDA coming down on doctors . Pharmacist helped me detox in six month taper. Please warn doctors to only prescribe benzos for a short period of time. No benzo should be prescribed long-term. When I was put on Xanax my kids decided I was "nuts". This led to them throwing me and my husband out of their respective homes over time. I have no relationship with my children anymore and if something happens to my husband I really have no one — I have no reason to live. I trusted the doctor that prescribed this — he is not my doctor anymore. Unfortunately, I have had over 10 different doctors and NONE of them told me Xanax was bad! WHAT CAN BE DONE? The data from this survey backs what has been clear to most benzo organizers and advocates for many years; that many medical professionals are not properly educated on benzodiazepine prescribing, deprescribing, and the lasting effects of protracted withdrawal, or BIND. The good news is that there are several organizations working towards fixing this problem. In addition to Easing Anxiety, other groups such as the Alliance for Benzodiazepine Best Practices and Benzodiazepine Information Coalition (BIC) have made great strides in the area of medical education. Another group —which I have had the pleasure of co-chairing for the past few years — is the Benzodiazepine Action Workgroup (BAWG). In addition to ongoing research involvement and developing the first national Peer Support Training Program specific to benzodiazepines, this group provides continuing medication education (CME) courses and evidence-based PDF documentation on prescribing, deprescribing, and peer support free and available to all on its website. While this is a long and arduous uphill battle, progress is being made on many fronts and I personally want to thank all of those individuals who have been involved in helping improve the medical establishment's treatment of benzodiazepine-affected individuals. References ORGANIZATIONS The Alliance for Benzodiazepine Best Practices — https://benzoreform.org Benzodiazepine Action Work Group (BAWG) — https://benzoaction.org Benzodiazepine Information Coalition (BIC) — https://benzoinfo.com Easing Anxiety — https://easinganxiety.com DOCUMENTATION & PROGRAMS BAWG Guidance Documentation (Prescribing, Deprescribing, Peer Support) — https://www.easinganxiety.com/post/benzodiazepine-guidance-from-bawg BAWG Peer Support Training Program — https://benzopeertraining.org Benzodiazepine-Induced Neurological Dysfunction (BIND) — https://easinganxiety.com/BIND RESOURCES Frances, Allen. Yes, Benzos Are Bad for You. Originally published in Pro Talk: A Rehabs.com Community, June 10, 2016. Accessed October 13, 2016. https://www.psychologytoday.com/us/blog/saving-normal/201607/yes-benzos-are-bad-you. Survey papers are listed below. About the Benzodiazepine Survey About the Research The largest survey of its kind, "The Benzodiazepine Survey of 2018/2019" was created and administered by Jane Macoubrie, PhD and Christy Huff, MD. Over 1,600 individuals took the survey, resulting in 1,207 qualified respondents. The survey constituted 20 questions, including demographic inquires. Some of these questions had multiple sub-questions and/or allowed multiple answers. The survey generated three published research papers in scientific journals (as noted below) between April 25, 2022 and June 29, 2023. The research team is still together working on new benzodiazepine-related research projects. Special thanks to the Alliance for Benzodiazepine Best Practices for sponsoring and organizing this research. Published Papers PAPER 1 — April 25, 2022 Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. PAPER 2 — February 6, 2023 Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. PAPER 3 — June 29, 2023 Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, Martin PR. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Research Team Research Team / Authors (alphabetical) A. J. Reid Finlayson, MD, MMHC — Vanderbilt University Medical Center D E Foster — Benzodiazepine Action Work Group Christy Huff, MD — Benzodiazepine Information Coalition Peter R. Martin, MD, MSc — Vanderbilt University Medical Center Alexis Ritvo, MD, MPH — University of Colorado Anschutz Medical Campus Bernard Silvernail — The Alliance for Benzodiazepine Best Practices Acknowledgements The Alliance for Benzodiazepine Best Practices — Sponsoring Organization Jane Macoubrie, Ph.D. — Survey originator Jo Ann LeQuang — Medical Writer Limitations SOURCE: Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey This study has several limitations. The study reported on ‘suicidal thoughts’, which can range from fleeting notions of self-harm to passive desperation, preparatory planning, and disinhibition. Suicidal thoughts may be underreported, even in an anonymous online survey, as respondents might hesitate or be embarrassed to report self-destructive thoughts. There was no control group. Much of the survey dealt with symptoms presented in multiple-choice lists, and it is possible that patients may have been suggestible to the list presented, may not have correctly remembered past symptoms, or may incorrectly attribute certain symptoms or feelings to benzodiazepines. We did not account for a nocebo effect. The large number of write-in comments suggests that many respondents felt the survey did not allow them to fully describe the extent of their experiences and emotions. Another limitation of our survey is that it recruited respondents from social media and online sources that deal with benzodiazepine use and withdrawal. Respondents were self-selected, forming a convenience sample that may not represent the population of benzodiazepine users as a whole because visitors may have sought sites such as these specifically because they have experienced problems. Moreover, those who use the Internet for health information tend to be younger, and those who join online support groups for medical conditions tend to be in generally worse health. Our results thus may not be generalizable to the population of all people taking benzodiazepines. Data Analysis A medical statistician produced the initial results of this survey utilizing SAS Software. Subsequent data analysis was performed in greater detail by an experienced data scientist who imported the survey data into a custom SQL Server data model. Customized queries were employed to obtain correlations among the data. In particular, this analysis examined conditions for which benzodiazepines were prescribed and compared them to symptoms and adverse life effects reported by patients who were tapering or had discontinued benzodiazepine use. All analyses were delivered via a structured reporting process and validated against the original SAS reports. The survey was made available online through websites and internet benzodiazepine support groups and general health and wellness groups. The data scientist mentioned above is D E Foster, who is also the author of this blog series and the founder of Easing Anxiety. D has been a member of the Benzodiazepine Survey Research Team since 2019, providing general benzodiazepine knowledge and lived-experience in addition to formal data analysis and reporting. Prior to his withdrawal from benzodiazepines, D worked as a database developer and data scientist for over 25 years. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

Just this month, I’ve had a huge awakening. I struggle with anxiety. And, I feel shame about it. I don’t want to let people in my life know about it, although my husband sure knows its there. When my friends ask me how I am, I’d never consider saying “I am wrestling with anxiety.” Why? A change in identity I have fibromyalgia and have wrestled with chronic pain for more years than I can remember. Like many people with fibromyalgia — especially if I am having a flare-up — I am sensitive to smells, noises, and tastes. I can hear a person tapping on the desk with fingertips or smell a tuna sandwich across the room. I often felt irritable with the smallest environmental changes like smell, taste, or sounds. Headaches were a part of my personal experience too. I took fibromyalgia in as a part of my identity: I recognize it and even embrace it. I never feel shame. In fact, I was prescribed benzodiazepines for fibromyalgia — and most of you know the problems with benzodiazepines. What I understood about myself is that I had a pain issue, not an anxiety issue. Well, I’ve tapered off of Klonipin (clonazepam) and I’ve been off for two years now. In so many ways, I am much better. Certainly better than when I was tapering. And I have discovered — maybe I have always wondered — that I am dealing with anxiety. Here I am owning the fact that I experience anxiety often, sometimes daily. It is uncomfortable. It can be gnawing. I feel it in my solar plexus. By owning this, it now means I can address the reasons that I often feel edgy, impatient, worried, and easy to cry. If I can't identify the reasons, then I am committed to finding ways to eliminate it or cope with it. I have some questions How does my identity change when I say I have anxiety? Why am I worried about being judged about anxiety? Does it make me “less than?” Why do I feel ashamed? I didn’t choose to feel such anxiety or behave in a way I regret. In the same way I didn’t choose how tall I am, I didn’t choose anxiety. The truth is, I'm in good company. 40 million other adults share this same type of experience every year. (https://adaa.org/understanding-anxiety/facts-statistics). These are the questions I am wrestling with and hope to explore on Easing Anxiety. I want to develop a different relationship with anxiety. I am challenging myself to be: Curious about it Understand it Embrace it Instead of being ashamed, I want to hear this: “ Vulnerability is not a weakness. Vulnerability is our most accurate measurement of courage” — Brene Brown, Listening to Shame, 2012 Ted Talk My hope is that I can be courageous. As always, let us know what you think. References Anxiety Disorders - Facts & Statistics. Anxiety and Depression Society of America. https://adaa.org/understanding-anxiety/facts-statistics. Brown, Brene. Listening to Shame. TED Talk. 2012. https://www.youtube.com/watch?v=psN1DORYYV0 For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing human. Please read our site disclaimer for more information.

It's been a couple of weeks since we produced any content here at Easing Anxiety (EA). That includes the monthly Benzo Free Podcast which I typically release the first of each month. My apologies to those of you who may have been looking for the latest from EA. Please believe me, we're not going anywhere. The truth is, I took a couple of weeks to get organized. Doryn is away on vacation and I wanted to spend some time catching up on emails, setting up a project tracking system, and working on infrastructure projects for the website that I've been putting off for some time now. In addition, the Benzodiazepine Action Work Group and the benzo research teams I'm on also keep me quite busy. I've made a lot of progress these past couple of weeks and I'm grateful to have the time to catch up. Our blog posts will resume starting today and we'll continue to produce a minimum of 2-3 each week. As for the podcast, there are a few changes here. I'm skipping the October podcast for now as we revamp our process. Starting soon, there will be two podcasts. The original Benzo Free Podcast will continue, alongside a new podcast more focused on life and anxiety. These will be produced each month, so we will double our podcast production. Also, we'll be adding video back to most of our podcasts and even live stream some of them. This includes a redesign of our studio in addition to several technical enhancements. So, keep your eyes peeled for those coming soon. Well, I'm going to wrap that up here. I just wanted to let you all know that we are still here, and that this short break was necessary to get things headed in the right direction. Doryn will be back in another week or so, but she left me a blog post to send your way while she is gone. Thanks for your patience and support these past several years. You are the heart and soul of EA. Thank you. Please take care of yourself, and I'll see you real soon, D :)

15 minutes of listening to psychologist and New York Times Best Selling Author Lisa Damour on 3 Steps of Anxiety Overload can make anxiety so much more understandable. As she talks about healthy and unhealthy anxiety, I felt like I had a way to differentiate the two. In August 2022, Dr. Damour gave a TED talk with over 1.4 million views. Her straightforward view of anxiety and how to deal with it is appreciated. Her message is that anxiety is a normal part of the human experience. It serves as an alarm system that helps to keep us safe. It can motivate us, make us aware of risks, and move us to solve problems. I've summarized some of her key points here below: Anxiety is normal Dr. Damour makes a big point that helps immeasurably: Anxiety is normal, protective, and useful. — Dr. Lisa Damour She suggests that anxiety is the most systematic of human emotions. It has healthy forms that we all know and serve as our alarm system. It is so meaningful to know that the issue we worry about actually makes sense much of the time. As she describes it, here is how anxiety works: Our Body Reacts — We all have heard about the ancient fight-or-flight response that we have within us. This is our early warning system which activates our sympathetic nervous system. We Label It Anxiety — Her first question is whether anxiety is this the right name for what we are experiencing. Could it really be excitement? Or perhaps apprehension? And if it is, how does that change how we feel about our experience? Defining Unhealthy Anxiety Lisa Damour describes unhealthy anxiety as a situation where we feel anxiety with no real threat. Or, when our response is much stronger than what the situation calls for. She suggests that when we engage in catastrophic thinking we either overestimate the risk or underestimate our ability to respond to a situation and handle it. In dealing with unhealthy anxiety, Damour suggests that we ask ourselves the following: Am I imagining this risk or situation is worse than it really is? In my view, this question gives perspective on the real threat of the risk. It helps you understand that it may not be as bad as first thought. Do I have more say in how this will go than I give myself credit for? This question suggests the possibility that I may have more strength and capacity to deal with the anxiety-provoking situation. Box Breathing: A Strategy to Deal with Anxiety When we feel edgy and impatient, or feel the tightening of our throat or pit in our solar plexus, Damour recommends the simple strategy of Box Breathing. This techniques is used for a variety of purposes and is even used by Navy Seals to deal with stressful situations, or to help with sleep. Ultimately, this type of breathing helps turn down the anxiety dial. From a scientific perspective, deep breathing helps because it activates the nerves on the surface of your lungs that transmit a message to your brain that everything is okay. Deep breathing activates the parasympathetic nervous system that counteracts the arousal of the sympathetic nervous system (that part of our nervous system that experiences fight-or-flight.). The parasympathetic nervous system controls our rest-and-relax response. Deep breathing can help quiet the sympathetic nervous system and therefore reduce feelings of stress or anxiety. Box breathing can be as simple as: Inhaling for a count of 1, 2, 3 Holding for a count of 1, 2, 3 Exhaling for a count of 1, 2, 3 Waiting for a count of 1, 2, 3 Practicing deep breathing for 10 minutes can activate your rest-relaxation response, and help calm you down after a stressful event. On Avoidance In her TED Talk, Dr. Damour makes an important point about avoidance. When we are afraid, our instinct is to get away or make the feelings stop. Avoidance helps, but only for a short time. She makes it clear that "avoidance feeds anxiety." Avoidance is not a surprising response to a stressful situation since it is easier to avoid or not do something, then face it. The problem with avoidance is that nothing changes. Damour explains that "your beliefs about what you fear is never challenged with new or competing data." Her straightforward advice is to face the issues we want to avoid by taking small, incremental steps. This allows the person to tolerate a bit of discomfort, and helps them dial down the anxiety. Each small step helps to build confidence and resolve anxiety. Each small step tells our brain that "we did it" and "we survived," Each small step prepares us to take the next step. As always, please let us know what you think! References Damour, Lisa. 3 Steps of Anxiety Overload - and How You Can Take Back Control. YouTube (TED). February 14, 2023. https://www.youtube.com/watch?v=oITW0XsZd3o. Swiner, Carmelita (Reviewed). What Is Box Breathing? WebMD. https://www.webmd.com/balance/what-is-box-breathing. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing human. Please read our site disclaimer for more information.

Welcome back to the Easing Anxiety blog series, "What We Learned from the Benzo Survey," where we dive deep into the data from the Benzodiazepine Survey of 2018/2019 to learn more about benzos, BIND, and the individuals who have taken these medications. In our first two posts in this series, we explored age groups, gender, and country. Today, we move past the initial demographics and investigate the types and classes of medication taken. I hope you find this post both informative and enlightening. *** Scroll to the end of this post for details about the survey and research team. *** MEDICATION TYPE As you can see by the data listed below, the most commonly taken medication from the survey was Klonopin/clonazepam. In fact, over half (52.9%) of the respondents had taken clonazepam at one time or another. This was followed by Xanax/alprazolam (41.7%), Ativan/lorazepam (36.1%), and Valium/diazepam (32.1%). It is important to remember that the respondents could select more than one medication, and many did. Question (n=1,207): Which medication did or do you take? Choose all that apply. MEDICATION CLASSES Another way to look at the data above is by the specific classes. The following data represents the number of respondents who reported taking any medication in these designated classes (n=1,207). Benzodiazepines: 1,190 (98.6%) Nonbenzodiazepines (Z-drugs): 247 (20.5%) Anti-psychotics: 167 (13.8%) GABA Analogues: 222 (18.4%) Antidepressants: 558 (46.2%) When comparing the above classes of medication, the one most commonly associated with benzodiazepine use is antidepressants. Of those who took or are still taking benzodiazepines, 46.0% also took antidepressants. This is not unexpected since SSRIs and SNRIs are often prescribed to benzodiazepine users during their taper, or as an adjunctive medication during use. When reviewing individuals who took more than one type of medication, the most common overlap was alprazolam (Xanax) and clonazepam (Klonopin). Of the survey respondents who had taken alprazolam, 255 (20.2%) were also taking, or had taken, clonazepam. In some of these instances, clonazepam may have been prescribed as a substitution benzodiazepine during taper. WHY IS CLONAZEPAM (KLONOPIN) USE SO HIGH? As mentioned earlier, over half (52.9%) of the respondents reported taking Klonopin/clonazepam at some time. The numbers for Xanax/alprazolam (41.7%) and Ativan/lorazepam (36.1%) were lower, even though they are more frequently prescribed in the U.S. Here is an excerpt from our second research paper on the survey where we address this finding: A potentially important finding in the survey was that a disproportionate number of respondents had taken clonazepam [Klonopin]. This was surprising because clonazepam is not the most frequently prescribed benzodiazepine in the United States. In 2019, there were 2.3 million Americans taking clonazepam compared to 3.9 million taking alprazolam and 2.8 million taking lorazepam. The percentage for alprazolam prescribing according to these figures from 2019 is 70% higher than that of clonazepam, and yet clonazepam usage in this survey is 27% higher than alprazolam. — Huff 2023 This leaves us with an interesting question. If alprazolam and lorazepam are prescribed more often, then why is clonazepam usage significantly higher in the survey than these other two? Here is a bit more from the research paper that may provide some insight: These findings mirror claims by benzodiazepine support groups that patients who have taken clonazepam appear to have a higher incidence of enduring symptoms than those who took other benzodiazepines, although little if any research has been published on this topic. Another possible explanation is that until recently, clinicians tended to switch the most severe benzodiazepine users to long-acting clonazepam for detoxification rather than simply tapering the first drug; this is no longer considered the treatment of choice. — Huff 2023 Since the majority of individuals who participated in the survey were struggling with long-term symptoms from benzodiazepine use, the fact that clonazepam was the most widely taken medication is telling. This is the first evidence we have seen which backs up anecdotal observations from the benzo support community regarding a possible link between clonazepam use and a higher incidence of protracted symptomatology, in comparison to other benzodiazepines. I am just one of those individuals who has made this observation. Anywhere from 50% - 75% of the individuals who reach out to me for benzodiazepine support through my podcast (The Benzo Free Podcast) have taken clonazepam, and I have heard similar reports from my fellow benzo organizers and coaches. These anecdotal observations appear to agree with the data above. As mentioned in the above quote, there are other possible explanations for clonazepam's high numbers. Clonazepam was widely used for substitution protocols until more recently, and thus more individuals may have been prescribed this drug for their taper. Also, I took clonazepam for over 12 years and discuss it on my podcast. This fact may attract clonazepam users to my channel more than others, and equally may have attracted me to news about clonazepam more than other types during my research. Regardless if clonazepam use does appear to be linked to a higher rate of protracted symptoms or not, all benzodiazepines can cause long-term effects and I have worked with many individuals dealing with protracted benzodiazepine withdrawal (BIND) who have had no exposure to clonazepam (Klonopin). References Survey papers are listed below. About the Benzodiazepine Survey About the Research The largest survey of its kind, "The Benzodiazepine Survey of 2018/2019" was created and administered by Jane Macoubrie, PhD and Christy Huff, MD. Over 1,600 individuals took the survey, resulting in 1,207 qualified respondents. The survey constituted 20 questions, including demographic inquires. Some of these questions had multiple sub-questions and/or allowed multiple answers. The survey generated three published research papers in scientific journals (as noted below) between April 25, 2022 and June 29, 2023. The research team is still together working on new benzodiazepine-related research projects. Special thanks to the Alliance for Benzodiazepine Best Practices for sponsoring and organizing this research. Published Papers PAPER 1 — April 25, 2022 Finlayson AJ, Macoubrie J, Huff C, Foster DE, Martin PR. Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey. Therapeutic Advances in Psychopharmacology. 2022;12. doi:10.1177/20451253221082386. https://journals.sagepub.com/doi/full/10.1177/20451253221082386. PAPER 2 — February 6, 2023 Huff C, Finlayson AJR, Foster DE, Martin PR. Enduring neurological sequelae of benzodiazepine use: an Internet survey. Therapeutic Advances in Psychopharmacology. 2023;13. doi:10.1177/20451253221145561. https://journals.sagepub.com/doi/10.1177/20451253221145561. PAPER 3 — June 29, 2023 Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, Martin PR. (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLOS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584. Research Team Research Team / Authors (alphabetical) A. J. Reid Finlayson, MD, MMHC — Vanderbilt University Medical Center D E Foster — Benzodiazepine Action Work Group Christy Huff, MD — Benzodiazepine Information Coalition Peter R. Martin, MD, MSc — Vanderbilt University Medical Center Alexis Ritvo, MD, MPH — University of Colorado Anschutz Medical Campus Bernard Silvernail — The Alliance for Benzodiazepine Best Practices Acknowledgements The Alliance for Benzodiazepine Best Practices — Sponsoring Organization Jane Macoubrie, Ph.D. — Survey originator Jo Ann LeQuang — Medical Writer Limitations SOURCE: Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey This study has several limitations. The study reported on ‘suicidal thoughts’, which can range from fleeting notions of self-harm to passive desperation, preparatory planning, and disinhibition. Suicidal thoughts may be underreported, even in an anonymous online survey, as respondents might hesitate or be embarrassed to report self-destructive thoughts. There was no control group. Much of the survey dealt with symptoms presented in multiple-choice lists, and it is possible that patients may have been suggestible to the list presented, may not have correctly remembered past symptoms, or may incorrectly attribute certain symptoms or feelings to benzodiazepines. We did not account for a nocebo effect. The large number of write-in comments suggests that many respondents felt the survey did not allow them to fully describe the extent of their experiences and emotions. Another limitation of our survey is that it recruited respondents from social media and online sources that deal with benzodiazepine use and withdrawal. Respondents were self-selected, forming a convenience sample that may not represent the population of benzodiazepine users as a whole because visitors may have sought sites such as these specifically because they have experienced problems. Moreover, those who use the Internet for health information tend to be younger, and those who join online support groups for medical conditions tend to be in generally worse health. Our results thus may not be generalizable to the population of all people taking benzodiazepines. Data Analysis A medical statistician produced the initial results of this survey utilizing SAS Software. Subsequent data analysis was performed in greater detail by an experienced data scientist who imported the survey data into a custom SQL Server data model. Customized queries were employed to obtain correlations among the data. In particular, this analysis examined conditions for which benzodiazepines were prescribed and compared them to symptoms and adverse life effects reported by patients who were tapering or had discontinued benzodiazepine use. All analyses were delivered via a structured reporting process and validated against the original SAS reports. The survey was made available online through websites and internet benzodiazepine support groups and general health and wellness groups. The data scientist mentioned above is D E Foster, who is also the author of this blog series and the founder of Easing Anxiety. D has been a member of the Benzodiazepine Survey Research Team since 2019, providing general benzodiazepine knowledge and lived-experience in addition to formal data analysis and reporting. Prior to his withdrawal from benzodiazepines, D worked as a database developer and data scientist for over 25 years. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing, human person. Please read our site disclaimer for more information.

Yesterday, I was in the kitchen and needed to go to the bedroom to get something. After about two steps, I turned back to the kitchen to get something else. Before I was back in the kitchen, I headed to the basement stairs to grab something different. Half-way down the stairs I turned around and walked back to the kitchen. When I arrived, I just stopped and stood there. Baffled. No, this is not an exaggeration. It's also not uncommon for me. If this sounds at all familiar to you, perhaps you might want to read on. The "What If Whirlpool" Indecision and anxiety are intertwined. Those of us who deal with chronic anxiety are often over-thinkers, and over-thinking is the cornerstone of indecision. While thinking through a decision — especially a major decision — is often beneficial; ruminating on a decision for hours on end is not. For those of us who struggle with moderate to severe anxiety, we can get trapped in what I like to call, "the what if whirlpool," and sink further and further into the fear. The fear of what others might think. The fear that we made the wrong decision. And ultimately, the fear that we may not be able to make a decision at all. According to an article in Psych Central, common causes of indecisiveness include fear of failure, perfectionism, people pleasing, overwhelm, lack of confidence, lack of knowledge, mental health disorders, and others. Any one, or combination of the above, may be factors in your diminished ability to choose. So, what can be done? 6 Tips to Help with Indecisiveness Here are some suggestions from a variety of sources. I hope one of them might help: Don't Overthink the Outcomes — We can't predict the future. Therefore, according to a Psychology Today article, "making decisions is usually a crapshoot." While it's useful to have confidence in the decisions you make, it's also important to be aware that you have no control over the outcome of them. In fact, many outcomes have no relation to the decisions you made at all. Let Things Go — As I mentioned above, we have total control over nothing. Once you accept that, and let go of any past or future mistakes, you can start to move forward in life. Make a decision and move on. Find a Balance — Find a balance between trusting your mind and trusting your instincts. Logic nor emotions alone are good leaders. It takes the two working together to find the answers. Pros and Con — This is a common method in our home. If there is a significant decision to be made, my wife and I write down the pros and cons on a sheet of paper. This helps to facilitate objective and sound decision making. Flip a Coin — This is an old trick, but a useful one. If the decision is binary (two choices), flip a coin to decide. The real benefit of this exercise is that it often reveals what you wanted in the first place. Give it a try. Don't Question Your Decisions, Celebrate Them — Once you've made a decision, don't second-guess it. Instead, celebrate it. Recognize your achievement and enjoy the success. This will help build confidence for future decisions. Now, go out there and tackle the world. Start small, if you like — but start, nonetheless. Every step forward is momentum that feeds your future. You got this. Later, D :) References Hallenbeck, H. W., Rodebaugh, T. L., & Thompson, R. J. (2022). Understanding indecisiveness: Dimensionality of two self-report questionnaires and associations with depression and indecision. Psychological Assessment, 34(2), 176–187. https://doi.org/10.1037/pas0001072. Strauss Cohen, Ilene. 7 Tips on How to Kick the Habit of Indecisiveness: Learn how to make better decisions. Psychology Today. November 5, 2017. Accessed August 28, 2023. https://www.psychologytoday.com/us/blog/your-emotional-meter/201711/7-tips-how-kick-the-habit-indecisiveness. Why Am I So Indecisive? 10 Methods That Can Help You Make Decisions. PsychCentral. Accessed August 28, 2023. https://psychcentral.com/health/coping-with-indecision. For Informational Purposes Only All information presented on Easing Anxiety is for informational purposes only, and should never be considered medical or health advice. Withdrawal, tapering, or any change in dosage of benzodiazepines or any other prescription drugs should only be done under the direct supervision of a licensed physician. This article was written by a living, breathing human. Please read our site disclaimer for more information.