Authors: Matt Samet
You could say I'm conducting my own one-man study. When the nurses come into my room, I grill them about what
they've
seen, as it's really them and not the doctors down in the trenches. The closest I get to an answer is one nurse saying that, as far as he knows, there have been no benzo-related “sequellae” and that I shouldn't pay attention to anything I read on the Internet. He parrots the doctors' spiel that apart from a week or two of flu-like symptoms and a slight elevation in anxiety, I will soon feel like myself again. Of course, what happens to patients once they're off the ward is anyone's guess, hence the lack of “sequellae.” Psychiatric hospitals do not follow up to see if their treatment has worked. Out in the world, patients can easily go back on benzos, continue to mask withdrawal symptoms with other medications, or re-intake with issues possibly related to cessation of the pills but that go undiagnosed as such. Even “the best hospital in America” can't acknowledge the existence of a benzodiazepine withdrawal syndrome nor their potential role in causing it. To them, these pills are like baby aspirin, to be stopped or started rapidly with impunity. Even when half their patients are experiencing issues that might be linked to benzos, they do not stop to connect the dots; they do not ask questions. The paradigm seems to be: “Benzos are bad, really, really bad, so we're going to get you off them.” But then, paradoxically, “Anything you feel beyond our official, drug-study-sanctioned, med-school-taught view of brief symptomology is due strictly to your own flawed biochemistry.”
If you continue down this road, you'll end up a lifer. In spring 2005, just as I began to taper, I met the Ghost of Christmas Future. A onetime climber who'd come to Carbondale to visit a coworker, he used a
fishing-tackle box
as a travel kit for his psychiatric meds. I will later learn, from a friend who interned at a VA hospital, about veterans with PTSD on thirty or more medications a day, including benzos. The chemicals accrue over the years, he tells me. Even once one med stops working, the doctors are reluctant to taper a patient off and hence keep piling on pills. I'm not sure how these vets' livers function or how the men get through the day. I cannot imagine. I will also, through a support group on Yahoo, read countless tales of people like me, dependent on or trying to stop benzos but placed instead on five, eight, ten meds a day: antidepressants, mood stabilizers, antipsychotics, barbiturates. I feel for these people even as I praise the Fates that I escaped before this too became my final chapter. You see, I left the hospital and have not looked back. Within a month, I found my solution: that number for a benzo-support group I should have called months if not years earlier.
This was not going to be my life.
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CHAPTER 11
The first thing to realize about acute benzo withdrawal is that it's not “anxiety” as you know it. If anxiety is a yippy little Chihuahua in a handbag, then this is a Rottweiler mauling your face offâfor months. A clinician listening to you describe your symptoms might diagnose anxiety, but deep inside, in your subjective experience where it truly matters, you will feel a primal and monolithic terror that cannot, as with garden-variety anxiety, be reasoned with: Your calming GABA “light switch” is busted or even frozen in the off position, and you will not experience reality as it was until your receptors renormalize. The merest trifleâa barking dog, a near fender-bender, an angry word from a friend, an upsetting movieâwill push you off the panic cliff. This much I learned by studying my own reactions to stress: If anger or fear entered my system, or if I overexerted myself physically, I'd have panic attacks and remain flooded with adrenaline for hours and sometimes days. The parasympathetic nervous system would not bring me back down reliably, as it had in the past, and sometimes it would not bring me back down at all.
I return alone on a four-hour nonstop flight home from Baltimore to Denver, raw around the edges, away from the hospital and my father's house. After a final two weeks as an outpatient at Hopkins, after countless panic attacks and night terrors at my father's, after the night he came to my bedroom and stroked my brow as he had when I was a child and woke up distressed, I need to let him resume his life. And I need to try to get on with my own. I swallow a Neurontin before boarding, take my seat, and pretend to read a potboiler novel. It's difficult, but I'm doing it, which is no small thing. Then the plane aborts its takeoff. The nose is up, the engines are firing, and then they suddenly cut to nil and the pilot is slamming on the brakes. He comes over the intercom to let us know that the tower mistakenly gave us clearance, and that we need to wait ten minutes to try again. My heart hiccups, it slams, my hands shake, I sweat. I wait for the panic to pass, as it has in the past, but it doesn't. I will stay in this heightened, hyperalert state for the next four hours, avoiding eye contact with other passengers, gripping my closed paperback like it's the Holy Bible, my gaze flitting about the cabin like a moth in a bell jar. As we descend into Denver, dropping through white, arctic-front storm clouds, the pilot comes on again to tell us that the runways are too icy to land. He eases the plane back up and we start circling, the ground invisible, the moist air turning pink with molecules of frozen sunset. The plane jostles in the mist, its engines firing intermittently to keep us at elevation while snowplows clear the runways.
Ice starts to crust on the wings, plastering over the landing lightsâthis is how jetliners crash. I think I might puke. I would rather open an exit door and jump out than feel this fear for one more second. When we finally land, I feel no relief being back on the ground. I should, but I don't. Kasey is waiting outside the airport. It's night. We drive home through lashing snows. The gentle prairie swells along Peña Boulevard heading south from Denver International overhead, poised to break like massive waves. I cringe in my seat, trying to disappear into the upholstery. Kasey talks about her infant nephew who's having seizures, and I can't stand to listen. This is too dark, too intense and scary, this poor, ailing baby boy. I become him, feeling that I might have a seizure myself, my gut as empty and stale as a mummy's core.
At Hopkins, they warned me that the transition back home would be hard, but this is something else entirelyâthis is sinister.
That night, I do not sleep. I do not even approximate sleep. The adrenaline keeps me awake, firing and firing until morning, until a thin meniscus of orange forms in the east and pale dishwater light seeps over Boulder. I thought I would feel stronger back in Colorado, but I'm weaker than ever, a textbook agoraphobe. I rarely leave the house. I pace and fret and writhe and sweat as the walls close in. I have nothing to do, but neither am I able to do anything because I'm so distracted and distractable. I was supposed to go to Hawaii with my father, his girlfriend, and her children for my dad's sixtieth birthday, but I demur. My father and I get into a shouting match on the phoneâhe wants me there and keeps saying, “You have to come. You have to,” partially for selfish reasons but also, I'm sure, because he wants the hospital to have fixed me. Kasey heads home to Oregon, and I'm alone over Christmas. I drive her a half mile to the bus depot from where she'll leave for the airport. Tiny Boulder seems immenseâdowntown, with its fifty-foot buildings, looks towering and frenetic as if I've been picked up by a tornado in Nebraska and deposited in Times Square. But also distant, like the surface of a glacier glimpsed through a telescope. I begin to taper the lithium and Neurontin; I don't care what might happen. One of these meds has brought a rash over my belly, and they need to go. I have a med check-in with Dr. Porridge. He urges me not to quit the pills, but I tell him that I'm doing it anyway. He reiterates that I have anxiety and depression, which must be medicated, and that I'm undoing all the “great treatment” I received at Hopkins.
Fine, whatever.
During those first two weeks back home, I'll e-mail my friend Jim: “I'm in complete and utter hell ⦠the withdrawal and panic attacks are awful, and the fucking shithead docs at Hopkins and my doctor here are trying to tell me it's my ânatural anxiety.' I feel pretty overwhelmed [and] can't leave the house much.⦔
It's a La Niña year so great fronts back up along the Continental Divide, sending Chinook winds howling over Mount Sanitas, flexing the windows, tearing the screen doors from their hinges. I fear that our duplex might, like me, blow away into the darkness, streaming off atom by atom. Clyde has figured out a way to escape under the backyard fence and launches rogue missions down the alley, upsetting trashcans to scrounge for food scraps. He's quickâif I don't stand watch atop the stairs, if I turn away for so much as ten seconds, he's gone, and I must spend an hour, maybe two, hunting him out in frigid winds under the sterile moonlight, beneath dead leaves rattling on threadbare trees reaching skeleton hands skyward. I can hardly breathe amidst a thick, molasses-like fatigue, lurching like some creep along the alleys, calling for the hound in a high, reedy wheeze. If Clyde heads uphill, toward Fourth and Third streets, it takes even longer to find him because then I can only shuffle, pausing every few steps for breath like a Himalayan mountaineer in the Death Zone. I'm always out looking for Clyde. He thinks it's the greatest game.
Mornings are bad because I wake up spitting blood, my throat and sinuses inflamed from chronic hyperventilation. I hack up the corrupt red blossoms, spit them into the toilet, and flush them away, wiping bloody sputum from my lips. This will go on for a year. I will start to sleep with nasal strips on and duct tape over my mouth in the hopes of promoting slow, diaphragmatic breathing.
Daytime is bad because I have nothing to do, am constantly in a state of fear, and my focus is shattered, a trifecta of idleness, terror, and distraction. I can no longer read books or even long-format magazine articles. It will remain this way for months. I will start back with
Maxim
, work my way up to
Esquire
, and finally
The New Yorker
before I can engage with a novel again. Also, I can't stand to let anything end, even a simple task like washing the dishes, because I'll immediately have to face the empty minutes again. But conversely, I hate to begin anything because I'm not sure I'll be able to finish. So I flit from meaningless chore to meaningless chore, breezing in and out of Web sites, cleaning the house in stages, pacing, going out to the front patio to sit in the sun for two minutes, picking up Clyde's poop, turning on the television, turning it off, trying to do breathing exercises, repeating it all over again. It's a simple pleasure, really, to sit still and be at peaceâthe healthy take it for grantedâbut it's one that will ever elude the benzo sufferer.
Nights are bad because I cannot sleep. At best I get two hours, and often wake up screaming, seeing phantoms levitate above me to wash against the ceiling and dissolve into squidlings of ectoplasm. I ask the neighbors, sheepishly, if they can hear me bellowing, but they cannot. It will be nine months before I take my first daytime napâa one-minute nap; an incredible victoryâand two years before I get more than five hours of continuous sleep at night. Some nights, scratching noises come from inside the bedroom closet, like someone is raking his fingernails along the doors. But when I turn on the lights and slide the doors back, no one is there and the noises stop. My brain is incredibly suggestible: If I watch an upsetting movie, it seeps into me until I inhabit whatever bad event has occurred on-screen. Before she left, Kasey and I watched the Russell Crowe boxing film
Cinderella Man,
and I almost had to leave the room. When rough punches landed and heads snapped back during the fight scenes, I could feel my own gray matter sloshing around in sympathy. With horror movies, it's even worse.
Who is this scared, pathetic man?
I continue to see the therapist. To her credit, she gets me out the door when no one else can. I help at the food bank where she volunteers, go to her house with Clyde, take walks around Mapleton Hill with its brick Victorians and silent, tree-lined sidewalks. She is not an unkind person, but again, she does not understand benzo withdrawal and neither does she try to. She does not listen when I say that I don't think that this is my natural state. This woman reiterates that I have the worst anxiety of anyone she's seen, that I need to stop focusing on symptoms and feeling sorry for myself, and that I need to stop letting myself have panic attacks because it will only reinforce the neurological channel along which they travel. The therapist tells me that I have what the Buddhists call “wild mind,” and that I need to harness my racing thoughts through meditation. She advises me not to stop my current meds, saying that the doctors must have had “a good reason” for prescribing. And she diagnoses that I'm “OCD about my breathing,” as the inability to draw a full breath has become my strongest symptom and hence an obsession.
My brain is so porous, so rudderless and unkempt, that I imprint her words. I start to worry that I've become permanently locked in a psychotic fear state. I fret that all my years of panic attacks, of drugging, of feathering the edge on the rocks, of too many adrenaline rushes, of harsh withdrawals from benzodiazepines, have changed my brain forever.
I will always be this frightened.
This notion makes me deeply suicidal. One day I call my mother threatening to kill myself, and sheâupon the therapist's adviceâsays she's going to hang up and call the sheriff. The sheriff will, of course, take me back to the hospital, where they'll probably reinstate benzos. I hang up and beat the living shit out of the couch as Clyde slinks into his crate. Poor Clyde: He has to bear witness to these things. As I calm down, he approaches with concern writ in his eyes, and I knead his neck folds and tell him that I love him until he licks my tears with dog kisses that smell of cold cuts. Clyde keeps me alive, where no one else can. He was abandoned outside Taos, New Mexico, as a puppy, and I cannot revisit this same unkindness upon him. The suicide urge will continue for the next year, lessening only in fits and starts. Many mornings I will wake up, look in the mirror, and say, “I promise not to kill you today,” leaving myself no choice but to continue.