What is Rebound Anxiety?
Anxiety is amongst the most common mental health disorders and is known to affect 40 million adults every year, which is also the number of people seeking treatment for their anxiety.(1) So, it can be even more.
There are anti-anxiety medications like benzodiazepine that are the sedatives that help in calming the feelings of anxiety and leaving the person relaxed. They help in easing the symptoms that include:
- Sweating and chills
- Head and muscle tension
These anti-anxiety medications bring in quick relief and people find them effective in relieving severe anxiety. Long-term use of these medications can lead to significant side effects and addiction.
Stopping these medications can lead to rebound anxiety.
Rebound anxiety is a condition that occurs when you stop taking anxiety medications and there is a return of symptoms with greater intensity. It not only includes the symptoms of anxiety but also increased irritability, fear, and worry.
Why Does Rebound Anxiety Occur?
The benzodiazepines work by binding to gamma-aminobutyric acid in the brain. Gamma-aminobutyric acid is an amino acid that acts as a chemical messenger that slows down the activity of the brain.
When a person is under stress or anxiety, gamma-aminobutyric acid helps block the signals of these emotions making you feel calmer and relaxed. Gamma-aminobutyric acid helps in getting sleep. Benzodiazepines bind with gamma-aminobutyric acid and boost their activity in the brain helping the chemical to work more efficiently.(2) This helps in easing anxiety, panic, and sleeplessness.
Research shows, long-term use of these medications cut down the binding sites.(3) Thus, the remaining sites take longer to bind and synthesize gamma-aminobutyric acid, leaving a heightened feeling of anxiety or panic.
Medications Causing Rebound Anxiety
Stopping or cutting down the use of benzodiazepines after using them for a long time can lead to rebound anxiety.
Benzodiazepines like alprazolam, triazolam, and lorazepam have a short and immediate half-life that leave the system sooner and carry a higher risk of rebound anxiety and withdrawal symptoms. Half-life is the amount of time the body takes to absorb or process any medication.
Longer-acting benzodiazepines like diazepam, flurazepam, and clonazepam are less likely to cause rebound anxiety.
What is Alcohol-Related Rebound Anxiety?
Just like benzodiazepines, alcohol acts on gamma-aminobutyric receptors prompting the release of gamma-aminobutyric acid in the brain. This gives a feeling of calmness and helps in getting sleep.
Alcohol also affects the chemical messengers that include dopamine, glutamate, and serotonin which can thereby affect mood and sleep.
Alcohol in small amounts can relieve anxiety. Hangover anxiety or hangxiety occurs when a person drinks plenty of alcohol to reduce anxiety.
Alcohol is not an approved treatment for anxiety and over time it can worsen the symptoms if used for a long period of time.
How Long Do the Symptoms of Rebound Anxiety Last?
The symptoms of rebound anxiety occur within 24 hours of stopping benzodiazepines.
There are a few factors that can affect how long and how severe the symptoms get, these include:
- Size of the dose
- Potency of medication
- Medication half-life
- Personality and psychological traits
- The severity of symptoms before taking the medication
The symptom of rebound may last for a few days, and soon afterward there may be the return of symptoms of anxiety.
Treatment of Rebound Anxiety
In order to reduce rebound anxiety, it is prescribed by many doctors to slowly taper down the medication. This lowers the risk of rebound and withdrawal symptoms.
Another way to prevent the symptoms of rebound anxiety is to start with longer-acting medication before beginning the tapering process. Many prescribers suggest starting different antidepressant medications before tapering down the regular medication.
But, even after following a tapering process, some may experience symptoms of rebound anxiety, which ease within few days.(4)
How to Cope with Rebound Anxiety?
Therapies for anxiety help in coping with the rebound symptoms. The therapies include:
- Cognitive behavior therapy
- Exposure therapy
- Acceptance and commitment therapy
There are also a few alternative treatments that can help with the withdrawal symptoms or rebound anxiety. They are:
Rebound anxiety does not necessarily occur while stopping benzodiazepines, but it does exist. The risk can be lowered by following the instruction of a doctor or a psychologist.
A therapist can also help get to the root cause and provide relief that can be long-lasting.
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