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What Happens to the Brain on Benzodiazepines

I’m going to attempt to explain Benzodiazepine withdrawal. Over and over, I hear from people who don’t understand why when they’ve been off their benzo for 2 weeks, a month, 3 months, why they still can’t walk in a straight line, speak in coherent sentences, why their skin is burning and they’re battling an all-consuming terror scarier than the devil himself. No one understands. Why when the drug is out of one’s system is this still going on?

Once I figured out that Klonopin was my problem, I was just as confused. I read the Ashton manual, but I still thought that the faster I was able to get off the benzo, that the faster I would be better. Like an addict, get the drug out of their system and they’re better. This idea is wrong. Even for recreational drug and alcohol abuse, the brain does not go back-to normal because the substance has actually changed brain chemistry and function. But that’s a topic for another day. The point is, the way we see drug withdrawal: as the faster the better, just get it out of your system, does not work for discontinuing benzos. And it perpetuates the belief in the sufferer, that they are mentally unstable or disabled because they are not “back-to-normal” once the benzo is out of their system.

People go searching for answers they can’t find and have their doctors shaking their heads and prescribing more and more psychiatric medicines making these people believe they must be real nut cases with lifetime passes for the crazy train. That’s because the vast majority of western medicine doctors are trained to know how to get people on meds, not off of them. And by calling this benzodiazepine discontinuation syndrome, withdrawal, it adds even more confusion. Because with other drugs and substances, once that substance is out of your system, you’re getting better. The withdrawal is easing. The distinction with benzodiazepines is that it’s not a traditional drug withdrawal, it’s brain damage that is causing the distress. I don’t say this to scare anyone. Your brain is fully capable of healing. But the timeline when compared to the way we look at drug withdrawal traditionally, is much longer. Because it’s not the benzo leaving your system that you’re after, but the brain’s GABA receptors repairing and restoring themselves to normal function.

Here’s the breakdown:

Benzodiazepines work by binding to the GABA receptors in the body.

GABA is gamma-aminobutyric acid. It is the main inhibitory neurotransmitter in the Central Nervous System (CNS). What that means is that GABA is what calms us down and keeps us calm. We all have GABA in our systems and GABA receptors, which are the sites where GABA is recognized and able to "plug in" to the CNS and do its job. Without the proper functioning of these GABA receptors, GABA would be useless. Not only are these receptors in the brain, but the entire CNS, including in the lining of the intestines.

Benzodiazepines work by binding to and blowing out these GABA receptors. Imagine GABA as a hand-held hair dryer. Now, imagine GABA receptors as electrical outlets in a home. Now, imagine taking a benzodiazepine is like plugging blow dryers into every outlet in a house and turning them all on at once. The breaker's going to trip. And when you go to plug in just one blow dryer, it’s not going to work anymore. The breaker has been tripped.

The “plug” and the “outlet”, like your body's own GABA and GABA receptors, aren’t going to work anymore. After taking a benzodiazepine, the CNS has been "flipped" and it no longer responds well/or at all to the body's own GABA. The receptors have been blown and will only recognize GABA in the form of a benzodiazepine. The time it takes for this to happen in the brain, varies for everyone. It could take one dose, a few weeks, a few months… But once the CNS “flips,” there’s no going back.

Here in lies the problem.

Benzodiazepines are prescribed for a wide variety of ailments from panic attacks, seizures, chronic pain, insomnia, migraines, PMDD, depression, anxiety, PTSD, the list is endless. All over the world, people are walking out of their doctor's office with a prescription for these drugs and are told how it is going to alleviate their problem, and never warned of the very dangerous trap that they are walking into. They’ve been given a pill that is going to calm down their overheated nervous system, but when they go to stop the pill, will find they are in worse shape than before they started. Some people find that after just one dose, their body needs the drug to feel even a little calm again.

That is the paradox of benzodiazepines. Taking a benzo calms the CNS, but these drugs exploit the GABA receptors to such a degree that even just from one dose, the receptors begin to lose their ability to do their job on their own. This leads to rebound anxiety, terror, depression, physical withdrawal, pain, suicidal ideation, even seizures.

Benzodiazepines work very much like alcohol in the system, loosening inhibitions and impairing judgment. (Alcohol also stimulates the GABA receptors. This is also why alcohol withdrawal can be so dangerous.)

Even when taking a benzodiazepine regularly, one can already be experiencing withdrawal. That's because the body can develop a tolerance for the dose and begin needing more of the benzodiazepine to feel the same level of calm as before.

When someone who is dependent on a benzodiazepine stops taking or lowers their dose, withdrawal will begin. That's because GABA works in the brain and nervous system as the coolant. Without properly working GABA receptors, able to utilize the "coolant," your engine (the entire CNS) is going to overheat. Everything will go haywire and nothing is going to work properly.

If the entire CNS is just one big engine, then in benzodiazepine withdrawal, without a coolant, the entire thing is overheating. The CNS runs from our heads to our toes. It connects your brain to every muscle, organ, and nerve in your body. That's why there isn't one symptom that is off limits in withdrawal. The CNS becomes like that of a newborn baby. Everything is overstimulating because you have no GABA to counteract that stimulation. Noise, lights, smells, touch, food, mundane day-to-day stresses become too much to bear because the CNS is overheated and overloaded.

Gaba receptors can and do heal themselves. But the key to remember is that this takes time. Don’t stress about how long the benzodiazepine has been out of your system. To your healing brain, this means nothing.

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