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What Is The Cause And Treatment For Anxiety?
Question: I'm 67 years old, female, and healthy. I've had anxiety issues my entire life due to loI dists of reasons --- including a difficult marriage. My husband passed 3 years ago, and now I'm still trying to get used to being alone. To try to shorten this ------ I took valium off and on for over 20 years. When my husband died 3 years ago, I took it every day ---- 5 mg. Since that time, I've been able to decrease it to the point of stopping it. Last month I took only .5 mg every other day or every 3rd day. I got along pretty well with that and felt good about stopping it. Then 8 days ago I took my last dose and felt happy that I was perhaps finished with it. Last night during the night, I had a XXXXXXX panic attack ---- I don't like being alone, but am getting more and more accustomed to it. My mind raced, and I had myself talked into feeling miserable. So I took 2 mg of valium and calmed down in about 15 minutes. Now my question is ----- do I need to begin tapering again from 2 mg? Or am I able to just stop as I did 8 days ago. Also, how do I know if I was having valium withdrawal --- or if it was just my anxieties? I'm so worried about this ---- and of course that doesn't help my anxieties either. I want to be off this medicine, but after taking a 2 mg tablet again, I'm wondering if I'm back to square 1 with stopping it. I read such horror stories on the Internet about going off this drug, and so I'm worried about that, too. Please help me with this. Thank you so much.
Brief Answer:
Less likely that your anxiety is due to valium.
Detailed Answer:
Hi XXXXXXX
I read your query in detail and can understand your concern regarding withdrawal effects of valium. Valium is Diazepam which is a benzodiazepine. Long term intake can lead to dependence on it which leads to withdrawal symptoms.
First of all, I would like to say that you have done wonderfully well in being able to taper the drug and stop it. Regarding your anxiety last night, it is highly unlikely that it is due to withdrawal effect of valium. Generally, withdrawal effect of valium occurs in the initial few days and most of the time is a continuous phenomenon. I would agree with your doctor that your anxiety symptoms are more likely due to anxiety per say rather than withdrawal.
I think you are preoccupied with thoughts regarding its withdrawal. Excessive worries in itself is leading to anxiety. At present, I would suggest that you stop valium altogether and don't take another dose. You will have to stop worrying about developing withdrawal. In case your symptoms of anxiety recur, I would advise you to start some other medication like a selective serotonin reuptake inhibitor (escitalopram or sertraline), which will help control your anxiety. You can discuss regarding this with your physician or seek a psychiatric consultation.
I do hope that I was able to answer your query. In case yo have any follow up query, please feel free to ask. I will be glad to help.
Best wishes,
Dr. Sunil Gupta
Less likely that your anxiety is due to valium.
Detailed Answer:
Hi XXXXXXX
I read your query in detail and can understand your concern regarding withdrawal effects of valium. Valium is Diazepam which is a benzodiazepine. Long term intake can lead to dependence on it which leads to withdrawal symptoms.
First of all, I would like to say that you have done wonderfully well in being able to taper the drug and stop it. Regarding your anxiety last night, it is highly unlikely that it is due to withdrawal effect of valium. Generally, withdrawal effect of valium occurs in the initial few days and most of the time is a continuous phenomenon. I would agree with your doctor that your anxiety symptoms are more likely due to anxiety per say rather than withdrawal.
I think you are preoccupied with thoughts regarding its withdrawal. Excessive worries in itself is leading to anxiety. At present, I would suggest that you stop valium altogether and don't take another dose. You will have to stop worrying about developing withdrawal. In case your symptoms of anxiety recur, I would advise you to start some other medication like a selective serotonin reuptake inhibitor (escitalopram or sertraline), which will help control your anxiety. You can discuss regarding this with your physician or seek a psychiatric consultation.
I do hope that I was able to answer your query. In case yo have any follow up query, please feel free to ask. I will be glad to help.
Best wishes,
Dr. Sunil Gupta
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much for your response. It certainly puts my mind at ease. If I'm feeling "normal anxiety" for me, I can accept that. If it's valium withdrawal, then that scares me. I think you are right in that I'm preoccupied with withdrawal symptoms. I've read so much about them on the Internet, and it has scared me a lot --- increasing my anxiety, of course. I've been seeing a psychologist, who is very helpful. She has me working on controlling my anxieties without medication. And it was with her help that I was able to taper my valium as well as I did. I've been doing breathing exercises and trying to practice mindfulness. I've been anxious since a child, and then had a not-so-pleasant marriage, but never learned to control my anxieties. My psychologist has been helpful with this. My concern now has been having withdrawal symptoms from valium, because I was on it for so many years. I keep thinking that my body is so used to it that it won't be able to be without it. And that scares me more than anything right now. I read that symptoms may not start until up to 3 weeks after completely stopping it, because it remains in your system for that long. Is it possible that the worse symptoms are still to come? I've had relatively few ---- if any --- up to this point -- other than my own preoccupation with it all. I would appreciate anything more that you might be able to tell me. As of now, I'm going to follow your suggestion and not take any more of it. Thank you so much for your assistance with this.
Brief Answer:
Please see details below
Detailed Answer:
Dear XXXXXXX
Thanks for following up. It was nice to know that I was able to help you relax and am glad that you have decided to follow my advice regarding not taking valium.
I understand that you have been through a lot of trouble in your life and your anxiety in such circumstances is understandable. I was happy to read that you have been seeing a psychologist for your anxiety symptoms and practicing deep breathing and mindfulness. These are very effective relaxation techniques.
Your being anxious throughout seems to be the reason that you are highly preoccupied about the withdrawal symptoms of valium. I am not sure what kind of source you are following for the information regarding it. What I can say is that internet is full of information which is wrong or half-baked knowledge. So, I would really ask you to be careful about the source that you select. The withdrawal symptoms of valium are most severe in the initial days (generally upto one week) and if you are able to get other this period, I don’t think there is much to worry about.
You have been doing fine without valium. In case you are having any more anxiety symptoms, rest assured that it is not due to withdrawal symptoms. Just try the relaxation techniques that you have learnt. In addition, try to defocus yourself from thinking about valium. You can distract yourself by engaging in some other activities depending on your daily schedule. Try doing the deep breathing frequently. You can also discuss with your psychologist regarding learning progressive muscular relaxation which is another effective way to control anxiety.
Hope I was able to answer your query. In case of any more follow up query, please feel free to ask. If not, you can close the discussion and rate the answer.
Regards,
Dr. Sunil Gupta
Please see details below
Detailed Answer:
Dear XXXXXXX
Thanks for following up. It was nice to know that I was able to help you relax and am glad that you have decided to follow my advice regarding not taking valium.
I understand that you have been through a lot of trouble in your life and your anxiety in such circumstances is understandable. I was happy to read that you have been seeing a psychologist for your anxiety symptoms and practicing deep breathing and mindfulness. These are very effective relaxation techniques.
Your being anxious throughout seems to be the reason that you are highly preoccupied about the withdrawal symptoms of valium. I am not sure what kind of source you are following for the information regarding it. What I can say is that internet is full of information which is wrong or half-baked knowledge. So, I would really ask you to be careful about the source that you select. The withdrawal symptoms of valium are most severe in the initial days (generally upto one week) and if you are able to get other this period, I don’t think there is much to worry about.
You have been doing fine without valium. In case you are having any more anxiety symptoms, rest assured that it is not due to withdrawal symptoms. Just try the relaxation techniques that you have learnt. In addition, try to defocus yourself from thinking about valium. You can distract yourself by engaging in some other activities depending on your daily schedule. Try doing the deep breathing frequently. You can also discuss with your psychologist regarding learning progressive muscular relaxation which is another effective way to control anxiety.
Hope I was able to answer your query. In case of any more follow up query, please feel free to ask. If not, you can close the discussion and rate the answer.
Regards,
Dr. Sunil Gupta
Above answer was peer-reviewed by :
Dr. Prasad
You have been so very helpful. I've always been focused a lot on my feelings. My parents contributed to my anxieties. They had them, too and convinced me that everyone has them. Then I married a person who was controlling, and he took advantage of that. In addition, he was a type 1 diabetic just 3 months after our marriage, and I had that to deal with on a daily basis for 42 years. Now that it's all over, I can't seem to rid myself of all of that stuff. I certainly want to enjoy my life more than I have been and I'm determined to get to that point.
I do have a muscular relaxation tape here that I occasionally use.
Can you tell me this? Was the 1/2 mg of valium that I was taking every 3rd day really doing anything for me anymore? I took it that way for about a month with one time that I took 2 mg. Then I stopped it for 8 days and ended up taking 2 mg again. I know it builds up in your body, so I wonder about the 1/2 mg every 3rd day --- and what effect that was having.
I think after this answer, I'll have asked everything that I need to. I just find myself living in fear of living alone. I have never lived alone in my life, and have always been very dependent on someone else. I find this whole experience terrifying at times --- and sometimes liberating!!!
Yes, my preoccupation with valium comes from a lifetime of anxiety ---- always worrying about something. And a lot of it comes from dealing with my husband's illness for so long. It seemed like I always had to anticipate the "next diagnosis."
Thank you for your kindness.
I do have a muscular relaxation tape here that I occasionally use.
Can you tell me this? Was the 1/2 mg of valium that I was taking every 3rd day really doing anything for me anymore? I took it that way for about a month with one time that I took 2 mg. Then I stopped it for 8 days and ended up taking 2 mg again. I know it builds up in your body, so I wonder about the 1/2 mg every 3rd day --- and what effect that was having.
I think after this answer, I'll have asked everything that I need to. I just find myself living in fear of living alone. I have never lived alone in my life, and have always been very dependent on someone else. I find this whole experience terrifying at times --- and sometimes liberating!!!
Yes, my preoccupation with valium comes from a lifetime of anxiety ---- always worrying about something. And a lot of it comes from dealing with my husband's illness for so long. It seemed like I always had to anticipate the "next diagnosis."
Thank you for your kindness.
Brief Answer:
Please see details below.
Detailed Answer:
Dear XXXXXXX
Thanks for following up and many more thanks for the kind words that you used for me. It is feedback from people like you which motivates me further all the time.
I do empathize with the kind of circumstances that you have faced through out your life. And it is really heartening to read that you really want to get over all that and are actually determined to be able to enjoy your life. I am sure that with proper effort, you will be able to do that.
Coming to your question regarding valium, taking 1/2 mg of valium every third day really has only a psychological effect on a person. The person feels comfortable that he or she has had something for anxiety and that automatically induces relaxation. We call it placebo effect. Trust me when I say this, you really don't need valium any more. You can manage very well without valium. Just try to focus on things that you might enjoy.
I understand being alone can be scary sometimes but as you mentioned it can be liberating. Just do things that you have always wanted to do but couldn't. Give yourself the time you have always deserved but were not able to give.
I really do hope that you will be able to liberate yourself form the worries and anxiety and able to remain calm and relaxed. I will be glad if my answer was able to help you in that in any way. In case of any follow up query, please don't hesitate. I will try my best to quell any doubts that you might have.
Wishing you a calm and serene future ahead.
Best wishes,
Dr. Sunil Gupta
Please see details below.
Detailed Answer:
Dear XXXXXXX
Thanks for following up and many more thanks for the kind words that you used for me. It is feedback from people like you which motivates me further all the time.
I do empathize with the kind of circumstances that you have faced through out your life. And it is really heartening to read that you really want to get over all that and are actually determined to be able to enjoy your life. I am sure that with proper effort, you will be able to do that.
Coming to your question regarding valium, taking 1/2 mg of valium every third day really has only a psychological effect on a person. The person feels comfortable that he or she has had something for anxiety and that automatically induces relaxation. We call it placebo effect. Trust me when I say this, you really don't need valium any more. You can manage very well without valium. Just try to focus on things that you might enjoy.
I understand being alone can be scary sometimes but as you mentioned it can be liberating. Just do things that you have always wanted to do but couldn't. Give yourself the time you have always deserved but were not able to give.
I really do hope that you will be able to liberate yourself form the worries and anxiety and able to remain calm and relaxed. I will be glad if my answer was able to help you in that in any way. In case of any follow up query, please don't hesitate. I will try my best to quell any doubts that you might have.
Wishing you a calm and serene future ahead.
Best wishes,
Dr. Sunil Gupta
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I "recharged" my account with you so I can ask a couple more questions. It's worth it to me, because you are so helpful.
I understand placebo effect. I've read about it. But one time a doctor (GP) told me that because I'm such a small person that the valium probably has more effect than on a larger person. Is that true? I'm 5 foot 6 and weight 120 pounds --- give or take a couple of pounds on any given day. I wish I could add about 10 pounds to that, but living alone makes it hard to eat --- but I'm really trying with that as well. But I wonder if a small amount of valium has a big effect on a small person like me.
I do trust you --- and I feel that I don't need valium either. I just don't want to go through any nasty withdrawal symptoms. Something inside of me keeps saying that I can manage my anxiety in the ways my psychologist is suggesting. I just didn't know about all of these natural methods before.
I keep wishing my husband was here --- he was company in the house. But, on the other hand, all of his medical issues were draining for me. I also worked from my home office. So I watched over him and also worked at home ---- therefore, I didn't get out a lot or develop much of a social circle. Now I've been pushing myself out more and have developed some friendships, and have lunch with ladies about once a week. It's the time at home where I'm finding time hard to fill. My husband is gone, and I'm not working anymore either. Those 2 things were my entire life, and I feel so lost. I have 2 wonderful children, their spouses, and 4 sweet granddaughters. They live about an hour and a half away from me, and I see them more during these summer months now and I enjoy that.
Please answer regarding the effect of valium on my small body frame. Other than anxieties, my doctor tells me I'm healthy. I've had blood tests for blood count, stress test, renal panels, even a CT scan of my brain for headache. All things come back normal. I'm thankful for that. Now to manage anxiety.
I understand placebo effect. I've read about it. But one time a doctor (GP) told me that because I'm such a small person that the valium probably has more effect than on a larger person. Is that true? I'm 5 foot 6 and weight 120 pounds --- give or take a couple of pounds on any given day. I wish I could add about 10 pounds to that, but living alone makes it hard to eat --- but I'm really trying with that as well. But I wonder if a small amount of valium has a big effect on a small person like me.
I do trust you --- and I feel that I don't need valium either. I just don't want to go through any nasty withdrawal symptoms. Something inside of me keeps saying that I can manage my anxiety in the ways my psychologist is suggesting. I just didn't know about all of these natural methods before.
I keep wishing my husband was here --- he was company in the house. But, on the other hand, all of his medical issues were draining for me. I also worked from my home office. So I watched over him and also worked at home ---- therefore, I didn't get out a lot or develop much of a social circle. Now I've been pushing myself out more and have developed some friendships, and have lunch with ladies about once a week. It's the time at home where I'm finding time hard to fill. My husband is gone, and I'm not working anymore either. Those 2 things were my entire life, and I feel so lost. I have 2 wonderful children, their spouses, and 4 sweet granddaughters. They live about an hour and a half away from me, and I see them more during these summer months now and I enjoy that.
Please answer regarding the effect of valium on my small body frame. Other than anxieties, my doctor tells me I'm healthy. I've had blood tests for blood count, stress test, renal panels, even a CT scan of my brain for headache. All things come back normal. I'm thankful for that. Now to manage anxiety.
Brief Answer:
The dose of valium would still be too low.
Detailed Answer:
Dear XXXXXXX
THANK YOU. It really makes me so glad that I am able to help you.
First of all, regarding valium. Its true that a person of less body mass would need a smaller dose. However, even then, a dose of 0.5 mg every 3rd day would still be considered an insignificant dose. I took the XXXXXXX of calculating your body mass index. It is around 19.5 which definitely falls in the average range. So, I don't think that you need to worry much regarding your weight too.
I was happy to note that you are physically healthy. I do hope that you have included some amount of exercise (preferably brisk walking) in your daily schedule. Daily morning walk is an effective way to keep yourself fresh and relaxed.
I was nice to read about your children and grandchildren. I strongly believe that grandchildren help there grandparents a lot in keeping themselves happy. In addition, your efforts to enlarge your social circle is deeply appreciated. I do hope you continue doing that. Try thinking of some interests that you might have which you can follow even when you are alone at home. I would suggest reading books, gardening, etc., for the same, if feasible. I know you would come up with something exciting.
Please do feel free to continue with your queries. I will try to respond in the best possible way.
Best wishes,
Dr. Sunil Gupta
The dose of valium would still be too low.
Detailed Answer:
Dear XXXXXXX
THANK YOU. It really makes me so glad that I am able to help you.
First of all, regarding valium. Its true that a person of less body mass would need a smaller dose. However, even then, a dose of 0.5 mg every 3rd day would still be considered an insignificant dose. I took the XXXXXXX of calculating your body mass index. It is around 19.5 which definitely falls in the average range. So, I don't think that you need to worry much regarding your weight too.
I was happy to note that you are physically healthy. I do hope that you have included some amount of exercise (preferably brisk walking) in your daily schedule. Daily morning walk is an effective way to keep yourself fresh and relaxed.
I was nice to read about your children and grandchildren. I strongly believe that grandchildren help there grandparents a lot in keeping themselves happy. In addition, your efforts to enlarge your social circle is deeply appreciated. I do hope you continue doing that. Try thinking of some interests that you might have which you can follow even when you are alone at home. I would suggest reading books, gardening, etc., for the same, if feasible. I know you would come up with something exciting.
Please do feel free to continue with your queries. I will try to respond in the best possible way.
Best wishes,
Dr. Sunil Gupta
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I so much appreciate your insights. I take walks, but not daily. I need to do that. And I always took a morning walk when I walked. But then I developed skipped heart beats that were debilitating and I stopped going. That's when the echo/stress was done and came back normal. So the skipped beats were related to anxiety. They have subsided again over the past few months. I also bought a new bicycle this spring, and I enjoy riding that, but I don't go as often as I should. I have a mindset that these things aren't productive and worthwhile ---- carry over from my past and my husband's thoughts. If I'm not "producing" a visible effect or earning money for my time, then it's wasted time. I love to read, and have a hard time sitting down and doing it without feeling guilty. I could pick up a book and read for hours ----- but then I feel like I've wasted my time.
I have a garden, and I enjoy working in that. I seem to have plenty of activities, but my motivation just isn't there since my husband died. He was the one, regardless of the difficult marriage, who praised what I did and made me feel worthwhile. Without that approval from him, I find that the things I do feel empty. I SO much want to find peace within myself.
So just to reiterate ---- even though I'm small framed, I can still stop the valium and not worry about it anymore. Is that correct?
I believe this will be pretty much my last note to you. I'm not going to "recharge" my account again! :-)
You are certainly a wonderful, caring doctor.
I have a garden, and I enjoy working in that. I seem to have plenty of activities, but my motivation just isn't there since my husband died. He was the one, regardless of the difficult marriage, who praised what I did and made me feel worthwhile. Without that approval from him, I find that the things I do feel empty. I SO much want to find peace within myself.
So just to reiterate ---- even though I'm small framed, I can still stop the valium and not worry about it anymore. Is that correct?
I believe this will be pretty much my last note to you. I'm not going to "recharge" my account again! :-)
You are certainly a wonderful, caring doctor.
Brief Answer:
No need to worry about valium anymore.
Detailed Answer:
Dear XXXXXXX
Thanks again. Let me come directly to your question. Your small frame doesn't matter. You can stop valium and completely stop worrying about it. I am confident that you can manage your anxiety without the help of valium.
I am glad you are trying to make things right. I loved the concept of bicycle and I would want you to be regular about it. Regarding reading and gardening, you have to stop wishing for immediate effects and feeling that you are wasting time. These things will do a lot good in long term and you will really feel great once you start doing these regularly. You have to keep yourself healthy and that should be your motivation. Think of your granddaughters and the fact that your being healthy will help you spend more quality time with them.
I thank you again for your kind appreciation. In case you feel you need me anytime in future, feel free to ask me at:
http://doctor.healthcaremagic.com/doctors/dr-sunil-gupta/67657
You can close the discussion and rate the answer now.
All the best,
Dr. Sunil Gupta
No need to worry about valium anymore.
Detailed Answer:
Dear XXXXXXX
Thanks again. Let me come directly to your question. Your small frame doesn't matter. You can stop valium and completely stop worrying about it. I am confident that you can manage your anxiety without the help of valium.
I am glad you are trying to make things right. I loved the concept of bicycle and I would want you to be regular about it. Regarding reading and gardening, you have to stop wishing for immediate effects and feeling that you are wasting time. These things will do a lot good in long term and you will really feel great once you start doing these regularly. You have to keep yourself healthy and that should be your motivation. Think of your granddaughters and the fact that your being healthy will help you spend more quality time with them.
I thank you again for your kind appreciation. In case you feel you need me anytime in future, feel free to ask me at:
http://doctor.healthcaremagic.com/doctors/dr-sunil-gupta/67657
You can close the discussion and rate the answer now.
All the best,
Dr. Sunil Gupta
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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