The most prominent feature of withdrawal is anxiety. In its acute form it is after all one of the reasons why a benzodiazepine is prescribed in the first place. Anxiety produces the most profound results. People report apparently quite unreasonable fears. They are afraid to go shopping, entertain a friend, or even just leave the house. Their lives become very limited. Fear becomes all pervading.


Fear of People and Events.  These fears are very real to the sufferer and must be taken seriously. If someone is frightened to leave the house, it is because they see the house as safe and the outdoors as a threat.  All sorts of normal events become threats, for example:

  • an unexpected visit from a friend
  • a sudden change of shopping trip
  • just going into a shop
  • almost any form of surprise however well meant
  • a misinterpreted facial expression.

Fear of the Present. Accompanying fears of others is fear of oneself.  People suffer from feelings of hopelessness, and their moods are flat. The fear of impending doom is much more intense than any normal equivalent, and although often overwhelming, it cannot readily be associated with any specific worry or trigger. Moods also swing from optimism to pessimism very quickly in the manner of a bipolar disorder.

Fear of the Future. Sufferers have serious doubts about the future, so they say:

  • I’ll never get better
  • no-one else is suffering as much as me
  • it’s getting worse
  • will it really happen
  • what happens if the rest of my life is like this?
  • I’m going to die

    The intensity and pain of withdrawal means that sufferers are certain to be somewhat pessimistic about the outcome, so the carer needs to be reassuring. But how? Withdrawal is unpredictable so a good day may be followed by a bad day, a better day or a similar one, in any combination. There is very little in the way of a reliable pattern. What is worse it is nigh on impossible to put an end date to withdrawal, so the inevitable “but how long is it going to take?” is pretty well unanswerable.

What the Carer Can Do

    The carer then has a number of options, which are covered in more detail in the sections which follow, such as:

  • talk through the problem
  • distract the sufferer from the problem
  • use other people’s positive experiences and successes
  • remind the sufferer that the problem is the direct result of withdrawal
  • call on outside support
  • encourage exercise
  •  help the sufferer to do things

    My wife had poor short-term memory and so tended to forget the cause of her distress. I used to question the thought itself, reminding my wife by getting her to repeat the simple mantra “it’s not me, it’s the illness”.  Sufferers are very wrapped up in themselves and the actual cause of the withdrawal gets lost in their minds. Reminding them that it is, or was, the drug which is at fault helps to alleviate any feelings of guilt they may have. These doubts are just thoughts and need to be put into a proper perspective.

    At this point the carer’s support will be at its most stretched, and constant reassurance most needed. Sometimes persuading sufferers that the mood problems they face are also faced by many other people and they will eventually disappear will help, but many sufferers will find it difficult to believe when they are distressed, and so all that the carer can do is hold on and wait until things improve. Moreover sufferers seem to feel guilty as if the illness were their fault. At the risk of seeming trivial I use some simple mantras such as:

  • “it’s one day nearer the end”
  • “you will recover – it’s the natural outcome of the illness”
  • “it’s not your fault – it’s the illness”

    These and smiling seem to help.