Anxiety Depression

Anxiety and Depression go hand in hand, but the relationship between them though can be hard to understand. For some people, anxiety is the main problem and they become “depressed” as a result of the effect anxiety has on their life. Although unpleasant, this may be real clinical depression or a case of low mood, after all, if anxiety is messing up your life then it is appropriate and understandable to become upset about it.

Some people have clinical depression, which we can describe as having a persistent low mood with no identifiable reason (sometimes called melancholic depression), and others have atypical depression where mood can be effected by events and circumstances. Often, people with these kinds of major depression also feel anxiety.

It is not surprising that there is a link, after all the chemical causes of both anxiety and depression are somewhat similar. Both anxious and depressed peoples tend to have low levels of various neurotransmitters in the brain. They key neurotransmitter effecting both anxiety and depression is serotonin and many medications and supplements that are suitable for depression also effect anxiety and vice versa.

For instance, 5-HTP is a popular anti-depressant supplement but is also touted as a possible anxiety solution (and also an aid to insomnia and various other mood disorders).

The drug Xanax (alprazolam) is an anxiolytic (anti-anxiety drug) but its users that are also depressed often report a brief alleviation of depression symptoms. Interesting as Xanax works on GABA receptors which are not known as being directly related to depression. (I mentioned this here just out of interest, Xanax is not a suitable anti-depressant in most cases as it is highly habit-forming when taken over a long period of time.)

Mindfulness Meditation is one of the best solutions for anxiety and depression. The technique, which requires persistence, is easy to learn. I great start is the book The Mindful Way through  Depression: Freeing Yourself from Chronic Unhappiness (USA), available also in the UK and Europe here. It comes with a CD with some mindfulness meditations on it and is written by Jon Kabat-Zinn, respected expert on using meditation to recover from anxiety, depression and stress related disorders.

Of course the classic anti-depressants, the SSRI’s like Prozac and Celexa, are often prescribed to people with anxiety and panic disorder, and with reasonably good results.

So the good news is that if you are suffering from both anxiety and depression the likely have the same cause and therefore the same solution.

Drugs for fear of flying

There is nothing wrong with taking prescription drugs for fear of flying. Many people find these drugs safe and effective, and a life-saver! Assuming you don’t fly three times a week, then the drugs of choice for you will probably be a benzodiazepine. The common prescriptions are Valium, Lorazepam and Xanax.

These drugs are addictive but that is a problem for regular users, not occasional users. If you fly once a month and take one or even a couple of tablets you are unlikely to suffer any withdrawals (but be careful-even using them regularly for just a few weeks can cause a lot of problems).

How effective they are depends on how much you take and how your body handles them. Many people find that they make flying easy, and in some cases have even cured the fear of flying by leading the brain to make a positive association with flying rather than a negative one! There is a personal experience of Valium here.

For others, the drugs just take the edge of the fear and allow them to keep in control. You will have to experiment.

Don’t be tempted by online pharmacies: their over-priced products may not be subject to rigorous safety testing and you can’t trust them with your credit cards. A sympathetic doctor will normally be happy to prescribe for occasional uses such as flying.

Tryptophan Anxiety Dose

The debate rages on about the usefulness of Tryptophan in the fight against anxiety. Fact: your body needs Tryptophan to make serotonin. If you follow a diet very low on tryptophan, such as a strict vegan diet with too little protein in the form of nuts and soya etc, you quickly become fatigued and miserable, with aching joints. You can also get worse anxiety.

Getting more Tryptophan into your body through diet is rather hard due to the complex way that Tryptophan and other amino acids vie for a way through the blood-brain barrier. Ultimately that means that you might need to consider supplementing if you are trying raise serotonin naturally.

But how much should you take? Especially considering the health scares and scandals that have surrounded Tryptophan for several decades.

Calculating the best dose of Tryptophan can be tricky. Like most supplements research is lacking and too much of the data is qualitative.

The most commonly suggested dose is 500-1000mg, but I would like to add a few caveats to that. Firstly, more is not better! Some studies have shown that higher doses of Tryptophan do not yield better results. That is because of the way Tryptophan is metabolized and some of the (unpleasant) enzymes produced. So don’t aim to take masses!

Secondly, Tryptophan can have some side-effects. Some people have reported nausea, dizziness and dry-mouth. Obviously taking in lots more Tryptophan than usual can be a shock to the system, therefore starting on a small dose and gradually increasing might be wise. I recommend starting as low as 50mg and increasing in increments of 50mg or even less every few days. Stop increasing if you get any side-effects and let your body get used to what it is getting before moving on.

Depleted levels of seotonin take time to recover, so don’t expect results for a few weeks anyway.

There is more on beating anxiety through nutrition and dealing with other physical symptoms in Killing Anxiety From The Roots.

Xanax Rebound Anxiety

Xanax (alprazolam), like other benzodiazepines, is famous for its rebound anxiety – the anxiety that you can get after you stop taking a drug or as the effects of the drug wear off.

With Xanax you can get a rebound effect just from taking the drug once. It is in essence a bit like a hangover. People have reported different symptoms and plenty of people don’t get any rebound anxiety from just taking xanax once or only occasionally. Some of the symptoms people have reported from Xanax come-down are:

  • Feeling Groggy/Spacey
  • Lacking Motivation
  • Feeling Lazy
  • Feeling Anxious
  • Having a Headache

This straight-forward Xanax hangover tends to be mild and pass over the course of the day.

Much more unpleasant and persistent is the rebound anxiety that you can get after you have been taking Xanax for some time (normally at least 2 weeks but less for some people). For an explanation of why rebound anxiety happens please click here.

Some common symptoms of rebound anxiety from Xanax:

  • Anxiety
  • Palpitations (racing heart)
  • Panic Attacks
  • Intense feeling of fear
  • Tight chest and difficulty breathing
  • Upset stomach
  • Aching Muscles

Rebound anxiety is often described as much much worse than the anxiety that lead the patient to take Xanax in the first place. It can be very serious and that is why you should never stop Xanax abruptly and always follow the doctor’s advice!

If you are suffering from rebound anxiety then speak to a doctor and talk about tapering your dose. Else you can be in for a miserable few weeks or months, as rebound anxiety can really go on (length of rebound anxiety seems to depend on amount of time you were taking Xanax, size of dose and personal differences).

Remember, drugs are not the answer to anxiety. If you are interested in permanent solutions to anxiety I recommend reading Killing Anxiety From The Roots, which is all about the underlying physical causes of anxiety.

You might also consider reading our Panic Away Review.

Does Xanax Work for Anxiety?

Xanax (generic name alprazolam) definitely does work. Most people find, that with the right dose, they can effectively control anxiety to the point where it doesn’t bother them. In that respect Xanax is the most effective medication for anxiety and panic attacks that you will ever take.

Let’s all take Xanax

No, accept for a very specific group of circumstances taking alprazolam is probably not a very good idea. In order to understand why we need to look at how Xanax works.

It all comes down to the chemical GABA. If we have lots of GABA we feel calm, if we are depleted of it we can feel anxious. By raising the amount of GABA in our brains we can promote calmness.

Xanax and other benzodiazepines work by blocking the uptake of GABA. This does not raise the level of GABA but makes the GABA you have go further; your brain thinks you have more GABA than you really do.

This is a problem. Your brain becomes confused by all this new GABA and decides that it is over-producing the chemical. It then produces less which means that as the Xanax wears off you are left feeling anxious. This is called rebound anxiety.

If you take Xanax for a short period of time then you might well not get any rebound anxiety as your brain has not figured that it is over-producing GABA. The danger comes when you take Xanax for a longer period of time, even a couple of weeks are enough.

After that, while you might not feel that you are addicted (you won’t necessarily crave Xanax) your body will miss the GABA and you will feel awful. In some cases suddenly stopping taking Xanax can be extremely dangerous, causing seizures. For many people the outcome is acute anxiety. Many people describe rebound anxiety as the worst they have ever felt, much worse than the anxiety that got them taking the medication.

If you are sensible at this point you go for a slow withdrawal from the drug. If you go cold turkey the rebound anxiety can last for months (although does pass over time). I have known rebound anxiety to last for more than five months from two months of using Xanax. So be warned.

When is it a good idea to use Xanax?

When you don’t need it for very long! If you are scared of flying and go on planes three times a year then Xanax is probably not going to cause you many problems (bar the potential side-effects). But as soon as you start taking it more regularly you should be wary, and look for alternatives.

Rebound Anxiety

Rebound Anxiety is anxiety that is caused by stopping taking some form of medication. It is most common to get rebound anxiety from tranquilisers such as benzodiazepines (see Does Xanax Work for Anxiety) and also anti-depressant SSRI’s such as Prozac and Celexa.

Rebound anxiety is thought to be caused by the fact that many drugs (including benzodiazepines and SSRI’s) achieve their goal by fooling the brain into believing that levels of certain brain chemicals are higher than they really are. The brain then cuts down on its own production of said chemicals leaving you deficient unless you keep taking the drugs.

The answer is to not get hooked in the first place. But failing that, it is best to withdraw slowly, to taper off from the drugs. This will allow your body to compensate by making more and more of its own chemicals.

That is why medication alone is never the answer to anxiety and panic attacks, only a symptomatic cure and one with major downsides.

How Physical is Anxiety

I recently read about a woman who had a mental disorder and was trying to come to terms with the possibility she had been abused as a child. As I read I became angry at the arrogance of psychology. The idea that everything we feel has a psychological basis is accepted not because it’s true, but because it has been repeated until everyone was brainwashed.

While psychological theories are cute and seem to make sense, they are very hard to prove. That doesn’t mean they are wrong and have no use whatsoever, but it does mean they should be considered alongside other ideas and theories.

It is strange that, for example, when a woman is pregnant or menstruating we are perfectly happy to accept that those physical and hormonal changes are having an emotional effect. But the idea of a physical issue having emotional symptoms is not one which is universally accepted, and psychologists are the keenest deniers of all! Psychologists don’t like to talk about the effect for example a vitamin deficiency can have on our emotions, or how an otherwise unrelated long term health concern can cause panic attacks or depression.

We need to free ourselves from psychology and look at the whole picture. That is all I am saying.


If you are interested in underlying physical causes of anxiety then Killing Anxiety From The Roots will interest you.