Anxiety and Chiropractic

Does Chiropractic work for Anxiety? Lots of Chiropractors have a list of conditions on their websites that they claim to heal and often anxiety, stress and depression are on the list. Does it work? The simple answer is it depends what is causing your anxiety.

If you believe that your mind and body are one, then this will make some sense to you. If you believe that anxiety is psychological and has no connection with the physical body then this won’t be of interest.

Chiropractors work primarily with the back, the spine and the neck. The nervous system has its superhighway, the spinal cord, running down the spine and any interruption in its flow could have an effect on mood. The link between anxiety and posture has often been made.

Let’s go back to common symptoms of anxiety: Feeling out of it, or strange, light-headed, slightly dizzy, difficulty swallowing, tight chest and breathing. Could some or even all of these be down to a misaligned spine butting pressure on the nerves and blood vessels in your neck and back? Yes, potentially they could. In which case, a Chiropractor might well be able to help you with anxiety.

If your anxiety is accompanied by, or exacerbated by, tension headaches that effect the back of your neck or reach over your crown onto your face then there may well be a link between you anxiety and spinal cord or skeletal structure, in which case in would well be worth speaking to a Chiropractor.

An interesting point: a lot of anxiety medication, such as Xanax and other benzodiazepines work also to relax muscles. Some people claim that part of their ant-anxiety effect is caused by the fact that they lessen pressure on the spinal cord and allow everything to work more easily.

There are no guarantees that a Chiropractor can have an effect on anxiety but it might well be worth a try.

Drugs For Panic Attacks

There are now a whole range of drugs for panic attacks on the market. For all of these drugs you will need a doctor’s prescription; none of them are available over the counter. All of these drugs have pros and cons, and some have serious side-effects.


The most effective Panic Attack Drug I have ever come across is Xanax (generic name: alprazolam). It works super-fast (in as little as twenty minutes if it is taken sub-lingually, or under the tongue). It is a benzodiazepine class drug, but unlike the others I have tried it doesn’t make you feel spacey, drunk, “out of it” or lethargic and sleepy. On Xanax I feel fairly normal, although I did once fall asleep on a large dose.

Xanax does have its drawbacks though. If you take it when you are having the occasional panic attack then that will probably be fine. But if you are a regular sufferer then Xanax might not be wise. While it’s side-effect profile is good, any prolonged use (more than a week or two of even small doses such as 0.5mg a day) can become habit forming. Being hooked on Xanax is not fun. It can lead to severe rebound anxiety and a host of other problems. Xanax carries a greater risk of rebound anxiety than other tranquillisers and benzodiazepines because it has a short half-life. The other drugs with their longer half-life are in a way “self tapering”.

Other Benzodiazepines

Clonazepam, Diazepam (Valium), Lorazepam (Ativan) all have significantly longer half-lives than Xanax and therefore are less habit-forming (but that does not mean that they are totally safe – addiction is still common!)

Side-effects include drowsiness and amnesia. Some people get paradoxical effects, in other words the opposite reaction to what they expected. In the case of someone taking these drugs for panic attacks that would be heightened excitement and possible anxiey and panic attacks! Therefore it is useful to start at a low dose and see how the drugs work for you. Some people don’t like using benzodiazepines because they feel out of control because they are so used to feeling anxious and panicky.

There are newer tranquillisers known as Nonbenzodiazepines, but their side-effect profile is no better and at the moment they are used chiefly for insomnia, not for panic attacks.

All in all, it’s important to remember that drugs don’t provide an overall solution to panic attacks but are fine for occasional use.

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.

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.

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.

Medication for Anxiety

There is lots of medication for anxiety available on the market. Almost all of it is only available on prescription from a doctor.

Normally, Patients presenting with anxiety are offered Selective Serotonin Re-uptake Inhibitors (SSRI for short). This family of medication is considered suitable if the anxiety disorder is ongoing, as SSRI’s are not suitable for short term use. They tend to take at least four weeks to start working (although some people claim to feel better in as little as two days) and aren’t thought to be fully effective until they have been taken for 6 weeks to two months. The common SSRI’s are:

Other drugs which might also be prescribed and are similar to SSRI’s are SNRI’s or Serotonin-norepinephrine Reuptake Inhibitors. The most commonly prescribed SNRI is Venlafaxine (Effexor). SNRI’s are newer than SSRI’s and tend to be slightly better tolerated with fewer side effects. They were designed to treat depression but are also a medication for anxiety. Likewise they are prescribed for long term use, normally six months or more and sometimes years.

Also read this post on Anxiety Medication Over The Counter.

If a medication for anxiety which is short term is needed then there are various other options. In times of extreme grief or pain, or when panic attacks are severe, a short acting anxiolytic might be used. The normal choice would be one of the Benzodiazepine family:

  • Xanax, alprazolam:
  • Lexotan, bromazepam:
  • Librium, chlordiazepoxide:
  • Klonopin, clonazepam:
  • Tranxene, clorazepate:
  • Valium, diazepam:
  • Rohypnol, flunitrazepam:
  • ProSom, estazolam:
  • Dalmane, flurazepam:
  • Paxipam, halazepam:
  • Dormonoct, loprazolam:
  • Ativan, lorazepam:
  • Versed (Hypnovel, Dormicum), midazolam:
  • Mogadon, nitrazepam:
  • Serax, oxazepam:
  • Doral, quazepam:
  • Restoril, temazepam:
  • Halcion, triazolam:

Benzodiazepines are good because they work quickly (less than an hour even) and are very good at what they do – stopping anxiety and panic. In a way they are the ultimate medication for anxiety. The problem is that if they are taken for too long they become less effective and can become addictive. Constant use for more then three weeks is rarely advised. For a personal experience of Valium click here.

Another drug that is not a Benzodiazepine is Buspirone, which is said to be as good as a Benzodiazipine for reducing anxiety but non-addictive and non-sedating. It has a better side-effect profile but can not be taken on an as needed basis. It has to be taken daily and takes two or three weeks to take effect. As it is non-addictive it is much better suited to long-term use Benzodiazepines.

Treatment for Panic Attacks

Treatment for Panic Attacks in mainstream medicine revolves around two things: medication and CBT (Cognitive Behavior Therapy).

Medication tends to fall into two categories: SSRI’s and Benzodiazepines.

The SSRI’s, like prozac, celexa, zoloft etc have pros and cons. They are clinically proven to be effective (although all data from big pharma companies has been called in question at sometime or other). Unfortunately they do have side-effects of which weight gain, nausea (normally temporarily) and sexual dysfunction/loss of libido  (normally temporary) are the most severe and commonly reported. SSRI’s normally take 4-6 weeks to start working and may need to be tapered off slowly at the end of treatment.

Benzodiazepines, like Xanax alprazolam and valium also have pros and cons. They are fast working, normally taking considerably less than an hour to kick in, and are extremely effective. On the downside they can be highly addictive and therefore are not best suited to long term use (although they are prescribed long term sometimes). They also can effect concentration and alertness so hinder the consumer’s ability to drive for example.

On the CBT front, over ten or twelve sessions a trained therapist will help you see panic attacks for what they are (harmless natural responses which appear nasty), will show you how to rationalize out the faulty and extreme negative thinking which causes panic attacks, and show you some physical techniques to calm your breathing and relax your mind and body.

Some people argue that CBT doesn’t really get to the heart of the problem, that you need some kind of psychotherapy to do that. Others argue psychotherapy is a pointless and long-winded waste of money.

Often a combination of therapy and drugs work best.

There are other potential treatments for panic attacks involving herbs and supplements like 5-htp which many people swear by. It should be noted that the effects of long term use of these other therapies has not bee fully studied.

Natural Anxiety Remedies – Passiflora

Passiflora has long been used as a natural remedy for anxiety. There have been some studies which actually proved its effectiveness for treating anxiety when compared to a commonly prescribed tranquilizer. There is also a scientific reason for it’s calming, soothing action: the flavonoids that passiflora contains work on the areas of the brain that cause anxiety. Chamomile is relaxing for the same reason. The flavenoids in Passiflora may well also be one of a number of natural depression remedies. Interesting link on flavonoids here.

While supplements and herbal remedies are good for anxiety, remember to tackle the psychological causes.

So how is it best to take Passiflora? Well, there are two main choices really: you can buy a supplement which you take daily, normally as a capsule full of powder, or you can buy a tincture which you add to water and drink. passiflora does not taste particularly pleasant, but it’s not so bad.

The tincture has two distinct benefits: firstly you can control how much passiflora you want to take. Personally I like to try things at small doses first. Secondly, it often comes as a complex meaning it has other ingredients with it that are also natural anxiety remedies.

Side effects of Passiflora: depending on who you listen to passiflora is either as safe as houses or carries the same side-effect profile as every other drug/natural remedy on the market. This product might cause dizziness, drowsiness, upset stomach etc. If effected do not drive or operate machinery. Personally I have never had any trouble with passiflora and I don’t know anyone who has.

Also read: Anxiety Disorder Herbal Remedies

Worst SSRI’s for weight gain

In response to the ongoing discussion about weight gain when taking Selective Serotonin Reuptake Inhibitors (SSRIs) I have added this post as I recently read some information that I found interesting.

Many people who take SSRI’s for depression or anxiety suffer weight gain as a result. Indeed it is a common reason for people to prematurely break-off from otherwise beneficial treatment. But in truth, appearance is so key to modern life that it is no surprise that people who are already suffering from mood disorders don’t want to get fat. This could lead to more depression!
It is important to point out that when taking SSRI’s, weight gain can be mitigated against in more or less the same ways you would avoid gaining weight under normal circumstances. A good balanced diet with plenty of fresh fruit and vegetables and not too much saturated fat and sugars as found in junk food, and of course some exercise. You will also find that exercise helps with depression as this article shows. Seeings that you will have to talk to your doctor about the medication anyway, why not ask him or her to do a quick fitness assessment and check what level of exercise your body can take.

I was interested last week when I got an email from revolution health that linked to an article on their site about SSRI’s that are known to cause weight gain. It is one of the most common questions I am asked so I am always on the look out for new material.

The table below shows what the article said, but I disagree with much of it. I personally have taken Celexa and found that it caused weight gain to the tune of 10KG! The table also shows escitalopram to be likely to cause weight gain. This is odd because citalopram (Celexa) and escitalopram (Lexapro) are almost identical. In the article and American academic stated that weight gain might be a sign that the drugs were having an effect. The professionals I have spoken to disagreed with this and thought that the point of view was outdated. I am not qualified to pass judgement on this. I would say though that the best indicator of efficacy when using SSRI anti-depressants is that the patients mood lifts!

These common drugs are likely to cause some weight gain – but that doesn’t mean they definitely will!:

  • Paxil (paroxetine)
  • Marplan (isocarboxazid)
  • Lexapro (escitalopram)

According to the article on Revolution Health these drugs generally don’t cause weight gain (in my experience some definitely do!):

  • Prozac (fluoxetine)
  • Luvox (fluvoxamine)
  • Zoloft (sertraline)
  • Celexa (citalopram)
  • Wellbutrin (buproprion)

I would be interested to here of other people’s experiences with SSRI’s and weight gain. You can email me or leave a reply on this blog!

Related Articles

Celexa – Tapering off and weight loss / gain

Tapering off anti-depressants like Celexa can be a miserable business. But you want to live your life without medication, so eventually you take the plunge and start to withdraw.

For me, a major benefit of coming off the drug was that I would lose the weight it had made me put on. I had tolerated the drug well, the only side effects were feeling very sleepy and yawning constantly. Not bad for someone with a history of insomnia.

The one major thing that bugged me is that I went to a about 10kgs over my normal weight after being on Celexa a few months. When I went onto Celexa at the height of a horrible depression I weighed 5kgs under my normal weight. So with the Celexa I had put on a whopping 15kgs.

Anyway, I thought I would lose it as I came off the drug, but things with SSRI’s are not so simple. Prior to coming off I embarked on an ambitious exercise and diet plan and lost a few kilos. But the plan was too drastic and I couldn’t stick to it.

As I started to taper my doses I began to get hungrier, craving large amounts of carbohydrates. I also felt quite lazy and the brain zaps and dizziness made exercising uncomfortable, especially in the afternoon and evening, when I had most spare time.

Even as the side effects passed and I could control my eating better, the weight did not start to lessen as I thought it might, just by my bodies metabolism getting back to normal.

To get rid of the pounds you put on while taking Celexa you need to work hard. I have discovered that I probably won’t go back to my heaviest, even if I really pig out. But I won’t lose much unless I exercise an hour a day and eat very sensibly. The problem is, I still crave carbohydrates!

What is true for me might not be the case for you, and you should get a thorough checkout before you start any drastic weight-loss. And remember, short term fad diets don’t work!

But remember, there is quite a lot that the drug companies don’t tell you, and quite a lot that your doctor won’t tell you either through ignorance or through loyalty to the drug reps that buy them dinner.

Other posts on SSRI’s that you might find interesting:

GSK Seroxat Suicide Link

Anxiety, Celexa and Weight Gain

Celexa, citalopram – a personal experience

Anxiety 2 Calm: Celexa, Effexor, know your drug!

Slow withdrawal from Citalopram (Cipramil / Celexa) with minimal side effects?