Question: “How can I best support my adult child through benzodiazepine withdrawal?”
Answer: First of all, thank you for offering your support—I can personally attest to how important it is to have family in one’s corner during benzodiazepine withdrawal. One memory springs to mind, from the evening in October 2019 when the documentary Medicating Normal was screened at a small venue in my town. By that time, I was ten years into my psychiatric-drug withdrawal debacle, still enduring a severe, protracted syndrome brought on by a medically negligent, rapid detox from prescribed polypharmacy—Xanax, Klonopin, Remeron, Adderall, Seroquel, and Ambien to be exact.
As part of the event’s post-screening discussion, I shared my personal experience in front of the audience. When the program was over, as I navigated through the maze of people toward the exit, I made eye contact with my dad, standing at the aisle’s end. We embraced in a tight hug, and both of us started to cry. We had experienced hell together, and that moment was a silent, shared acknowledgement of that fact.
I had been an adult with a professional career—around thirty, to be exact—when I became disabled by my withdrawal from the benzodiazepines and other psychiatric medications a psychiatrist so casually doled out for years. Yet during the worst of my suffering, I was reduced to a childlike state, rendered so ill I could no longer work and was forced to move home. At my worst, I could barely leave the house, drive, or shop for groceries for myself.
Without mincing words: I would not be alive today were it not for my father. Having family support is an integral part of healing from benzodiazepines, especially for the more severe cases, so I consider myself incredibly lucky. Together, my dad and I have navigated my benzodiazepine injury the best we could, but we certainly didn’t do everything right from the beginning. There were countless mistakes made, and no shortage of frustration, screaming, crying, and hurtful words.
Being the supporter (or the sufferer, for that matter) doesn’t come with a manual. And often there’s no warning of what is to come—it just barrels into your lives, disrupting everything in its path, and everyone has to jump quickly into action if it is to be survived.
Having navigated this challenging situation myself, alongside my dad, for the past twelve years, I’ve attempted to answer your question with the tips below.
Note: Each person’s experience of withdrawal is unique. An ideal situation is a slow and tolerable taper which minimizes suffering and maximizes functionality. Sadly, that is not everyone’s reality—some become severely disabled. Tailor my answers to your own family’s circumstances, which may shift and change throughout the withdrawal process. It should also be understood that this list is not inclusive.
- Educate yourself: First and foremost, arm yourself with knowledge about both benzodiazepines and their withdrawal syndromes, including common symptoms. There are a plethora of:
Your child may also send you things—if they do, read or watch them! [Note: be mindful that there is much inaccurate information out there too, some even co-signed by doctors, psychiatrists, and government agencies.]
- Believe them: Withdrawal is common and very real. Unfortunately, many people, including doctors, are uneducated about these issues and will deny they exist. Your child needs you to believe that what they are experiencing is real, and that the symptoms are as distressing as they report. See: Lay Down the Burden of Proof.
- Appreciate the seriousness of withdrawal: Withdrawal can cause chronic illness and in severe cases has resulted in psychosis, seizures, and suicides.
- Provide practical support: People in withdrawal need their basic needs met (food, money, shelter, healthcare, peace, quiet, privacy, etc.). Other practical support might include groceries, cleaning, childcare, filling out disability paperwork, or a ride to the doctor.
- Advocate for them: This might look like accompanying them to doctor’s visits (armed with information to educate a prescriber about the need for ongoing refills for a slow taper), assisting with a disability application; etc.
- Respect their wishes: Withdrawal is more of an art than a science. Because some things work for some and prove disastrous for others, there will be difficult decisions to make. On top of that, (often uninformed) doctors may suggest things like adding a new medication, speeding up the taper, etc. Your child may reject this advice. You can aid your child in making decisions (help them research, weigh the pros and cons, etc.), but, ultimately, it’s best to respect their wishes if they are different from yours.
- Communicate & listen: Ask what they need from you or how you can help, and listen to their answers (which may change over time). Also, communicate your own availability, so that there are no surprises and they can have reasonable expectations of you.
- Check in often/Be available: It often helps to know that someone reliable is available to help, if needed. Some in withdrawal wish to be alone, but you can still let them know you’re there without violating their space. Others want company, in which case it will help to be physically present when you can.
- Reassure & offer hope: It helps to hear that this is a temporary state that will get better with time. Sometimes, this message will need to be repeated over and over again, especially during times of heightened distress. You can also offer anecdotes or read success stories.
- Stay calm: This is easier said than done when your child is suffering, especially if they experience some of the more scary and bizarre symptoms of withdrawal such as paranoia, terror, dissociation, and panic. If you are anxious, your child will feed off that. Try to remain calm and grounded in their presence.
- Be patient with them (and with yourself!): Withdrawal can be a long process— issues (such as tolerance withdrawal and interdose withdrawal) can begin even before dose reductions are made and persist long after the drug is out of the body. It sometimes takes years. It’s best to release expectations and timelines. Let your child know they are not a burden, and that you will be there no matter how long it takes for them to heal. Encourage others around you (family, friends) to be patient too. Lastly, be patient with yourself, too—supporting someone with chronic illness can be incredibly challenging.
- Stay in today: Don’t get too far ahead of yourself. Take things one day at a time. Some of the things you worry about or fear may never happen.
- Be gentle, flexible, and forgiving: Withdrawal symptoms can drastically impede one’s ability to participate in life. Be flexible. Your child may need to reschedule or cancel often. Withdrawal can also cause rage, mood swings, and irritability. My dad used to say things to me like, “You’re still in there!” This let me know that he knew my behaviors were from the drugs, and that he believed I’d eventually be myself again. Withdrawal can also cause neuro-emotions (eg, neuro-guilt, neuro-fear, neuro-anger, neuro-shame), so it may help to express that you understand the involuntary nature of it and that you’re not angry or upset. Be gentle with them, and encourage them to be gentle with themselves. As the parent and supporter, you will also make mistakes—forgive yourself too.
- Have empathy: Without enduring benzodiazepine withdrawal yourself, you will never fully understand it, but you can empathize. This video is informative. Also, take heed of the following quote:
“In order to empathize with someone’s experience, you must be willing to believe them as they see it, and not how you imagine their experience to be.” ~Brené Brown
- Employ the Ring Theory: Your child is in the center ring. The people closest to them (e.g., you, the parent) fit around the center ring. Others fill outer rings the further they are from the crisis. Bring comfort in and dump your own stuff out.
- Get support and take care of yourself, too: People in withdrawal can be draining and exhausting. You will need breaks and support. There are online groups for families (e.g., Family Circle at Inner Compass Exchange). Also, don’t be afraid to set boundaries (“I am not able to do that today, but I can make time tomorrow”) and ask for help from others if you need it. Burnout is real. You can’t help others if you’re not healthy yourself (there is a reason airlines instruct parents to put their oxygen masks on first).
- Love them: Tell them you love them. Often. Provide loving physical touch, like hugs (if that is comforting and they’re open to receiving). Offer loving gestures (make their favorite meal, leave an encouraging card).
What is as important, if not more, than what you can do to support your child is what NOT to do! Below are some things to AVOID:
- Regressing into the “parent-child” dynamic: Avoid infantilizing or parenting them. Even if impaired from withdrawal, they are still an adult. Understand that it is already incredibly demoralizing to lose your autonomy, to have to move home, rely on others for your basic needs, and/or lose financial independence.
- Excessive stimulation/stress/pressure: Benzodiazepine withdrawal can make one feel over exposed, like a snail without a shell. The natural calming mechanism of the body that non-withdrawal people enjoy is often malfunctioning in withdrawal. Noises can be loud and intolerable, crowds too stimulating and multitasking overwhelming. Too much stress or pressure can tip someone over the edge into meltdown or crisis.
- Judging/shaming/blaming: When someone is suffering, the last thing they need is shame or blame in the form of comments like, “Why did you take benzodiazepines to cope? You should’ve known better!” Trust me, they are already beating themselves up enough as is. Understand that most people in withdrawal were not provided adequate informed consent about the potential risks and harms of the medications. Hindsight is 20/20, but we can’t go back in time, so it’s best to accept what is and work on a plan to move forward.
- Wrongly labeling them an “addict”: The presence of withdrawal with attempts at dose reduction does not indicate addiction/substance use disorder (SUD). All benzodiazepines and other psychiatric drugs (including antidepressants) have the potential to cause physical dependence (this is not synonymous with addiction/SUD) and subsequent withdrawal. This happens simply by way of neuroadaptation (physiological changes from chronic exposure to the drugs). Withdrawal symptoms do not mean your child is “addicted,” suffering from an SUD, or abusing their medication. See: FDA guidance document for definitions of terms (pages 6-11).
- Threatening hospitalization: Being locked up against one’s will is an intense fear held by many people experiencing withdrawal. It is a legitimate worry that a hospital will disbelieve withdrawal or, worse, “cold-turkey” medications, or add or force more medications that could further harm. Using this as a threat is cruel.
- Suggesting that this is “all in their head” or that they “need to pull it together,” “try harder,” or “get off the internet”: Sadly, these are all comments commonly reported by withdrawal sufferers. “Tough love” or a “pull yourself up by the bootstraps” mentality will not work to reverse neuroadaptation from benzodiazepines or other psychiatric drugs. Believe me, your child wants this to end more than anyone, but cannot just “snap out of it.” Regarding the internet, online support groups are often the only place where information and support from others in the same boat can be found.
- Minimizing what they are going through: Comments like “other people have it worse” should be avoided. Even if true, that doesn’t negate your child’s very real suffering.
- Ignoring their suffering: It is important that you validate their suffering. Please do not act like it is not happening.
- Toxic positivity: Asking them to hide their true emotions, minimizing their experience with “feel good” statements, shaming them for exhibiting anything other than positivity, or trying to cheer them up excessively are all examples. Anger, frustration, grief, and crying are all normal in withdrawal; making space for them is integral to healing.
- Acting like they no longer exist: Because withdrawal can persist for so long, people sometimes stop including the sufferer. It is better to continue to extend invitations (with an easy out: “No pressure, I know you’re sick, but want you to know you’re welcome when you’re ready!”) so they know they’re still missed and wanted.
I cannot stress enough the importance of a support system in withdrawal. In providing the right support for your child, you will have an immeasurable influence on the outcome of their withdrawal experience. The end result can also be a much closer and deeply connected relationship than existed before. This was the case for my father and me, and I am so grateful for that.
~Dedicated to my incredible father. I love you, dad. Thank you.~