My Problems with Drug Therapy

What Your Doctor May Not Tell You About Anxiety, Phobias, and Panic Attacks: The All-Natural Program That Can Help You Conquer Your Fears
by Douglas Hunt, M.D.

(Page 2 of 2)

So, if you are diagnosed with an anxiety disorder, you simply pop a pill to alleviate it, right? Wrong! While some anxiety disorders respond to pharmaceuticals, there are short- and long-term adverse effects to be considered that can often be more crippling than the disorder itself. In addition, pharmaceuticals are extremely costly compared to natural therapies, which are usually found over-the-counter at your local health food store. My holistic program will show you a safer, cheaper, and more effective way to strengthen the body and increase wellness, and in doing so, reduce anxiety.

When I started my practice in the 1960s, pharmaceuticals were usually reserved for hospitalized patients and psychotics. Of course, there were many other modalities available then, and I'll get to them in a moment. But first I want to share with you my initial experiences with psychotropic drugs, which explain why I resisted the pressure of joining other doctors in embracing prescription drugs as mainstream psychiatric therapy.

Keep in mind that "psychotropic" and "psychoactive" have virtually the same meaning and are often interchangeable words. They describe a drug, generally used to treat mental illness, which has the ability to alter moods, anxiety, behavior, thinking processes or mental tension.

Short-Term Side Effects

I'm a prime example of someone whose body and mind are not the least bit compatible with mind-altering drugs. For example, if I take a stimulant such as a mild appetite suppressor or even a cup of coffee, I will develop tachycardia (rapid heartbeat) and an arrhythmia (irregular heartbeat) that lasts anywhere from hours to days. This is dangerous, to say the least-not to mention unpleasant. When I am in this altered, medicated state, I am unable to focus my thoughts or do any constructive work. If I ingest a tranquilizer (a downer), I am zonked out for a day and a half.

To give you an idea, when I was an intern, I once took a 10 milligram (mg) Valium (diazepam), a commonly prescribed class of drug called benzodiazepine, before going to work. After taking this anti-anxiety agent, I literally was unable to get off the couch for a full day. I had to call in sick-the only day of my entire internship that I missed. Psychoactive drugs and I simply do not get along.

Many of my patients have experienced the same adverse effect with benzodiazepines. Along with the drowsiness, they have reported slurred speech and dizziness. One patient, thirty-two-year-old Victoria, said she was unable to wake up until noon after taking medication the night before for mild anxiety. When she awoke, she discovered that her two preschoolers had unlocked the front door and were playing in the front yard near a busy highway. I'm sure Victoria's mild anxiety turned into outright panic when she thought of what could have happened to her unsupervised young children.

Another woman, Caroline, age forty-seven, took Valium to help ease anxiety during a lengthy divorce. She came to me for a natural therapy, saying the tranquilizer made her so numb that she was devoid of all emotions. "The drug calmed my anxiety," Caroline said, "but after taking it for a week, it also dulled any joy or enthusiasm I had for life."

People who do not have problems with drugs are often puzzled by or suspicious of those who say they can't take mind-altering medications. To them I say, why not see this for what it is-one extreme along the spectrum of responses to chemicals. At the other extreme are those who never feel normal without drugs. These people can easily become abusers. In between, we find the average person, who can tolerate the majority of drugs pretty well. Still, there is more to the problem of taking drugs than simple tolerance.

Long-Term Adverse Effects

Along with the short-term uncomfortable side effects of drug therapy, there can be long-term adverse effects that can sometimes be toxic. Any drug that acts on the central nervous system (such as an analgesic, a stimulant, or a depressant) is potentially able to cause noxious side effects such as cognitive impairment, dependence, habituation, or neurological disorders. In fact, up to 10 percent of patients using psychotropic drugs report serious side effects, including hepatitis, dermatitis, low white blood cell count, amnesia, paradoxical excitation, changes in vision, hearing alterations, breathing problems, hypertension, low blood pressure, fast or slow heartbeat, palpitations, and headaches, among others.

Today there are thousands of studies on the toxic effects and resulting adverse reactions to psychotropic medications. There are hundreds of studies on suicides, overdoses, and deaths from use of these drugs, not including driving accidents and memory impairment.

Drug therapy for anxiety usually consists of using anti-panic drugs for immediate symptom relief while attempting to find the most appropriate mix of drugs from several different categories, including antidepressants, anti-seizure and anti-anxiety medications. Yet, drugs, and especially psychotropic drugs, are not as specific in their actions as you may think. For example, the benzodiazepines (tranquilizers such as Valium, Ativan, and Xanax) have five major therapeutic qualities:

1. Anxiety reduction (anxiolytic)

2. Hypnotic (sleep-inducing)

3. Muscle relaxant

4. Anti-epileptic

5. Amnesic (ability to ignore or forget unfavorable events)

Benzodiazepines such as Valium act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another. GABA inhibits activity in many of the nerves of the brain, and it is thought that this excessive activity is what causes anxiety or other psychological disorders. Patients who take this class of drug may be subject to all of the above-mentioned treatment actions, along with any other adverse effects that may result, including rebound anxiety or insomnia (a major surge of anxiety or insomnia immediately after a drug that controlled the anxiety or insomnia is discontinued), aches and pains, epileptic seizures, and memory problems, among many others. In fact, most people are unaware that more than 500 different types of adverse reactions to benzodiazepines have been reported to the FDA. Because there are so many chemical effects and because benzodiazepines are fat-soluble and thus remain in the body, no part of the body or brain is exempt. Yes, the expected benefit may occur with these medications; but there is always the potential for an enhancement of any preexisting psychological or physical problem in addition to possible new problems.

Virtually every doctor recognizes individual variability in therapeutic and adverse effects. For example, a strong prescription might affect you and yet have no effect at all on a family member. Benzodiazepines accumulate in the body and brain at different speeds and different levels in each person.

With the long-term use of psychotropic drugs, mental and emotional impairment, if it occurs, comes on gradually and is often barely noticed by the patient. It is of interest to note that patients who have become dependent on the drugs are unlikely to ever respond normally to those drugs again, once they are discontinued.

Big Pharma Promotes Expensive Options

Prescription drugs are driven by what is known as Big Pharma, the big-business pharmaceutical industry. In fact, many of the so-called latest and greatest breakthrough medical studies are funded by the pharmaceutical industry and thus the outcomes reported can sometimes be biased. Deserved or not, Big Pharma often gains power and respectability from the government through lobbying and financial contributions. Consequently, legislation and government agencies such as the Food and Drug Administration often reflect the interests of these companies.

Most doctors get their drug information from well-paid sales reps who work for Big Pharma and don't have time to explore other remedies, specifically the healing benefits of natural (and inexpensive) therapies that are less known. These doctors have little time to explain the possible risks of these medications to patients or to teach them key lifestyle changes that might benefit the patient's overall health.

This is problematic because the consumer often receives pricey and sometimes ineffective pharmaceuticals when a natural therapy might work just as well and cost a lot less without all the deleterious side effects. Natural approaches often do not make big money for powerful drug companies and do not get the testing, FDA approval, and the million-dollar advertising budget that drugs produced by Big Pharma receive.

Post-Withdrawal Symptoms After Long-Term Benzodiazepine Use During the 1980s, there were substantial long-term studies related to latent physical and psychological symptoms (see pages 13-14) that resulted from discontinuation of psychotropic drugs. The effects were not exclusive to acute withdrawal but also were seen after discontinuation of long-term benzodiazepine use. These symptoms would not be occurring had there not been a semipermanent or even permanent change in the brain's neurochemical or neurological system. While it is true that some people who use psychotropic drugs do not experience post-withdrawal symptoms, the risk is still there for many others.

• behavioral disorders • bursting head feeling • delusions • depression • gastrointestinal problems • headache • increased anxiety • insomnia • irritability • malaise • moodiness • neck tension • neuromuscular problems • numbness in extremities • palpitations • panic • paranoia • perceptual difficulties • phobias • poor concentration • sensory disturbances • shaking and trembling

The Mental Health System before Drug Therapy

The mental health system did not always rely on pharmaceuticals for treatment. During my residency, psychiatric treatment was focused on helping patients gain insight into their problems. It was believed that insight would eventually translate into behavioral changes favorable to a happier and more productive life.

I did my residency on a farm. I'm not kidding! The California mental health system was originally created around the concept of a self-sufficient facility, and it worked beautifully. The idea was for patients to play a large part in their own recovery. Patton, Napa, Camarillo, Norwalk, and other mental hospitals were actually self-sufficient farms.

During the daytime hours, patients were assigned work. During off-work hours, they could be active in the many recreational facilities. Patients worked in every department of the facility, tending farm animals, working in the fields, or performing maintenance work, depending on their individual abilities.

In the evening hours, patients enjoyed movies or activities such as baseball, tennis, horseshoes, basketball, or dozens of other games around the grounds. Traditionally, patients were required to attend group therapy or, when there was sufficient staff, other forms of therapy during the week.

Patients spent their days engaged in productive but simple activities. At the end of the day, they had something to show for their efforts; they had created an orderly and hygienic environment. Besides keeping their minds off their problems, the tasks they performed encouraged a real sense of self-enablement. Moreover, there was also a huge cost savings here for the mental health system. Because the patients were contributing to their own upkeep, the burden on taxpayers was reduced.

Today, the California mental health system's approach differs vastly from its former communal treatment methods. And, in my opinion, the current therapies that favor medications and behavioral modification often leave patients less able to function in society than before. For example, those patients who are the most mentally handicapped often become homeless. They become easy prey to drug dealers and other bottom-dwellers who also inhabit this dangerous environment.

I was fortunate to have participated in a successful but long-forgotten system of mental health that did not rely entirely on drugs. So, when I began my private practice in the 1960s, I gravitated toward more natural approaches. Early in my practice, I found an article on nondrug approaches to mental health written by Dr. William Philpot, a psychiatrist then practicing near Boston, Massachusetts. Dr. Philpot was kind enough to invite me to spend time with him so I could observe his nondrug modalities. I also drove to Connecticut to see Dr. Marshall Mandell, a psychiatrist, now retired. Dr. Mandell introduced me to the idea that food sensitivities could influence mental stability. I met with Dr. Theron Randolph, another expert, who practiced in Chicago, Illinois. Dr. Randolph graciously allowed me to watch him interview patients for environmental influences on their mental status.

In observing these gifted physicians, who favored natural therapies over prescription drugs, two things struck me immediately: One, the natural approaches they used were successful in helping patients. And, two, each one spent a great deal of time with each patient. Dr. Randolph, for example, spent as many as four hours performing a single intake interview. Instead of looking at each patient's obvious symptoms, the doctors would search for the patient's uncommon, individual characteristics and then connect them to a possible causative agent or situation. Taking such care and time in reviewing patients' unique situations became a cornerstone of my methods.

Still not convinced that natural was necessarily better or safer, I continued to dabble in these alternative therapies on patients with milder cases of anxiety. Some patients took the natural treatments along with a reduced dose of medication and were pleased with the relief they felt. Others were able to give up pharmaceuticals altogether as the natural modalities eased their anxiety and gave them a better quality of life. I also experimented with a host of alternative and lifestyle modalities such as diet, exercise, hypnosis, biofeedback, and magnets. Gradually I began to coalesce the many ideas that I had collected along with my own ideas into a solid plan to benefit my patients-especially anxiety patients. Moreover, for the most part, my plan avoided the use (and misuse) of conventional drugs.

Almost all of my patients on the natural therapy plan responded in a positive way and were pleased that these inexpensive alternative therapies were effective but with fewer side effects. As these patients shared success stories with family and friends, more and more people heard of my holistic treatment plan, and my practice started to expand, which is why I'm writing this book today.

My 5-Step Holistic Program

Since my first experiences, learning from brilliant doctors and holistic therapists who used natural modalities for psychiatric illnesses, I have gained invaluable insight in how to treat anxiety disorders without potentially dangerous pharmaceuticals. I wrote this book to put you at center stage by focusing on the many alternative modalities that I've found to work.

The 5-step holistic program in this book is neither intrusive nor does it include mind-altering drugs that reduce energy and productivity. As you read the book, you'll see that it quickly moves beyond the descriptions of common types of anxiety disorders on to pages of natural, self-help tips that you can use today to feel more relaxed, worry less, and be more productive. This multifaceted program is the same one I recommend to patients and will give you the most effective low-tech, natural approaches to stopping mild anxiety and reversing related disorders without deleterious side effects.

In the thirty-five years that I've been in practice, we've had many successes. Working closely with my patients, we've learned what works and what doesn't. I share all of this information with you in the pages of this book, including how making a few small changes in lifestyle habits can give tremendous anxiety-relieving results.

In the upcoming chapters, I will discuss the various types of anxiety disorders as found in the official Diagnostic and Statistical Manual of Mental Disorders. As you read this first section of my book, I will help you identify the particular type of disorder you might have, understand the risk factors and symptoms, and then discuss the diagnosis and treatment in the holistic program to follow. It is important to note, however, that while the various expressions of anxiety may differ, the core problem is always the same. In some cases, dealing directly with the primary symptom is the key to recovery. But, in many, if not most, of the other forms of anxiety, simply addressing the anxiety itself is sufficient for reducing the symptoms and returning to full health.

I believe that this book is the next best thing to consulting with you in person. Therefore, in preparation for the 5-step program, I want you to take the test "Assess Your Risk for Anxiety Disorders" and evaluate your own risk factors. If you already have an anxiety disorder that is stealing your productive life, this test will help you see what you need to do to recover as fully as possible and to prevent the disorder from recurring.

Assess Your Risk for Anxiety Disorders

Take a few minutes to identify your personal risks and symptoms for anxiety disorders. The following questions are similar to the ones I ask patients who come to my office for a consultation. Give yourself one point for each time you respond with "yes." Add up your score at the end of the questionnaire and use the key to interpret your score.

1. Do you suffer with anxiety around the clock, during all waking hours?

2. Are you easily "set off," irritated, or frightened?

3. Do you harbor sensitive feelings, and see everything as a perceived threat?

4. Does anxiety make your inner life hell?

5. Has anxiety influenced your daily life to the extent that you sleep poorly, over- or under-eat, have urinary frequency, or smoke too much?

6. Has anxiety taken all of your energy so that you feel chronically tired?

7. Are you so desperate for relief that you have turned to alcohol?

8. Has your anxiety caused those around you to respond with anger, irritability, impatience, or avoidance and even rejection?

9. Has your intellectual performance declined because of poor memory, concentration, or task stamina?

10. Has your career or job performance fallen significantly because of your anxiety?

11. Are you suffering much more than anyone around you suspects?

12. Is your mind racing from one worry to another and thus complicating most of your everyday obligations?

Interpreting Your Score:

0: Superb! You have no signs or symptoms of anxiety disorders. Following the lifestyle suggestions in this book should help you stay healthy.

1-3: Low risk. You have a low risk of anxiety disorders. Still, review the areas where you responded with a "yes" and modify your lifestyle accordingly.

4-6: Moderate risk. You have a moderate risk of anxiety disorders. My program will enable you to get back in control of negative lifestyle habits and decrease the chance that anxiety disorders will overwhelm your active life.

7-12: High risk. Though you might not feel as if anxiety has taken over your normal life, you are at a high risk for having problems with this illness. Read this book and learn all about the various anxiety disorders. Also, evaluate your personal lifestyle to see what habits need to be changed. Consider the natural therapies as you strive toward a healthy mental state.

Now, Let's Get Started!

As you read this book, you'll meet many of my patients who have successfully conquered some debilitating anxiety disorders with my holistic program. Just like them, your goal is to change the habits you can control so that you greatly reduce the chance of having anxiety overwhelm you.

Throughout these pages, I will help you get focused so that when you talk to your doctor, you can explain clearly what you are experiencing with anxiety. However, before I discuss the many natural therapies and lifestyle habits for relieving anxiety, let's look at signs and symptoms you might feel, as discussed in Chapters 2 and 3. I want to help you get back in control of your active life without the burden of anxiety-and understanding the problem is the first step.

Copyright © 2005 by Douglas Hunt, M.D.

About the Author

Douglas Hunt, M.D. is the author of the successful No More Cravings and No More Fears and has been practicing alternative and preventitive medicine for more than 20 years. His newest title is What Your Doctor May Not Tell You About™ Anxiety, Phobias, and Panic Attacks: The All Natural Program That Can Help You Conquer Your Fears.