The Realities of Ativan

I can admit when I am struggling down this road with my social anxiety.

One of my main struggles with my social anxiety is the battle with my psychiatrists (I say this in the plural for a reason) over what is the right dosage for me. Is it my current dosage of morning and evening, or is it better for me to take it three times a day. If you follow my blog since the start this issue with my Ativan pops up almost weekly.

I will be the first to admit I always research when a medicine is introduced as part of my diagnosis. However, with Ativan it was one of the first medications ever prescribed to me. From the very beginning, it was a medicine that always helped me with my anxiety. It is the only medicine over the last ten years outside of my Seroquel that hasn’t been stopped since I started taking it.

The issue at hand is that the government is cracking down on doctors prescribing because, as my psychiatrists are so fond of telling me, it is highly controlled. I wanted to find out how true it is, and it surprises me that it has taken me so long to research the truth about Ativan.

I decided to do a Google search with simple perimeters, “why is Ativan addictive?” I was surprised at what I learned. Having no experience in medicine other than having taken different medicines for different things, it was interesting to read those people that take Ativan run a high risk of it being an addiction in the long run. I knew from experience that Ativan is a controlled substance and it’s highly regulated. Why do they prescribe something that is so addictive in the long term?

Ativan (lorazepam) belongs to a class of drugs known as benzodiazepines. These are very commonly prescribed by doctors. I had no idea that Ativan is in the same family as Valium or Xanax. I can give witness to how effective Ativan can, and in some ways isn’t, helping to prevent panic attacks and to alleviate the symptoms of a panic attack when needed. Some of my worst anxiety and panic attacks have been elevated with Ativan but at a price. Sometimes I end up taking one or two more than prescribed in the really bad panic attack cases.

During my research, I found that experts prescribe Ativan because, unlike drugs like Xanax, the effects last longer in the system. The “calming effect” that comes over me after taking my Ativan is a good feeling after being stressed all day with anxiety. One thing that made a bit depressed is that everything that I have read says it is not to be used as a long-term solution. That’s great and all, but I was never told any of this over the years, or when it prescribed. Therein is the issue at hand, it is so highly addictive that my doctors fear the consequences of raising my dosage back to three times a day, but at the same time it would be disastrous to be off of Ativan

Every psychiatrist in the of the revolving door of them has continued to prescribe Ativan without issue other than raising the dosage. Therein is the issue at hand, it is so highly addictive that my doctors fear the consequences of raising my dosage back to three times a day, but at the same time, it would be disastrous to be off of Ativan altogether. Which is the right?

I wasn’t told this by my psychiatrists, in fact, all they really tell me is that I have to manage the dosage I do take and there is not much else I can do about it. What a reality check.

It doesn’t surprise me that it has taken so long to truly understand the realities of Ativan treatment. I confess that my social anxiety over the years has only increased and it makes sense a bit more why I feel so attached to Ativan. I will share an example.

I have been following my psychiatrist’s advice and managing my Ativan the best way I know how, without taking extra and keeping my dosage the same. This is no easy task. I do what I have to. That means not taking my morning dose unless I am leaving my house early that day and saving it for the afternoon when my social anxiety is at its worse. I can’t forgo my bedtime Ativan because my night time dosage because that would be disastrous. I have tried to make that adjustment and it just doesn’t work.

I know I am part of the problem. My reliance on Ativan comes from years of only relying on Ativan to solve my issues with social anxiety without meditation or mindfulness breathing. Its only been seven or eight months since I started CBT and compared to not ever dealing with it, my journey has just begun.

I am partly to blame because I never dealt with social anxiety head-on. But, it also comes with the way doctors prescribe medication to those of us with mental illnesses. I can count the times a psychiatrist explained my medication to me on one hand. I have changed medicines over the years countless times.

Early on in my diagnosis, it was simple. I had to take whatever they prescribed to me or I would end up back in the psych ward. I always chose to be blissfully ignorant because the other option I hated. I just didn’t ask questions and in the beginning, I was okay with all of it.

It has taken me looking back over the last three months to start to really understand the realities that come with my diagnosis of Bipolar One, and the medication that I have taken over the years. I wish sometimes that I was better at figuring out things in the beginning. Would it have changed what is going on with the present day me?

If I have inevitably built up a tolerance for Ativan is it the addiction the medication that makes me ask so many times for an increase? Or is it a real need? I’m conflicted because Ativan could be a real addiction. Was it better to not know the truth? I have enough issues already. I do know when before I stopped taking it three times a day my anxiety was manageable, and in the years since the change in my dosage, my social anxiety has only gotten worse.

Even understanding that Ativan is addictive I can’t imagine a world where I wouldn’t have to take it every day. It has become that important in my life. It’s a sad reality and maybe when I get my anxiety under control, that is always one of the goals of my recovery, it could be a reality.

I am curious, have any of my followers and my people in the mental illness community have a similar issue with Ativan?

I wanted to end with this, for those of you who are changing medications or just starting out taking medications, doing proper research is so important. Don’t be afraid to ask the “why do I have to take this medication” question. I believe that medication is part of the equation of my mental health, but I am left with the lingering question ” would knowing more mean I didn’t start Ativan?”

Always keep fighting.

J.E. Skye

Photo Credit: Jesse Bowser

51 thoughts on “The Realities of Ativan

  1. Oh my, yes. Been there, done that, had withdrawal… It’s a really crappy situation. As you say, there’s the benefit of that buffer which makes being in public more tolerable – on the other hand, you’re feeding your brain chemicals that are not terribly good for it. Then, it becomes terrifying if there is a short term need, because you know how difficult it is to come back from that “safe place”. I’m truly sorry that you’re dealing with this, and really peeved with the prescribers that just hand things off without giving good data.

    Liked by 1 person

    • Thank you for sharing. It’s not the greatest of situations but as life moves on we have to adjust and move forward. I know I have to figure out a way to not be reliant on my Ativan. Thank you for taking the time to read my blog and for sharing your experiences.

      Liked by 1 person

  2. Interesting information on Ativan! I’ve never taken it but I have taken Xanax. It was horrible. I ended up having an adverse reaction to it. It made my panic attacks worse. I’m now on a cocktail of medicines for my bipolar, anxiety and depression. It seems to be working.
    Thanks for the information! I do enjoy reading your blog posts! 🙂

    Liked by 1 person

  3. I also like Ativan for helping to calm down during a panic attack, especially. My doctor is loathe to prescribe it, too. I stopped asking because she gave me such a hard time. I’m now on two different meds, one taken during the day, one before bed, and have noticed the panic attacks are better. But I miss the Ativan in a pinch. I appreciate you sharing your research and wish you peace and love.

    Liked by 1 person

  4. I would feel scared if I didn’t have Ativan. I use it for panic attacks only, though. There’s no regiment to it for me (I take Paxil once a day for that). It worries me often – and I know it’s a bandaid fix that doesn’t fix any underlying problem. Keeping up with CBT is a very good plan for you – perhaps one day you can shift from taking it preventatively, and rather use it when needed (acutely). ..?

    Liked by 1 person

    • That is going to be my goal. There was a time when I didn’t take it every day, only when I needed it. But, lately, that has changed to the point where I am in tremendous agony with my anxiety until I take it. I realize how bad that makes it for me. So my focus is on fixing this issue.

      Liked by 1 person

  5. Speaking as a mental health professional, I would say that a major problem with the benzo class of medication is the development of tolerance. These meds work well, but the more you take them the less they work. Increasing the dose to overcome tolerance can become a never-ending spiral. Also, anyone who is on regular doses of benzos for an extended period of time will develop physiological dependence, meaning stopping the medication would cause withdrawal symptoms. The higher someone’s dose, the slower their downward taper has to be to prevent withdrawal. Doctors really need to be talking about this issue with their patients so people can make an informed decision.

    Liked by 1 person

  6. I can’t believe that your Psychiatrist prescribed Ativan and didn’t explain to you how addictive they are! I have only ever taken Ativan as a temporary measure (usually 2 weeks) while I was waiting for anti-depressants to take effect. My Psychiatrist over the years has always warned me of how addictive benzo’s can be. Having said that I have a similar conundrum when it comes to anti-depressants and Seroquel. Even though these drugs aren’t known to be addictive you inevitably become dependent on them. I’ve been on anti-depressants for 14 years now and have come to accept that I will probably have to take them for the rest of my life. Like yourself in hindsight I have always questioned whether I would have started taking any medication if I was better informed at the start (When I was 19). I was quite naïve at 19 and just went along with what I was prescribed thinking they new what was best for me.

    Liked by 1 person

    • I take a high dosage Seroquel and I have similar issues with it, but it is so important that I take Seroquel. I probably will the rest of my life. I think part of the issue is that my case has always been on the extreme side. I have extreme depression and extreme mania. The same goes with my anxiety. My doctors over the years have not seen enough change in the right direction to even consider decreasing my medication. I think in their minds that the positives, like the fact that the withdraw could be bad considering the need, that it outweighs any major change. Still I mean from what I have learned taking it for ten years ins’t best thing for me, and yet I could be hospitalized without it. I have to work on getting my social anxiety under control the right way. Thank you for sharing your experience with me!

      Liked by 1 person

  7. Hello James, I feel the same way with some of the meds my Shrink prescribe me. I choose no to take but only epival and do a lot meditation and exercise. Hard I know but I don’t want be dependent of meds. Keep the good fight!

    Liked by 1 person

  8. I’ve had Ativan as a prn “as needed” for maybe 7 years now. There was a period when I started to abuse it. It’s always been prescribed as up to 3, 1 mg pills per day, but at a point I took 6 mg. I did eventually tell my psychiatrist and he was angry and ordered me to cut it down to 3 mg or less. I was eventually very successful, then for a long time rarely took it at all. Then akathisia started from Geodon. Normal akathisia meds didn’t work, so my psychiatrist said to take Ativan. Ativan helped, but had some limitations. I have been taking 1 mg of Ativan every single day for at least 3 years now. The Geodon is finally gone as off 2 weeks ago, so really I may not need it. I’ll try to be weaned off the Ativan over time this coming year.

    I actually had almost no anxiety for quite a long time, but have had some lately, but I think because some stressful situations coming up.

    I will want to keep Ativan as a prn, but I doubt I’ll ever use that much in the future unless anxiety really gets out of whack. I’ll definitely not let myself abuse it.

    Liked by 1 person

    • Thank you for sharing. Reading this helps me to remind myself that it is possible to not have to rely on the Ativan so much. There was a point a few years ago where I only took it at night. But then I started to need it again just after my doctor lowered my dosage to 1mg twice a day. It’s tough for me because my social anxiety has reached such high levels this year.

      Liked by 1 person

      • I’m sorry you’ve been struggling with social anxiety, James Edgar. I hope that with therapy you can battle that a bit. I’ve had various anxiety issues, particularly performance anxiety. I never had performance anxiety when I was much younger. Happenings in my life have brought on a number of challenges I never had before. I am making headway at calming them, though.

        Liked by 1 person

  9. I was on 1mg per day (0.5mg morning, 0.5 at night) of Ativan for about 4 years and after some health flare ups and going to see an acupuncturist, my body started rejecting the Ativan. It lost it’s therapeutic touch in the long term for me. I found, as you said, it was a band aid for me and I didn’t further my own mental health and strengthen my inner self. After a breakdown at work, I realized I needed to take a break and detox from Ativan completely while seeing a therapist for the first time in years, going to meditation classes, learning and receiving reiki healing, and doing singing lessons. All of these components have helped me through my detoxing process and I will be completely off of Ativan on Monday. I tapered down 0.25mg each week. It was not as bad as I thought, although I know things have changed drastically, and I won’t be able to jump back in to the level of stress I was balancing before this. I am learning to do socialize again, now with a raw and open heart. I do feel the anxiety rise up, but I try to let it flow through me and not stay. I tell myself, this is a natural reaction and it’s only temporary, and I give it space to breathe. I find that chamomile lavender tea and natural calming herbs help when I need it, before going outside or at night before sleeping. However, after a scary experience with Hydroxyzine, which my doctor prescribed for withdrawal symptoms, I decided to stay away from antihistamine sleep aids altogether. I’m sure they help for some who aren’t sensitive to them. I will say when I read the withdrawal effect list before going off Ativan, I was shocked because I was already experiencing the entire list while on Ativan. I realized it became a crutch and wasn’t helping effectively anymore. I was a previous smoker and going off Ativan feels a little similar to quitting smoking. There is a time of recalibration of the brain to learn how to function again. I hope that I will continue down the road using CBT (I like the Pacifica CBT app) like you are, and with weekly counseling and the healing techniques I use, and be okay. Voice lessons helped me to become more confident when I speak and to practice being vulnerable in front of someone I don’t know that well.

    With that said, I really liked your post and applaud your honesty and openness. It brings t mind a lot of what I started realizing in the last few months—I never questioned anything and I thought it was hopeless to get off of Ativan. Now I know, so far, it isn’t. But I do know that I can’t handle the level of stress that I was able to handle while on Ativan (with my job). Maybe that’s a good thing though.
    Thank you for sharing. 💙

    Liked by 1 person

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  11. I had a similar “fear”, for lack of a better word, when I was on Ativan. Did I really need more? Or was I addicted? I don’t think I was addicted, I think it was the anxiety talking. Plus, I wasn’t on it that long before I switched facilities, and they switched me to hydroxyzine, which is the non-benzo form of Ativan. I now take they hydroxyzine for my emergency situations. Like if I am getting ready to travel or be around a large amount of people.In some ways I like it better than the Ativan, because I can feel it’s affects better than the Ativan. Never the less, it is healthy to be concerned. Just make sure if you ever go off of Ativan, that you taper off with the help of a doctor, because I hear benzo withdrawals are horrid.


  12. As I struggle with GAD , social anxiety, moderate panic attacks, and moderate depression, I have tried a whole slew of pills, just like it seems you had. Xanax .5 mg has been my saving grace to maintain my sanity. On the average day, I could take 0- 1.5 mg depending on how my mood is for the day. While I understand there is risk for addiction amongst all benzos, using it as prescribed for your condition puts you at a low risk. Unless you are taking more than advised or combining these medications with other substances, i.e. alcohol, opioids, stimulants, then you can live a normal life even in the longterm. Those studies try to warn of longterm use, as it is possible to develop additions at high dosages. Taking your low dose 3x daily along with CBT is using the medication for its’ intended use. If you are regularly seeing your psychiatrist(s) , they are closely monitoring you for abuse and risk of addiction. When you swing between the manic and depressive states, your doctor may even lower or raise your script for your current mood. They have prescribed it because the benefits outweighed the risks in your situation. I work in the mental health field and understand through my own struggles how incredible medications are in coping with mental illness. Best of luck to you and thank you for sharing!!

    Liked by 1 person

  13. Hi. I have been on Ativan for 20 years. Well, on and off of it. I got through these periods where I feel ok and don’t take any medicine, then I reach a breaking point and am on 35 different medicines. But one thing I have noticed… I must ALWAYS have 1 or a few Ativan in my purse. Not having them sends me spinning, even if I never need to take them. So my fear of having an attack and not having a way to stop it is huge.
    I also go through phases… when I am “normal”, I take Ativan, and I manage my anxiety on my own (take it as needed for my anxiety). When I am in crisis, which I very much am right now, my doctor will switch me to Clonopin. Same family, but the difference is the half life. If I’m taking Ativan 4x a day because my anxiety is THAT BAD, then I know I need something stronger. Ativan has a 4-6 hour half life. For every day life and the occasional anxiety, that’s perfect. Xanax is only 2-4 hours, Valium would be 6-8 hours, though I feel as this isn’t as commonly prescribed anymore, and then Clonopin saves the day for me, with an 8-10 hour half life. The most important dose of my clonopin, or Ativan I take when I am in crisis, is the morning dose. Clonopin with my other morning meds keeps me good for most of the day. It’s preventative maintenance. Just as it’s easier to prevent pain from happening, then to make it go away once it’s bad, anxiety and panic disorder are the same way. Once I am managing to keep my head above water again, the clonopin will feel too strong and I will switch back to the Ativan.
    No one wants to be on these meds forever. But I think the important thing to focus on is that IN THIS MOMENT AND FOR RIGHT NOW, this is what you need to do for your own mental health. If you worry about tomorrow or even 6 months from now, your head will start spinning and you get pushed off of the anxiety ledge and start falling towards panic. I want to also say… I am on the other side of the bi-polar spectrum having the 2 instead of the 1. Drs have been treating my depression and anxiety for 20 years, to no avail. You can treat the depression all day, but if you don’t treat the mood swings, you’re fucked. Which is how I was living.
    Also deserving an honorable mention is the fact that finding a GOOD psychiatrist is extremely difficult. Prescribing Ativan and sending you home and not seeing you for another 3 months is irresponsible and unethical. You’re putting a band-aid on the festering wound.
    Sorry for the long winded post, but this is a subject I have studied extensively and consider myself to have an extremely good understanding of psych meds, though I am by no means professional. But it does pain me to see how many people go to their family drs for mental issues (which is like getting a burger at a Chinese restaurant) or have psychiatrists who just push drugs rather than monitoring you, checking in with your therapist and refuse to understand that our moods and mental issues can change just like anything else, so being closely monitored is EXTREMELY important.
    Whew! If you ever wanna wax mental, please feel free to email me at Best of luck to you.

    Liked by 1 person

    • Sorry… I forgot to add… you never mentioned what dose of Ativan you’re on. I was taking a 1mg pill several times per day. With the clonopin, I take a .5mg in the morning and IF I need to take it again, it’s around 5 or 6. If you’re taking 4mg of Ativan at a time, then I would say it’s a problem. But people are prescribed doses up to 2mgs. I don’t use it for sleep because once it wears off, I’m awake. I don’t like ambien because it makes me depressed, so I use temazepam and Trazodone. Do I hate that I can’t sleep without it? Absolutely? Do I hate staying up all night and feeling even worse? Absolutely. We do what we can to get by from day to day. Don’t beat yourself up over it.

      Liked by 1 person

    • I always carry my Ativan with me in my messenger bag when I go out into the world. I never leave my house without it. It always makes me feel so much better. Thank you for sharing this information. It is very irresponsible to not see my psychiatrist for three months but I don’t have control over that. Thank you for connecting.


      • Just to clarify… I didn’t mean it would be irresponsible on your part not to see your psychiatrist but every 3 months, I meant on their part to just give you mind altering chemicals and send you on your way without any follow up besides a “come back in 3 months to see how you’re doing”. Especially with the “increased risk of suicide” warning on most medicines, though I don’t really subscribe to that theory or the idea of suicide coming from antidepressants or whatever.
        I tried to somehow tag you in a post that I wrote but I’m not sure if it worked correctly. It’s called “The Real Me”. I wrote it today. Thank you.

        Liked by 1 person

  14. Pingback: My Continued Struggles with Ativan – The Bipolar Writer

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