Prozac Nation Is Now the United States of Xanax

I'm sympathetic to your pov, but those big traumatic events likely left huge scars on the psyche of the previous generations. The PTSD was not being diagnosed at the time.

Big struggle may not be the recipe for mental health.

This resonates with me. I would like to add age element. When I was younger learning to a ride a bike was an all consuming objective and a big achievement. I didn't need an alarm to wake up to go try riding again. This was followed by the different big schools, football matches against what always seemed were bigger boys ... Each one all consuming.

Being a middle class grown up is not inspiring. Work, code, moderate exercise (no more football), meetings, dinner, pay bond, repeat. Its been pretty much the same for the last 15 years in my case.

They lived through fear during the war, lessening the anxiety they likely felt pre-war. Things look an awful lot like the relatively peaceful and comfortable times before the last wars, and the military advances are terrifying since then. This is where anxiety thrives.

Don't just look at the big stuff. Look at the everyday environment.

I've had -- partially bad luck; partially trying to accomodate bad advice from authority figures -- a horrible time trying to achieve simply a quiet living space. And a peaceful work environment.

It's not "big, dramatic stuff", but it has dragged on me, day in, day out.

Jobs used to be more secure. Neighbors, even if they were jerks, didn't have so many instruments with which to be so loud. And neighborhoods tended to have more cohesion, including allies when you needed to deal with the jerks.

A lot of people are not being shot at. They are just being chronically, highly stressed. In everyday ways that add up.

P.S. Yes, definitely a U.S. perspective. I'd say "first world", but an increasing portion of the U.S. is actually in the process of leaving the first world, if it ever was in it.

But, there is a level of social isolation here, and a lack of a sense of allies and someone who "has your back", even if at the same time someone else is trying to "take you out".

I guess I can't really compare. I don't have the experience. But, for a lot of people in the U.S., the everyday stuff is plenty stressful. And, it never goes away.

I just finished listening Joe Rogan's podcast with Sebastian Jurgen [1] where they talked about humanity's need to be involved in society in order to feel happy. While they talked Jurgen mentioned something interesting that I've never heard before and don't know if true or not. He said that the survivors of The Blitz in some weird way missed the time that they spent hiding in the subway tunnels of London. Similarly, many veterans missed the combat after arriving back home and settling back into normal life. The obviously didn't miss the horrors. They missed the comradery. They missed the purpose they had. Their lives were all of a sudden critical to their own survival and the survival of others. And I too believe that our often sedentary way of life is the reason why we fall into depression and anxiety. We are starved for deeper meaning.

[1] https://www.youtube.com/watch?v=W4KiOECVGLg

Humanity has had big big challenges up until maybe about the industrial revolution. Then we had us a couple of wars to deal with. The post-war period has been a new era of human evolution, one in which survival is a given for most people, expansion through conquer and war is mostly out of the question, and even scientific discovery - yes - has seemed to plateau in recent decades. Not to say all of these things affect some people, but each of these is diminished on a population scale. With industrial agriculture there is a lot of food to go around, nuclear weapons make total war a thing of the past, and the low-hanging fruit of scientific endeavor has been picked. Major advances come from large teams with big funding, much more than, say, the enlightenment or the industrial revolution. Most people alive today in first world nations face no existential threat or deep motivation for betterment, not like in the past history of humanity. In the history of humans, this is not normal, we're built for striving and surviving, and fighting each other for territory and resources. We have been honed through thousands of generations to be ambitious and cut-throat and daring. But the future calls for a different ethos, one of efficiency and moderation. One where economies cannot grow indefinitely, and wars cannot be waged. Where people can find meaning outside of labor, as pretty soon we won't need human labor - physical or mental. The more likely scenario is that we will see a regression before that future hits us, the expansionary drive is too ingrained in the human psyche and societal norms. War will come, sooner or later, and give a 'purpose' to the world. And I fear this is unavoidable.

Came here to say basically this. It can take months or years to taper down. I've seen a lot of people prescribed a lot of benzos (Klonopin specifically but also others. I think there are rules about how Xanax can be prescribed in my home state) , even when my peers and I were younger. It seems to me that these drugs are surprisingly accessible to people with the right resources. Unless there is no other way you can function taking Klonopin for long term

To my untrained eye being prescribed any benzo for extended daily use seems like it should be an exceptional treatment, but maybe I'm wrong.

I have started to take a more active role in my wife's ongoing treatment for this very reason. While I generally like her doctor, his willingness to bounce from drug-to-drug in an effort to treat her depression and anxiety is incredibly troubling for me as someone who grew up in a society where medication was seen as a last resort in the treatment cycle.

She has now been on Xanax, Cymbalta, Lyrica, Klonopin, Ativan .... I could go on. Every time she begins a new medicine or comes off an existing one is a trying time for both of us as the side effects (both mental and physical) can be incredibly brutal.

Oh my god this is such a true statement!!!

Unless you want to be curled up on a couch for 5 days and sleepless with your muscles and forehead visibly spasming every 15 seconds, DON'T take any benzos, and DON'T quit them cold turkey.

I had the misfortune of experiencing this first hand, but others have had it much worse, going into seizures and dying after trying to quit benzos for years.

There are definitely other treatment options. Don't mess with benzos unless you absolutely cannot bear an acute situation!!!

Good luck to everyone who is truly suffering out there! You can make it through !! :)

Aside from being a terrible experience, death is also a possible side effect of benzodiazepene withdrawal.

I wonder why drugs like propranalol and gabapentin aren't used more as first line treatments for anxiety. Propranalol is particularly effective in treating anxiety without the potential for abuse.

Is there a tipping point as to how much you can take and quit without experiencing withdrawal effects? I'd think it would affect everyone individually, but it would be interesting if there was a safe amount of time.

I made this account specifically to reply to this comment.

I take Klonopin. It is the ONLY thing that works for me. I have tried nearly everything. Every form of therapy you can think of, basically every class of drug to treat anxiety...

But Klonopin (benzos) are the only things that allow me to function enough to work and provide for myself. If I didn't have Klonopin, I would be without a job and would be homeless. I would literally be unable to function outside of the house (by function, I mean interact with people, work, go to the grocery store...), until I were forcibly removed because I haven't paid rent in months.

So if this attitude you and others share continues to embed itself into the minds of doctors, then people like me will be left without proper care. And what that means is that people like me will be unable to work, and unable to slog through the process of acquiring disability (and trust me, it's hard as hell), so we will be homeless or forced to burden our families with our care. It's not some abstract issue, one that can be handwaved away, one that you can distance yourself from by saying "the drug is bad so it should not be used with regularity; those who need it with regularity can instead be treated in other ways". There are zero other ways, in my case, and I am sure in many others' cases too.

Sorry if I seem accusatory, but people's insistence that these drugs be given only for short periods of time is in effect an insistence that I be left without any options after that short period of time expires.

Just smoke some weed on the weekend, works better than antidepressants.

Sadly, you need the right strain - if you live in a state where cannabis is legal, you're lucky.

I have 3 different types right now, only one is actually good for anxiety and stress, the other 2 make my thoughts race. And I can't choose what I buy, the dealers tend to go for high THC content because it gets you high. I suggested the lower THC plants and they said I'm crazy.

Not contradicting your statements, but I thought I would offer a single anecdata point for a different perspective.

I take Alprazolam (generic for Xanax) in a low dose (0.25mg) 2 or 3/day. This makes the difference between my being able to work and not, so in my case it is certainly effective and beneficial. I haven't noticed adverse side effects at this low dose level.

After over two years of use, I haven't felt any need to escalate the dose. I have only one experience stopping (as an experiment). Disabling anxiety returned in less than five days and persisted without change for 3 weeks. Stopping was otherwise not difficult, certainly not "seriously horrible". Resumption of the med after four weeks off returned me to manageable anxiety levels in two days.

I've considered the tradeoffs inherent in long-term use and have decided for now to continue. Things that could change my mind about this: absence of relapse into disabling anxiety after an experimental stop; unambiguous demonstration of damage caused by long-term use; appearance of a better alternative.

Check with your doctor before using this med. There are contraindications and adverse interactions with other meds.

Further, anxiety is highly idiosyncratic, therefore YMMV. My mother was essentially disabled by chronic anxiety for her last 3 decades, and I suspect I'm predisposed to chronic anxiety. Others will of course present differently and need a different treatment plan.

Not preaching just curious did you try any diet changes?

I got tested for hypothyroidism after my hair started falling out one day. I had a TSH level of 64.0.

My body was effectively screaming for more thyroid hormone.

I've also had high levels of anxiety and cortisol, I wasn't aware of the relation though. Unfortunately hypothyroidism is so common place that my doctor's don't really give me the info. I'll read through your links to find out more about this.

EDIT: After reading the chronic exposure article I think I'm going to avoid adrenalin releasing activities for a while. Coffee and intense video games :)

Thyroid test is the first thing psychiatrist look at when dealing with mood disorder. Wouldn't this kind of problem be diagnose and treated immediately? Or are the "standard" tests not accurate enough? What kind of "non-standard" tests should one be asking for?

While we're at it, we should also add sleep apnea to the list of disorders to screen for. Sleep apnea causes anxiety. Estimates of prevalence range from about 1-2% at the low end to 30% for certain demographics. And increasing with time due to changes in the facial skeleton. Diagnosis rates remain low because the symptoms can be difficult to trace back to it and there's low awareness among doctors still.

Counter-anecdotally, this worked the opposite way for me. I had a pretty shitty childhood and had panic attacks until I was about 24 and realized it by googling air hunger. Prior to that, I was so clueless that I thought that my regular inability to fill my lungs was due to my minor allergy issues or something, and had no idea why I would seemingly unpredictably start sweating and (separately) why my heart would beat rapidly sometimes.

Being able to identify the problem made it way easier to handle, even before I started actively trying to fix it with things like mindfulness. These days whenever I notice air hunger, I stop and think what I might be anxious about and am usually able to reason my way out of subconsciously freaking out (even if it's as simple as "this isn't going to make it _more_ likely that the situation resolves well").

It seems just as likely to me that more awareness of anxiety will work in the opposite direction from what you're describing, mitigating anxiety off for people earlier since they're able to start recognizing and managing it earlier through greater awareness.

> Anxiety about anxiety is probably the most dangerous kind.

So the prose was effective! Sometimes being dry and objective is not the best way to get across a point.

The New York times? I don't think so. They're not pushing any crises, they're just reporting what's going on in the world. Maybe you're a bit biased.

>People are stressed because they are never free.

I disagree that this is the root cause. News media and social media have both become extremely efficient and high speed conduits for "stress loading" upon our population.

A local news story used to only isolate the stress to a small locality; now, however, mass media is amplifying and propagating this local stress all around the country. It's only going to get worse.

> Yes this might not apply to the upper class tech of hacker news but they are not representative of the vast majority of people.

It should be clear that this doesn't encapsulate the problem if there's a reasonable segment of the population feeling the same effect without being subject to the same causes. And the stuff you're describing is on the order of 20% here, not 1%.

Care to recommend any good books?

> Drugs for depression may not make enough money these days since there is insufficient evidence that they really do much.

Ignoring the fact that I'd like to see your evidence for the latter claim, there certainly hasn't been a drop in prescriptions of antidepressants or a lack of new patented (and popular) ones.

There's a huge difference between hallucinogens and tranquilizers. People are probably seeking help for anxiety or depression, not just going to a doctor for a physical and ending up with a prescription. Anxiety medication has been around for a long time, thus isn't patented, so it is unlikely that your drug company conspiracy theory holds water.

> drugs like LSD are illegal because it might change how your brain works

Drugs like LSD are illegal because people enjoy them in a non-medical context, enough to become a visible cultural phenomenon. This is the entirety of what motivates (or at least used to motivate) US drug policy.

I might be misunderstanding where you're coming from, but presumably the concern isn't for medicating the anxiety, it's for the prevalence of anxiety itself. If there's a novel high incidence of anxiety across the population, how is that _not_ interesting? Is the concept of concern for other people really that alien to you?

Hell, even if we stick with your model of "why would I ever care about another person's well-being", understanding that anxiety is apparently so common can help an individual better understand where his anxiety is coming from (eg perhaps weighting universal factors more heavily than personal ones).

But I'm a nobody and I feel great when I meditate.

Is it because I don't occupy my mind with any memory or thoughts of that problematic?

The world feels splendid when you don't keep in mind your past or future experience of it.

If reading a piece of text makes you have an anxiety attack, the problem lies in you and not in the fact that that piece of text was published.

This is getting ridiculous.

Probably the opposite, as people then now would be scared of all the crisis happening without them knowing it ...

No, they're making the point that anxiety is both sociological as well as biological, and that the sociological dimensions of anxiety have worsened. I'm not sure I agree either, but is that so hard to gleam from TFA?

Here's a book that adds to this point that mental illness "spreads" in a social contagion sense: https://www.amazon.com/Crazy-Like-Us-Globalization-American/...

>Is this article really drawing a conclusion that nobody was anxious during the 1990's?

No.

>This article is a great example of "unless it's reported by the media, it doesn't exist."

Why?

It's a great example of the nytimes and the media having to create stories in order to sell ads.

The easiest way to get clicks is to sell fear. "Opioid" crisis. Trumpaggaedon. Ebola/SARS/etc. "Your child might die from this!!! Click to find what it is before your child might die! Click NOW!"

Think about it. If absolutely nothing happens in the world, the "journalists" have to write something to sell themselves and make the newspaper money.

These people are no better than clickbaiting youtubers.

Also, fear and anxiety are great ways to control and manipulate the people. It's what north korea does to its people. It was the nazis did in the 1930s.

Just like reading the bible critically is the cure for christianity. As a former 7-day subscriber to the NYTimes, reading the NYTimes critically is the cure for propaganda.

and the way they are presented as "alerts" creates more suffering than it's worth.

Alerts should be for things like tornadoes, floods and hurricanes, not upcoming birthdays.

And even more fundamental than that, most of us are unprepared to deal with such intimate knowledge of one another. The goody-goodies are losing it when they realize how much suffering there is in the world. It makes us all feel so powerless (if we let it).

Humans apparently evolved to have enough memory to deal with about 150 personal relationships... We're now pervaded with human contact and persona from thousands of people at varying distances...

And our mistakes, instead of being dealt with on a personal, intimate level of people nearby to us are projecting outwards to the entire globe! And stored there indefinitely!

I liked playing low-res video games and calling BBSes, but this world-wide persistent network is too intense!

Been taking Lexapro for over two years now. Started at five, moved up to 7.5 and ultimately been settled at ten for the last year and a half. Have not seen side effects (I was deathly afraid of something like ED but if anything my sex drive is enhanced thanks to no longer being depressed).

It has been one hundred percent effective. If I miss a day, I know (and so does everyone else). We (psychiatrist and I) tried to see if I had gotten past the point of needing it by tapering off. Didn't work, so I'm back at ten, probably for life. That's fine, there's way worse medications to be dependent on!

> Would grateful to hear anyone's experience taking SSRI's (Zoloft, etc.)

The experience of others doesn't mean a darned thing. Each person's biochemistry is highly individual which is why the success rate of treating various mental disorders using medication is so low.

I, for example, get rapid tolerance to just about everything, so even the few SSRIs that worked didn't help for long.

I'm on Lexapro (very low, 2.5 at the moment but normally 5mg. 7-10 mg causes tension headaches for me) and have also taken zofoft, celexa, lithium, and also the usual Ativan/Xanax thing as well as a bunch of other meds years ago. The SSRIs have side effects for me so I battle with them constantly, going off for many years, getting back on, etc. However, they are side effects I know very well and are all fairly benign compared to the kinds of side effects associated with other antidepressant classes. And they work, they make it more likely that any given thought or sensation is just going to be... What was I thinking about? Like that. My depression / anxiety are very ruminative. When outward stressors are lower, I like to lower my dose which leads me to be a bit more creative and also reduces other side effects, but I become more emotionally reactive - a thing i practice a lot in trying to recognize in a flash and control. It's a lifelong struggle.

If for the sake of argument we presume the postulate true and we envision a better informed future could a company such as Google (or others) be obliged to a point where past a certain threshold social media and media in general adjust one's exposure to counteract people's unhealthy impulses?

For example, if (Google) knows you are living beyond your means then ads targeted change in aspect from aspirational to more basic needs and the news and social media surfaced to you modify so that you feel less stressed and less out of a loop till the time you have more disposable income?

(just a thought experiment)

> Anxious people are more likely to over-consume

Do you have a source for that ? (Eg empirical study)?

> are more likely to 'stay tuned in'.

Same?

Media and advertising may result in increased anxiety, but it's a bit conspiratorial to imply that its a concerted effort with anxiety as the goal. I feel like it's more of a perverse incentive.[1] In media (in the news in particular), stressful stories get more attention, so they are reported more aggressively. In advertising, companies can sell more of their product if they can make you feel insecure, and then sell you the purported remedy. When it's difficult to feel calm and self-assured, it's easy to feel anxious.

[1] https://en.wikipedia.org/wiki/Perverse_incentive