Managing Anxiety Without Benzodiazepines

Why This Matters

If you’ve been prescribed a medication like diazepam (Valium), lorazepam (Ativan), or alprazolam (Xanax) for anxiety, you’re not alone. These are called benzodiazepines. They can help in the short term, but over time they can cause more harm than good.

This fact sheet explains the risks of benzodiazepines, safer alternatives, and what you can do to feel better and stay well.

What Are the Risks of Benzodiazepines?

While they may work quickly, benzodiazepines can lead to problems like:

• Dependence: Your body may rely on them to feel calm.
• Tolerance: You may need more over time to get the same effect.
• Withdrawal symptoms: Stopping them suddenly can cause anxiety, insomnia, and other symptoms.
• Memory and concentration issues
• Falls and injuries, especially in older adults
• Worsening anxiety in the long term

Understanding BIND – Benzodiazepine-Induced Neurological Dysfunction

Some people experience a condition called BIND, which stands for Benzodiazepine-Induced Neurological Dysfunction. This can happen during or after long-term benzodiazepine use — even if the medication has already been stopped.

What is BIND?

BIND is a long-lasting condition that affects the brain and nervous system after benzodiazepine use. It is not withdrawal — it’s a separate condition that can continue even after withdrawal symptoms settle.

Symptoms of BIND may include:

• Ongoing anxiety, panic, or fear
• Dizziness or balance problems
• Trouble concentrating ("brain fog")
• Feeling emotionally numb or overly sensitive
• Tingling, burning, or other nerve sensations
• Sleep problems
• Mood swings or feeling detached from reality

Why it happens

Benzodiazepines change how your brain’s calming system works. After long-term use, the brain may struggle to return to normal, and this can cause lingering symptoms. These aren’t “all in your head” — they’re real and physical.

Is BIND permanent?

No — most people do recover with time and support. Healing can take months or sometimes longer, but it’s possible. The key is avoiding re-starting benzodiazepines, and using other safer strategies for anxiety support.

Good News: There Are Safer Alternatives

Many people can manage anxiety well with non-addictive options that work in the short and long term. These include:

Breathing Techniques & Mind-Body Practices

Great for: Mild to moderate anxiety, panic attacks, or those wanting natural approaches.

• Box Breathing: Breathe in, hold, breathe out, hold – each for 4 seconds.
• Cyclic Sighing: Deep breath in → little top-up breath → slow sigh out.
• Daily breathing practice can reduce stress, improve sleep, and build calm.

🧘‍♀️ Many people feel better without needing medication at all!

Propranolol (a beta-blocker)

Great for: Situational anxiety like public speaking, or if your anxiety causes physical symptoms (racing heart, shaky hands).

• Helps with calming the body, not just the mind.
• Doesn’t cause sedation or dependence.

Clonidine (for nervous system calming)

Great for: Anxiety with a lot of physical symptoms, PTSD, or if you also have ADHD.

• Can help reduce nightmares, restlessness, and overactive thoughts.
• May be useful if other medications haven’t worked well.

Who Can Help You?

You’re not alone. If you’re feeling anxious or concerned about your medication, talk to:

• Your GP (General Practitioner)
• A mental health professional
• An Addiction Medicine Specialist or General Physician
• A psychologist or counsellor to learn tools and techniques that really work

What You Can Say to Your Doctor

• “I’ve heard that benzodiazepines can be risky long-term. Are there other options I can try?”
• “Can we talk about non-medication ways to manage my anxiety?”
• “I’d like to feel better without needing to rely on something long-term.”

You Deserve to Feel Better – Safely

There is strength in seeking help with anxiety. You deserve treatments that won’t create new problems later on. Many people feel better using safer options — and so can you.