After my own experience with extreme depressive anxiety and obsessive thinking, I am not surprised to see a new study in Biological Psychiatry suggesting that patients with severe depression display low levels of GABA--an inhibitory neurotransmitter that "applies the brakes" to excess brain activity by calming overactive neurons.
Sedative drugs like benzodiazepines, which are used to treat anxiety, seizures, and sleep disorders, enhance GABA efficiency. Although a number of antidepressants already work on neurotransmitters like serotonin, dopamine, and norepinephrine, a GABA-centered therapy could be a new approach to treating depression.
Study - The role of GABA in severe depression
In my case, benzodiazepines were used off-label to treat my extreme anxiety and discomfort at the worst of my depression. I can't begin to describe how helpful these drugs were in allowing me to function during this period. At its worst, depression paralyzed my mind with obsessive thinking about past transgressions. Although I was aware that my level of guilt and obsession was irrational, I was unable to steer my thoughts in any other direction. The intrusive thoughts felt like a strong rip tide sweeping me toward insanity, and the harder I tried to swim against the current the worse things got. At my lowest, I could barely hold down a conversation, had stopped eating, and was in a constant state of discomfort -- I would lie in bed for hours at a time unable to go more than a few seconds without the thoughts. When I eventually got up, I was unable to do anything but pace around the house. There was no activity that was comfortable--not lying down, not pacing, not talking. I would switch from one to another only to find that the pain plagued me regardless of what I was doing.
Benzodiazepines were a godsend in my situation. They didn't restore control over my intrusive thoughts -- it wasn't until months later that I found Lamictal and finally regained most of that control -- but they turned down the volume long enough for me to be moderately functional. I was able to eat again, avoid taking time off from school, and engage with others enough to feel like I hadn't completely dropped out of everyone's life. Benzodiazepines bridged the gap in time between the onset of acute symptoms and finding an effective, long-lasting treatment.
Although benzos can be dangerously addictive, when used under the care of a professional they can go a long way toward restoring function in patients whose lives have been turned upside down. I imagine they are a bit like morphine for the mind -- not good for you, but necessary in certain situations to make life livable.
In my case they took a huge burden off my family as well. Before starting the drug, we almost had to cancel a long-planned vacation to Hawaii because I was so sick. After my first few doses I felt confident I could make the trip -- even if it wasn't under ideal circumstances. The change in my ability to function was enormous -- it was like the difference between being in a wheelchair and walking with a limp. And since I was more functional, I was also able to take responsibility for my own healthcare rather than burdening my family with arranging appointments and constantly monitoring me.
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