In the fall of 2019 I started having panic attacks. I didn’t know what they were at the time. Long standing health anxiety and some unfortunate google searches led me to believe there was something wrong with my heart.

I went to a cardiologist. He did every test he could short of a full blood vessel catheritization. Ultrasound, EKG, stress test, blood pressure, pulse, oxygen level. Everything was normal. He said it might be “psychological.” I was relieved.

But I continued having panic attacks. They were relatively infrequent – once or twice a month – but utterly debilitating and terrifying. I started to doubt my cardiac results. So I went back, and he did all the tests a second time. Once again, everything was normal.

Then one Friday evening, after pushing myself too hard in a game of full court basketball, I had a panic attack that nearly caused me to lose consciousness. Black spots bloomed across my field of vision. I lost feeling in my hands and feet. I couldn’t breathe.

The doctor from the US embassy, who had also been playing basketball, thought I was having a panic attack. He walked me to a lounge chair and had me lay down. He gave me a brown paper bag to breathe into and he brought me a sugary drink. It was 45 minutes before I felt well enough to stand up.

The doctor asked me if I had thought about seeing a psychiatrist. I had not. He also mentioned the possibility of medication. I want to be clear. He did not prescribe anything to me or even tell me I should look into one particular medication or another. What follows is purely the result of my own stupidity.

I started doing my own research. The Internet is an incredible place. But you can easily find yourself on the wrong path. I could have landed on a website about the perils of benzo dependency and withdrawal. Instead, I ended up reading a benzo boilerplate about their widespread use and their relatively low toxicity.

I didn’t come across any information about down-regulation of GABA receptors, cognitive impairment or brain fog. I didn’t read about the functional changes in the brain that benzo use can provoke. And nothing about the horrific withdrawal and the long road to recovery.

According to the information I found, benzos were the magic pills I needed. I went to the local pharmacy and picked up a box of valium (diazepam).

Just what kind of pharmacy gives out valium without a prescription? My local pharmacy in Bamako, Mali. To be fair, they did ask for a prescription. I said I didn’t have one and explained I was having panic attacks. And that was that. The freewheeling distribution of medication in West Africa is a whole other conversation.

To recap: I did not see a doctor. I conducted minimal research, and I purchased a course of benzos without a prescription.

In the beginning, I only took a dose (a dose for me was half a pill, so 5mg) if I had a panic attack, or if I felt like I had one coming on. Guess what happened next? I started having panic attacks more often.

Enter COVID

It probably doesn’t need saying, but a global pandemic is the last thing someone dabbling in a highly addictive anti-anxiety medication needs.

On March 26th, 2020, we closed our small hotel and restaurant in Bamako. We moved into the hotel with a group of friends and a small crew of staff. We couldn’t have asked for much more to be honest. We had plenty to eat and drink, a swimming pool and lots of sunshine. We were extraordinarily lucky.

But day to day life belied deep anxieties. The financial uncertainty on its own was overwhelming. We had recently completed a costly move after being evicted from our previous location. We were a long way from climbing out of that hole when we closed for COVID.

At the same time, my wife was pregnant. She was due at the end of August 2020. We had no idea how things were going to proceed with her scheduled check-ups, let alone the delivery.

Of course, there was also the health anxiety surrounding the virus itself. Every day we were trying to process new information about the virus’ transmission and severity.

What do you do when you have no work to do, nowhere to go, the world is collapsing and you live in a bar with a bunch of your friends? Please excuse this rhetorical question. I know plenty of people worked on their fitness during the pandemic, or they developed new hobbies and skills. I didn’t do that. I drank. A lot.

And I started taking benzos every day. Alcohol works on the same GABA receptors as the benzos and as your brain tries to restore some sense of equilibrium, you need to drink more (or take more benzos) to get the same effect. Ever hear of the term hangxiety? There is a reason we are anxious during a hangover. Our neurons are running wild as they shake off the GABA slowdown.

The pharmacy actually ran out of valium. So I started buying Ativan (lorazepam). They had 1mg pills. Five mg of Valium is equivalent to roughly .75 mg of Ativan. So now I was taking benzos every day and I had upped the dosage.

We eventually re-opened the auberge and restaurant. My wife Bintou gave birth to a beautiful baby girl. Everyone was in good health and we had avoided bankruptcy. Sounds like I might be able to stop taking benzos, right?

Wrong. Now I needed benzos just to fall asleep. I was fully dependent. I continued taking them throughout 2021.

Taste of Withdrawal

In May of that year, I had my first experience with benzo withdrawal. I contracted COVID while in Cape Verde and was forced to quarantine in my hotel room for 10 days. My Ativan ran out on the 10th day. A friend and I celebrated my release and negative COVID test by drinking profusely. What followed was perhaps the single worst experience of my life.

This would be the first time I would experience akathisia, a condition in which you are unable to sit still. I was pacing back and forth in the airport for hours. If anyone saw me on a security camera they would have likely had me arrested.

Restlessness itself sounds manageable, but there are other aspects of akathisia that you don’t see when someone is suffering from it. Those who have experienced it use words like “chemical torture” or “being tortured alive.” Many people have homicidal or suicidal thoughts during bouts of akathisia. It is a brutal combination of psychological terror and physical misery.

After 10 hours of binge drinking, I was going through alcohol withdrawal and benzo withdrawal. During the long layover in the Dakar airport I thought about seeking medical attention. I was with my friend, who was supportive and willing to do whatever it took for me to be ok.

But I worried about disrupting the trip further. I pressed on, teetering somewhere between losing consciousness and absolute madness. In hindsight, I am lucky that I made it back to Bamako without having a seizure.

When we landed in Bamako, I was hanging by a thread. We went straight to the hospital. After some initial confusion over whether I was still COVID positive or not, the doctor finally understood what was going on. He administered a sizable injection of valium, and I caught my breath for the first time in 12 hours.

I spent the night in the hospital. In the morning, a neurologist came to see me. He didn’t ask me any questions or try to learn about my situation. He prescribed 0.5 mg of Xanax to be taken twice a day and sent me on my way.

When that prescription ran out, I went back to taking Ativan. The pharmacy had run out of 1mg tablets and now they only had boxes of 2.5 mg tablets. I split those tablets in half, so I was now taking 1.25 mg instead of 1 mg.

This continued for another year. I drank regularly, took my Ativan and life was good.
Or so I thought.

Memory lapses and brain fog were becoming more common. I was constantly fatigued. And I never felt particularly good despite having low levels of anxiety.

Then I started learning about down-regulation of GABA receptors and benzo withdrawal. I never imagined that I was causing functional changes to the infrastructure of my brain. Down-regulation can begin after two weeks of use? I had been taking this stuff for over two years.

Jumping Off

In the hot season of 2022, sometime around April, I decided I would stop taking Ativan. The 1mg pills were in stock again at the pharmacy, so I dropped my dose by .25mg (I had been taking 1.25mg). After a month, I dropped down to .5mg. I stayed at this dosage for another month before dropping down to .25mg. I was at that dosage for two weeks. I jumped off on July 13th, 2022.

Please do not follow my taper. I should have switched to Valium (diazepam). I should have taken more time. Follow the Ashton Manual and speak to a doctor who understands the importance of tapering if you are going to stop taking a benzodiazepine.

In those first days following my last dose, I thought I might be one of those miracle one-percenters that have minimal withdrawal symptoms. No, it turns out I am just like everyone else.

On day 3, I had a fitful night of sleep punctuated by panic attacks and depersonalization episodes. This was after taking 50 mg of Benadryl. I woke up feeling like I did when I had COVID. Fatigue, heaviness, brain fog, a persistent headache. I actually took several COVID tests that day and canceled dinner reservations with family.

From this point on, my withdrawal spiraled. I had a full-on flu (I would later chalk this up to MCAS from the benzo withdrawal), which, let me tell you, was fantastic during COVID times. I couldn’t sleep. I regularly had panic attacks and bouts of depersonalization and derealization. Brain fog, palpitations, irritability, restless leg syndrome, tinnitus and spontaneous feelings of all-consuming anger and rage.

And then the Akathisia. It is a particularly cruel feature of our neural hardware that something like akathisia is even possible.

If something can go wrong with brain and body, it will go wrong during benzo withdrawal, particularly a withdrawal brought on by a hasty, inadequate or nonexistent taper. A well managed taper can make a big difference. I was as foolish in my plans to stop taking benzos as I was in taking them in the first place.

I am writing this nearly nine months after I took my last dose of Ativan. I still have a problem with histamine intolerance. I have had to adjust my diet to avoid flu-like symptoms, which can flare up almost instantly if I have a histamine-rich meal.

I may in fact have Mast Cell Activation Syndrome (MCAS). Benzodiazepines are mast cell stabilizers and their absence is wreaking havoc on more than just my GABA receptors. In that case, it may not be histamine intolerance I’m dealing with, but rather my aggravated mast cells flooding my body with chemical mediators, histamine being one of them.

I still can’t drink. I don’t know when I will be able to again, if ever. Alcohol is problematic because of its high histamine content (particularly beer, wine and colored spirits) and its inhibition of DAO (Diamine oxidase, the enzyme that breaks down histamine). It also interacts with GABA receptors and can act as kindling, re-igniting withdrawal symptoms.

I continue to have depersonalization episodes, but they are less frequent. I can say the same for my panic attacks. I still suffer from varying forms of cognitive impairment and memory loss.

This has been without a doubt the hardest thing I have ever done. And it’s not over.

But I’ve made progress. There was a moment in August when I lost all hope. Like falling into a bottomless abyss. Panic attacks, depersonalization, akathisia, terror. I got a glimpse of madness. I will never forget it.

From there to where I am now is a jagged line of ups and downs, but the overall trend is in the right direction. It feels like a small miracle just being able to say that.

I made this site to document my recovery and to share info and practices that I’ve found helpful. Everyone’s path is different, but I hope my experience can offer some lessons. If nothing else, I hope to provide support and commiseration.

If you are going through benzo withdrawal, you know how difficult it is to talk to people who have not experienced it. It is in another realm of human experience.

I’m here. I’m listening.

If you want to hear from me more often, join my email list where I send every-now-and-then letters about my recovery, progress and setbacks, and life after benzos generally.