Loading practices
Loading practices
Areas › Worry and anxiety › Panic and the body
They work by strengthening the braking system the brain already runs, which is why they act quickly and why they need that braking chemistry to be present in the first place. The quieting is real and sometimes it is exactly what a person needs. What it is not is learning. A calm hour teaches the body nothing about whether the sensations it dreads could have been survived, so the work that does teach that still has to happen somewhere.
So truly where there is hardship there is also ease (Quran 94:5). The ease is placed inside the hard thing rather than in place of it.
الشرح
فَإِنَّ مَعَ ٱلۡعُسۡرِ يُسۡرًا
So truly where there is hardship there is also ease
Qur’an 94:5read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
In a large randomised trial for panic disorder, cognitive behavioural therapy and imipramine each did better than placebo, and combining them did not clearly beat either alone, so medication and psychological work are not automatically additive. The inhibitory-learning account of exposure supplies the reason that matters here: what shifts fear is the expected catastrophe failing to turn up, rather than the anxiety subsiding. Neither of those looked at benzodiazepines, so this is a general principle rather than a finding about this class.
David H. Barlow; Jack M. Gorman; M. Katherine Shear; Scott W. Woods (2000). Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder. JAMA doi
Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. (2014). Maximizing exposure therapy: an inhibitory learning approach.. Behaviour research and therapy doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A drug that takes the feeling away also takes away the chance to find out you could have handled it.
None of this is an argument against prescribing one for someone who is genuinely stuck and suffering.
The strengthened warning on this class covers misuse, addiction, physical dependence and withdrawal. The part most people miss is that dependence builds with ordinary correct use over weeks, with nobody doing anything wrong.
The speed is why these work and also what they cost. Relief that lands within the half hour is the most teachable kind there is, and what it teaches is to reach for it sooner next time.
Drug names ending in pam or lam are almost always benzodiazepines. It is a quick way to pick the class out of somebody's medication list.