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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5808
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Hi Kate I just finished sending you a question but Im not

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Hi Kate: I just finished sending you a question but I'm not sure it went through so I"m sending it again.

Today is the 5th day of my 5 day withdrawal and you were right - it wasn't anything I couldn't handle. Praise God!

My question today is how long do you think it will take for me to begin feeling the effects of the one less .5 XanaxXR? I would imagine it would take a couple of days for my body to get adjusted to even not having the .25 dose.

I'm calling Dr. Hernz tomorrow to tell him I did okay and when can I go down another .5. I don't know if he'll want me to wait a few days to see how this went or just tell me to go ahead. I know we have to do it slow because we don't know what shape my brain chemicals are in or how much I need or don't need regarding keeping the panic attacks in check.

Once we get my thyroid in balance, if it needs meds, then I'd like to go down to no Xanax and use only anti-depressants to keep the attacks in check. But one thing at a time.

All I want to know now is when can I expect to experience clearheaded thinking and calmness that I used to. I so want this over and done with.

Until I hear back from you,
God bless,



That is good news! I'm glad to hear that you have had no real side effects from the withdrawal. Praise God indeed!


I'm not sure that you will feel much of a difference with the next level of withdrawal. Even though it is more of a reduction than before, you have your dosages so spread out during the day and you are taking an extended release medication, which is a constant in your system. This means that you are not introducing the medication, having it metabolize then reintroducing it again like you would on the regular Xanax. So a reduction in your medication means that you just have a bit less in your system. It is not as much stress on your body as regular Xanax withdrawal would be.


I also believe that you are not as sensitized in your reaction as we thought you might be. Your body is able to handle more and is stronger. You are getting support and you are in a good place right now. People do not realize how mental health affects physical health. For example, you can actually talk yourself into a headache. When someone is stressed, they experience the stress physically. So how you think about this affects it more than you realize. And this time, when you began your withdrawal, you had good support around you. You thought about this in a better way. So your body reacted better to your situation and you had a better experience.


You are handling this so well, Rita. I really believe that you are going to come through this and feel so much better than before.


Let me know how your next reduction progresses and what Dr. Hernz says.





Customer: replied 5 years ago.

Hi Kate: I'm not sure I understand what you're saying. Maybe I used the wrong words to explain what I'm looking for. Are you saying I shouldn't feel any more alert as I taper down to one .5 at 10 a.m. and another at 10 p.m. than I do now taking a total of 2mg. 4-5 hours apart?


It seems to me taking a smaller dose with more time inbetween would be less sedating than a larger dose taken closer together.





No, I wasn't saying that. I was just saying that you should not experience greater side effects as you reduce your medication. I misunderstood. I thought that you were asking about side effects of increased reduction of medication. Sorry about that.


I would imagine that you would continue to recover your alertness as you taper down off the medication. That makes the most sense to me.



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Customer: replied 5 years ago.

Hi Kate: I just spoke to Dr. Hernz regarding my next dose to taper off.


Either he forgot or changed his mind about how many days he wants me to taper off but he told me to wean off for 7 days, not 5 as he said earlier. That's fine with me because I'd rather go slower than too fast.


So one more day of lowering the 5 P.M. dose, then he said if I'm not having any anxiety problems, I should lower the 10 pm dose (1mg) by taking one .5 and 1 .25 for one week. That will take me up to next Wednesday, if everything goes okay. That Friday, the 12th, I have an appointment with the endocrinologist regarding my thyroid. Perfect timing.


After I see her, Hernz and I will reevaluate what to do next. If things go okay, there is only one more .5 that I take at noon that I'd like to get rid of and then I'll be back on the dosage I was before this all began.


We're only talking about a couple of weeks here and I'd rather go slow and sure than have to go back up again. If I need to take longer than 7 days to wean off to feel comfortable, then that's what I'll do. I decided no more whining about getting what I want when I want it.


I never thought I'd finally get where I am today, so the light at the end of the tunnel is getting brighter and brighter. Praise God!!


God bless,




Rita, that is excellent news!! I am so happy for you. I knew this would come about for you. You have the strength, you have the support and you have God on your side.


I agree, I think the longer period of tapering is a good thing. The longer your body has to get used to the lower dosage, the better. And it does put you right up to your appointment with the endocrinologist so that is perfect timing.


Do you have questions you are going to ask the endocrinologist? You and I have talked about many of your concerns and I wondered if you are considering making a list of questions so you can get some of them clarified while you are there.



Customer: replied 5 years ago.

I am having a really bad morning, Kate. My fault, though. After I emailed you, feeling so on top of things, I began thinking about withdrawal and all the complications that I had read about and started getting really anxious.


Then on top of that I called my daughter around 10:30 and I told her how I was feeling and how scared I was about going down another .5 and what might happen. Totally bad timing before going to sleep, so of course I had an anxious nights' sleep and woke up just as anxious as I was last night.


What is wrong with me, Kate? Is this just me doing this to myself? Please tell me truthfully, (I am counting on you) is the way we're going off the xanax a good way? Please be honest with me. Are things going to get worse rather than better?


Maybe if I tell you what I did yesterday might explain why I'm feeling like I did. I didn't even tell Dr. Hernz. Okay, since yesterday was the 6th day after he told me I only needed to go off 5 days, and he hadn't called me back yet, I decided on my own to replace my noon .5 with a .25. Since I had stopped my 5 o'clock pill, that meant I wouldn't be taking another dose until 10 PM. And since my first pill of the day was at 7 A.M., that meant there would be 17 hours between doses, except for the .25. I don't know what I was thinking. Of course when I began thinking what I did later that afternoon, I began getting panicky and did take a .25 at 5 o'clock.


According to Dr. Hernz, one of the things that was really important was to take my meds at the same time every day within reason, which I didn't do yesterday. I should never have dropped the noon time dose. So what I'm feeling this morning (remember, it's my bad time) might be part of why I'm feeling anxious. I definitely will be taking my noon dose in a short time and one more 5 o'clock dose to make it a full week.


I know this is convoluted but could you answer me another question? Do you think I should wait a couple of days before starting a new withdrawal routine? Dr. Hernz didn't say to but I was just wondering.


Please don't worry about getting in trouble with being truthful with me. I think you realize by now I would never do anything to hurt you. Just be honest with me like you would if we were on the phone talking to one another.






You are ok. There is nothing about of the ordinary wrong with you. This is anxiety. Anxiety can make you feel exactly as you are feeling now. You are right, you thought about this and thought about it to the point that you created anxiety for yourself. Your thoughts created this, nothing else did. Your medication is still fine and you are ok.


Anxiety is about control. Having control, having understanding and details are very important to you in dealing with your Xanax withdrawal. When you decided to go on your own and reduce your medication yourself, you realized you felt out of control. This was not Dr. Hernz telling you to do this (safety net), but yourself. What if you were wrong and triggered panic? What if you somehow hurt yourself and began to feel horrible again? This is all related to anxiety. The control you had before felt gone. It really wasn't, but you told yourself it was. That is the anxiety producing thoughts that made you feel this way.


But this is not a bad thing. Not at all. It is showing you that this is what is underneath your need to have control. Letting go is an important part of recovering from anxiety. It's realizing that nothing is going to happen to you if you do let go. Think of all the people out there who are on medications. Sometimes, they forget to take their medicine. Sometimes the doctor tells them to take one dose and they take another (cutting pills in half, such as some elderly do to save money). Nothing happens to them. There are others who are weaning off Xanax like you are. They may be doing it differently. Nothing will happen. They may notice how they feel, and they may not. It's all about how anxious you feel about it. Anxiety makes you not only want control, but it wants details and it wants to know exactly what is going to happen. Because to not know the future is too anxiety arousing and therefore dangerous.


I understand exactly how you are feeling. But you are completely normal. Nothing will happen to you if you detour somewhat from what Dr. Hernz said to do. Doctors know how to work with medications but they also are human. They do what they think best according to how they are trained and their experience. Another doctor may have you doing something completely different with your medication. So you are not going to be harmed by a slight change or a different regimen.


Rita, I do tell you the truth in everything. It is only about what you need, and that is what I am here for. I do you no service if I fudge the truth or try to make you feel better by not telling you the truth. I will always be honest with you. And what I told you here is the truth. You are having anxiety. And you are ok. Anxiety has never hurt anyone, just made them feel bad. You are fine. You are talking with me and making complete sense.


Try some of the things we have talked about before. The books, links and other resources are there to help you deal with your anxiety. They are a comfort, things you can do to feel more in control. Pray about how you feel. Take a deep breath and repeat to yourself that you are ok. Because you are.


I'm here for you whenever you need me,



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Customer: replied 5 years ago.

I know I can trust whatever you tell me, Kate. I just wanted to ask you some questions that might have crossed over the line and wanted you to know you could trust me even if your answers didn't agree with my doctor.


You are so good for me, Kate. What you wrote back was just what I needed to condemnation, just acceptance and have a true heart of God.


I went to a neighbor's house this afternoon who had her own bout with Xanax years ago and she told me the same thing you did, that anxiety was part of the withdrawal and to pass my time by doing something else. After our talk and what you had to say in your return email this morning, when it came to 5 o'clock I knew I didn't need the extra .25 dose and didn't feel any anxiety whatsoever, so I didn't take it.


I will lower the dose tonight at 10 - one .5 and one .25. I'll be okay. You were so right about me getting anxious because I was afraid I did something wrong. I certainly don't feel that way any more. Thanks for showing that to me. Sometimes I need to be told about something that's right before my eyes that I'm not seeing.


I feel sort of excited about starting weaning down tonight. This is the dose that bothered me the most, both mentally and physically. I know that doesn't mean I probably won't have some bad times because my body has been under a lot of stress for three years straight (I did tell you about my husband and what we went through in 2009, didn't I?).


I'm tired tonight and will be in bed extra early to read and get a good night's sleep.


Thank you again, my dear friend...


Rita, you are very welcome. That was very nice to hear. I am heartened that my response helped you so much. And your neighbor sounds like a wise woman!


Anxiety is a tricky thing. It can really play with your head and make you think something is really wrong. But once you confront it and know what it is, you take it's power away. And that is exactly what you were able to do. It not always easy to see that it's anxiety causing the problem. You did the right thing reaching out.


Remind me what happened with you and your husband in 2009. I think you might have told me but my memory is not what it used to be!


Let me know what happens with your next reduction. I can't wait to hear.


Have a good night!





Customer: replied 5 years ago.

Kate, I've been doing a lot of thinking and I came to the conclusion that until my brain has had a chance to be left alone on one dose regimen long enough to really adjust and mainly rest, I am going to be experiencing anxiety randomly and without reason. My poor brain chemicals have had so many drug changes continually for almost a year and a half, one on top of the other, with no time in between long enough to adjust. It's just going to take time for me to feel like myself again and there's no use in trying to fool myself it will be any different. And all the drugs have been "bad" meds, from steroids to opiates to benzo's.


Kate, you will not believe this but I left writing to you to go downstairs to watch an old movie with my husband for two hours. Just at the very end of it, around 4:30 a sudden anxiety attack came over me, out of no where. My husband encouraged me that it would be OK. The timing is just what one would expect....yesterday was my first day without taking my 5 PM .5 dose of Xanax, so obviously my brain (or is it my body) is not yet adjusted to being without it.


I walked outside to put up my car windows for the day and then sat on our yard swing for a few minutes and then came up here to finish this. It has almost passed. I think the one mistake I also made was not eating a good lunch and here it is dinner time. I have to learn to take care of myself, don't I?


I'm so proud of myself. I didn't panic or get upset like I usually would. The one thing I told my husband when he asked me if I wanted a pill was that no way would I do that or else I would only prolong the undertaking.


I'm going down to get something to eat. We don't usually cook on Friday nights but I do have something in the freezer.


God bless,




That is really good news! You really handled the panic attack well. You felt it and let it pass. That is exactly how to handle panic attacks. You can "fight" your panic by allowing it to flow over you. Relax into the panic. The more you can relax, the faster the adrenaline dissipates.


Panic often comes on when it's least expected. That is normal. But the more you learn how it sneaks up on you, the better you can control it. Remember to keep track of your thinking. Are you feeling afraid? Is your self talk negative? Are you worried? These kinds of thoughts can cause the anxiety to build and create a panic attack when you least expect it.


Also, you are right about taking care of yourself. For now, until you figure out all of the medical issues, getting enough rest and eating enough is the best option. After you get all the results of your tests, then you can see what is medical and what is the anxiety.


I am happy for you, Rita. You are really making headway with the anxiety. Your insight is excellent and your efforts to work on this problem make all the difference.


I hope your evening goes well. I'll keep you in my prayers,


Customer: replied 5 years ago.

Whew!!!!! Today has been the worst day yet. Continuous anxiety and shariness but I'm getting through it. I'm not upset or worried about how I'm feeling and that's because of what you have taught me, Kate. It might be uncomfortable but it's normal under the circumstances and not a sign that I'm going backwards. It really is a sign that I'm going forward in my recovery. Am I right? ;-)


I figure it can't last forever...maybe today and tomorrow and then lessen as my brain or body adjusts to the lower dosage. Am I right? ;-)


Actually the very fact that I'm not stressing out over how I'm feeling is a tribute to you, Kate. Remember how bad I was mentally and physically plus emotionally a couple of weeks ago? I was a wreak! And look at me today. Your words of comfort and explanation of what was happening in my body and mind plus a multitude of other uplifting things have helped me beyond measure to go through with this pretty calmly.


Of course the fact that I told the Lord this morning to please carry me today because I knew I wouldn't be able to do it on my own might have something to do with it, Am I right? ;-)


God bless you, Kate.

xxoo Rita





Oh Rita, you are so right! That is such good news I could not help but smile a big smile. I am so happy for you right now!


Yes, it is completely normal to have many panic attacks and anxiety when you are recovering. That is right, you let it come and wave over you. It is so hard and I admire your strength through this. It takes one tough person to face panic attacks and anxiety and get through it. I often thought of all the people in the world, those who suffer from panic are some of the bravest of all.


Thank you for all the kind things you said. I feel humbled. But the credit really goes to you. I was just the guide. You have done all the hard work. And you continue to push and face this problem.


Prayer can make such a difference. I can't think of how many times I have prayed and told the Lord, I just can't do this. It is the strength that gets you through.


I could not be more happy for you, Rita. I truly believe that you are going to recover and live the life you have been dreaming of.





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