Alprazolam (Xanax) anti-anxiety medication can be a lifesaver for those in the throes of panic disorder, generalized anxiety disorder, or social anxiety disorder. However, like any drug, there are potential side effects and risks associated with taking Xanax. One of the most common concerns among Xanax users is, “Can Xanax make anxiety worse?”
The answer is a bit complex, but the short answer is yes – using anti anxiety medication like Xanax for long periods can lead to worsened rebound anxiety. Fortunately, anxiety is one of the most highly treatable conditions, meaning people can learn to cope with their symptoms more effectively over time. If you’re using Xanax to treat anxiety, here are some risks you should consider and ways to manage anxiety in the long-term.
What Is Xanax?
Xanax (also known as alprazolam) belongs to a class of drugs called benzodiazepines. It works by enhancing the effects of GABA, a neurotransmitter in the brain that helps to calm down excessive activity and slow down nerve impulses.
Xanax, in addition to other benzodiazepines like Valium, Ativan, and Klonopin, are commonly prescribed to help treat:
- Seizure disorders
- Anxiety disorders
- Sleep disorders
- Amnesia
Risks of Xanax
Xanax is usually only prescribed for short-term use. Studies have shown that Xanax is associated with increased risk of:
- Addiction
- Withdrawal
- Cognitive decline
- Motor vehicle crashes
- Hip fracture
Substance Use Disorder and Xanax
Additionally, the risk of overdose deaths increases especially when Xanax is used in combination with opioids and alcohol. One study in North Carolina found that the overdose death rate among people receiving benzos and opioids was 10 times higher than among those only receiving opioids.
The best way to minimize your risk of overdose is to take your medication as prescribed and to stay away from drugs and alcohol completely. Unfortunately, this can be difficult for those who use substances as a way to cope with anxiety, and those who have a dual diagnosis of anxiety and substance use disorder.
Rebound Anxiety and Xanax – Can Xanax Make Anxiety Worse in the Long Run?
It’s clear that, despite its risks, Xanax can provide relief for people and quickly reduce severe symptoms associated with anxiety and panic disorder. These include symptoms such as racing heart, sweaty palms, and incessant worrying. But what happens after the initial relief subsides? Can Xanax make anxiety worse?
Some patients report that their anxiety symptoms return with a vengeance while taking Xanax or once they stop taking it. This is known as “rebound anxiety,” where the original symptoms of anxiety are worsened once the medication wears off. Rebound anxiety is usually short-lived and starts 1-4 days after stopping Xanax.
Severe Withdrawal From Xanax
It’s important to note that rebound anxiety is not the same as withdrawal from Xanax. For those who have developed a physical dependence to Xanax, abruptly stopping the medication can lead to withdrawal symptoms such as:
- Sleep disturbance
- Irritability
- Increased tension
- Hand tremors
- Difficulty concentrating
- Nausea
- Weight loss
- Muscle pain and stiffness
- Headaches
- Seizures
- Psychotic reactions
Along with these withdrawal symptoms are increased anxiety, panic attacks, and palpitations. If you have been abusing Xanax or are on a higher dose, it’s never a good idea to stop abruptly. While you may worry, “Can Xanax make anxiety worse?” and want to quit, it’s essential to consult with your provider before stopping.
Common Xanax Side Effects
Beyond the risk of rebound anxiety, Xanax use also comes with a range of side effects that can affect the body and mind, even when the medication is taken as prescribed. Common Xanax side effects include:
- Drowsiness and fatigue
- Dizziness or lightheadedness
- Blurred vision
- Dry mouth
- Trouble concentrating or memory lapses
- Changes in appetite
- Slurred speech
Most of these effects are mild and tend to fade as the body adjusts, but some — especially drowsiness, dizziness, and memory lapses — can become more pronounced with higher doses or when Xanax is combined with alcohol or other sedatives. If side effects feel severe or don’t improve, it’s worth checking in with the prescribing provider rather than adjusting how the medication is taken on your own.
Can Xanax Make Anxiety Worse the Next Day?
Many people notice that their anxiety feels worse the day after taking Xanax, even after a single dose. This next-day effect is different from rebound anxiety, which typically develops after regular, ongoing use. Instead, it often comes down to how quickly Xanax leaves the body. Xanax has a relatively short half-life, so as the drug wears off, GABA activity in the brain drops back down — sometimes below where it started. That dip can leave a person feeling more anxious, irritable, or on edge than they did before taking the medication, particularly if it was used during a stressful event, after a poor night’s sleep, or on an empty stomach. Anyone who notices this pattern repeatedly should talk to a provider about how Xanax is being used, rather than reaching for another dose to manage the next-day symptoms.
Treating the Root of Anxiety
Anxiety can make people avoid certain situations, places, or people, or turn to using other substances to relieve symptoms. But avoiding triggers or relying on medication can make anxiety worse in the long run. If you’re wondering, “Can Xanax make anxiety worse?” The answer is that relying on Xanax and avoiding triggers is maintaining your anxiety disorder.
While it might seem counterintuitive, the best approach to managing anxiety is to face your fears and learn healthy coping mechanisms. Here are some steps you can take.
Consider Dual Diagnosis Treatment
Dual diagnosis treatment can be beneficial for people living with anxiety and substance use disorder. If you rely on Xanax, alcohol, or other substances to relieve anxiety symptoms, dual diagnosis treatment can help you address both issues simultaneously. By addressing the root cause of anxiety and finding healthy ways to cope, you can heal from both your anxiety disorder and achieve long-term sobriety.
Engage in Individual Therapy
There are many different types of therapy that can help reduce anxiety symptoms and teach you healthy coping mechanisms. These include:
- Cognitive-behavioral therapy (CBT) to reframe negative thinking patterns and behaviors.
- Dialectical behavior therapy (DBT) to learn mindfulness skills and regulate emotions.
- Exposure response prevention therapy (ERP) to face fears gradually in a safe environment.
These are just some of the many different types of therapy that can help you manage anxiety. A therapist can help you find the best therapy that works for you, in addition to engaging in talk therapy to help you develop better anxiety coping skills.
Consider Medication-Assisted Treatment
Dual diagnosis treatment, individual therapy, and other forms of therapy like group therapy are a great way to begin addressing anxiety. However, for some people with severe addiction issues, medication-assisted treatment (MAT) may also be necessary. MAT can help manage cravings and alleviate withdrawal symptoms so that a person can focus on their recovery from anxiety and addiction.
Feel Relief From Anxiety Today
For those wondering can Xanax make anxiety worse, Xanax can be a good way to begin to manage anxiety. However, for long-term relief, it’s always best to consider psychotherapy and mental health treatment. At Atlanta Recovery Place, our addiction treatment in Atlanta offers a range of dual diagnosis treatment programs, outpatient treatment, sober living arrangements, cognitive behavioral therapy, 12-step plans, and more to help you find relief from anxiety and addiction. Stop masking the symptoms of anxiety and start addressing the root cause today. Reach out to us today to learn more about our comprehensive treatment options and begin your journey towards a happier, healthier life.
Frequently Asked Questions (FAQs)
1. Can Xanax actually make anxiety worse?
Yes, Xanax can make anxiety worse in some cases. While it is effective for short-term relief, long-term use or misuse may lead to increased anxiety due to tolerance, dependence, and withdrawal effects.
2. What is rebound anxiety from Xanax?
Rebound anxiety is a sudden return of anxiety symptoms after the effects of Xanax wear off—often more intense than the original anxiety. This happens because the brain adjusts to the drug and reacts when it leaves the system.
3. Why does Xanax sometimes worsen anxiety over time?
Several factors contribute to this:
- Tolerance: You need higher doses to feel the same effect
- Dependence: Your body relies on the drug to feel calm
- Withdrawal: Anxiety spikes when stopping or reducing use
These can create a cycle where anxiety becomes worse instead of better.
4. Is Xanax safe for long-term use?
Xanax is generally intended for short-term use. Long-term use increases the risk of dependence, withdrawal symptoms, and worsening anxiety, so doctors usually recommend alternative treatments for ongoing anxiety.
