Withdrawal is never good; withdrawal is especially detestable when it’s medically unsupervised in a foreign country. This was a lesson that I had to learn the hard way as I found myself feeling like Alice in Wonderland after she eats the cake marked “Eat Me” and suddenly becomes a disproportionate giant; monstrous yet fragile.
It was one of those days with an overcast gray sky and thick sitting air; the way Hollywood always portrays 1970’s San Francisco. Rickshaws sped past and cows roamed the road. It was a mere 24 hours after I decided that I was going to take matters into my own hands and end my addiction to Xanax.
I was already feeling the intense side effects of withdrawal. I was lightheaded and wobbly. Though there was no breeze, I felt unsteady, like I was swaying. My sensations of derealization were so intense that I felt as though I was levitating a foot above the hectic New Delhi street.
I began to convulsively gasp; I was drowning in the air in which everyone else seemed to be breathing just fine. As the scenes of my imminent death flashed in my head, I stumbled – slamming my sandal-clad foot perfectly into a glob of cow manure. I started to fold, and my vision went out of focus.
My American friend, Tyler, who had been around for the entirety of my anti-anxiety medication “over-indulgence” grabbed me by the wrist and dragged me the few blocks to the local cabstand. In broken Hindi, she somehow managed to communicate to the driver that we needed to quickly be delivered to the nearest hospital.
While this specific withdrawal-induced panic attack was just another episode of my four month mental unraveling, it wasn’t until I was being wheeled into the quaint, if not terribly outdated, Indian hospital that I realized how absolutely insane I not only looked, but had become. From my loosely fitting White-Boy-in-India linen shirt and culturally-inappropriate-above-the-knee shorts, to my cow shit strewn foot; from my sunken, absent eyes to my emaciated limbs; I had become the poster child of first world dysfunction abroad.
I was promptly brought into a room with stiff cots separated by retractable curtains. The nurses wasted no time in closing the curtains around me as to not disturb the other patients and their families.
I was in a sheer panic; I was shaking uncontrollably and my vision was blocked by the endless refills from my tear ducts. I compulsively moved two fingers back and forth from my neck to my chest as I searched for a heartbeat. My subconscious paranoia had taken over; I could feel no pulse. I plead for the doctors to save me. I was convinced that my heart was going to quit at any second.
These feelings were nothing new; I had spent every night of the past couple of months trying to coax myself to sleep while battling that sinking feeling that never failed to consume my mind. Each night, I was utterly certain that this would be the night that my heart would finally stop pumping blood through my veins. I was positive that this headache was actually an aneurysm ready to burst. All of these nights ended the same: After taking a few Xanax and chasing them with watered-down whiskey, I was able to subdue this fear of never waking up enough to finally drift into sedative-induced stupor.
Despite my familiarity with these psychophysical symptoms of anxiety attacks, the degree to which they were hitting me was incomparable to my prior experiences and the foreignness of the hospital wasn’t helping. Unlike in America, where every medical supply seemed to be readily available to the hospital staff, I was disturbed to discover that at this Indian hospital, the doctor gives the patient’s companion a list so that she can purchase each item – whether it is a pill, a needle, or an IV bag – a la carte from a desk in the lobby. Not only would this transaction involve overcoming a language barrier, it also meant standing in a long, slow-moving line.
Tyler had to continuously go back and forth from my bed to the desk to get my medical supplies. When you’re having an anti-anxiety-medication-addiction-withdrawal-induced-panic attack at a hospital in a less than modernized sector of New Delhi, the last thing a semi-privileged mildly-sheltered American wants is to be left alone. I worked myself into such hysteria that I began vomiting the remnants of my McSpicy Paneer, which I had foolishly mistaken as a home-away-from-home comfort food a few hours earlier.
I was l lying on my stomach with my head over the side of the bed retching into a bucket – all the while pleading both aloud and in my head for salvation. Cold hands pressed themselves against my lower back as my shorts and underwear were swiftly pulled down to my knees, leaving my butt completely exposed. In complete confusion I craned my neck to look at the nurse whose minimal spoken English abilities did not prevent me from knowing – from the locking of our eyes – that something painful was on its way.
“Breathe,” she said firmly as she jabbed what felt like the longest and thickest needle known to man into my semi-clenched behind. After the initial jolt of pain shot through my body, I began to feel an instantaneous sense of relief. She continued her work; shoving a cocktail of pills into my mouth while inserting an IV into my arm.
I looked up and tried to catch the nurse’s attention. I was still gently sobbing with streaks of throw-up smeared across my cheeks. When I caught her eye, I managed to whimper, “Am I going to die?” The nurse shook her head and giggled as she pushed her cart away.
The injection of what must have been Librium set in, and I began feeling woozy as my sense of imminent tragedy subsided. I silently sat up and peeked around the curtain. From my little area I was able to see a stoic younger woman hunched over the bed of an unconscious man. From the way her trembling fingers were entwined with his, it was clear that he was her husband; her beloved. His face was smashed; it was covered in blood, and he lay nearly lifeless, yet still breathing.
At the bed next to them were three adult-children gathered around an old man with an oxygen mask. He looked very much on his way out of this life, and they held onto each other as they came to terms with his impending passage.
Tacked directly on the wall in between their two beds was the calendar sold by Palna, the orphanage where I volunteered. Palna means, “cradle,” in Hindi, and the name was not random: A cradle was installed within the secure wall that surrounded the facility. Parents could drop anonymously drop their babies and small children off in the cradle – which was manned by security guards – when they could no longer provide.
For the month of November the calendar showcased the grinning face of the Shivani, one of the children I spent time with during my visits. I pictured Shivani, shrieking in delight as she played hide and seek in the open courtyards of the orphanage. She was mischievous, and sneakily pinched the other kids when she thought none of the adults were watching.
Utter chaos was occurring around me as patients and doctors zoomed in and out of the emergency room, but I fixed my stare upon Shivani’s two-dimensional smirk. I thought about the two patients and their families.
These are people with real problems, I thought to myself. What is wrong with me?
Two months before, in September, my dad had come to visit.
Waking up early, I took the metro to meet him at the New Delhi airport. The High Court of Delhi had been bombed the week before, and I had stopped taking the metro as the line I took passed right beneath the site.
On this morning, I convinced myself this was the most practical way to travel. I had always been adventurous, fearless. I had never been afraid of death, and now I needed to work up the courage to just ride the metro.
My dad’s visit coincided with my first (unsuccessful) Xanax detox, and as I sat on the train an old Sikh with a traditional sword sat across from me. I spent the next half hour of my journey thinking about all of the terrible ways my life could end from that cool metal sliding into my essential organs before being swiftly pulled out.
I completely lost it the second I met my dad at the gate of the uncharacteristically calm airport. He came off the plane beaming; he was so excited to be in India for the first time.
I began instantly weeping, and continued to do so for the entirety of the first two days of his visit. I confessed my feelings of anxiety and dependence upon Xanax. I tried weaning myself off of Xanax with his support, but his presence could not stop the withdrawal effects. I had constant headaches and debilitating waves of panic; my appetite disappeared and the tears just wouldn’t stop.
On the third night of his visit, we went for a walk in a beautifully preserved ancient garden. We watched the sunset as we sat on top of a structure that had occupied that space since the days of the Mughal Empire. I could not relax in the slightest or even notice the natural painting that lay before me. I sat in an auto-rickshaw with him and sobbed like I had not sobbed since I was a child.
He asked me why I had come to India, especially for six months.
“To try to fight inequality,” I bullshitted.
“How?” he asked.
And I could not provide him with even the simplest of answers; I honestly did not know.
“You came to run away from yourself,” he told me. “And I think you’re learning the hard way, that whatever you’re running away from will always catch up with you.”
He told me that the most glaring indicator of someone being mentally unwell is their complete self-centeredness and inability to speak about anything beyond themselves; for that entire week all I could talk or think about was how miserable I felt.
I remembered years before in high school when one of my friends had joked about my party boy-Valedictorian ways, “You have the most imbalanced existence of anyone I’ve ever met.” And here I was, years later, an ivy-league student abroad who had decided to come to India to pursue interests of social justice, but was instead spending his days drinking whiskey, taking Xanax and crying. I realized that he was right.
And now I lay in the hospital bed, having a teen-celebrity-style-substance-abuse-induced-breakdown in a windowless room. I tried to recount exactly how I had gotten to this point. I had always had a susceptibility to overwhelming anxiety and a slight tendency for self-medication – a Klonopin before a flight or a glass of wine when I was wound up before bed – but never would I have imagined myself having to be sedated through an injection because I was so terribly certain that I was on the brink of untimely death.
Over and over, I used the same piece of aging prescription paper to refill my stash. The first bottle of “take as needed” pills was only supposed to last a few weeks, but I had been taking quadruple dosages for months. I jokingly referred to the small change pocket of my wallet where I kept my Xanax as the “Land of Naughtiness;” it was an attempt to deflect attention from a glaring addiction.
I’ll take Valium to detox from Xanax, I convinced myself.
Becoming overconfident, I had tried to write myself a prescription for Valium on a piece of loose-leaf paper. When I took it to the chemist, the old man behind the counter had narrowed his eyes as he shook his head at my pathetic attempt. “No!” he said, wagging his finger in my face. I snatched the paper from his hand and left in a huff.
During my dad’s stay, I weaned myself off of the medication, but within a week or two of his leaving I relapsed. The whole experience shook my entire perception of an addict’s mentality. I was not in denial of being addicted to Xanax; in fact I was completely aware. I had reached a point where I believed I did not know how else to survive during my time in India.
I must attempt to make the addiction as functional as possible until I can return home, I told myself. When I’m home I’ll have access to an abundance of readily available psychotherapists and psychiatrists who can fix me.
But, I never thought to ask myself why I was so broken.
It had all begun in the most unsuspecting of ways. After spending a day shopping, my friends and I decided to have dinner in some nondescript, poorly lit, overpriced chain restaurant in an upscale Indian mall.
Midway through the meal I had a strange headache and kept losing focus; I had the terrifying sensation that my time to die was imminent. As I sat at the table and tried to continue the conversation, I kept having that same feeling as when you’re on the verge of sleep and you suddenly feel a sharp jolt of free fall until you crash back into reality.
I excused myself to go the bathroom, and started pacing in the corridor of the mall.
I can’t die outside of Gucci.
In retrospect, I had been on a massive alcohol bender, and this feeling was my first experience with withdrawal symptoms. But, at the time, all I could comprehend was that I felt like I was dying.
I finally told the others what I felt and one friend explained that I was having a panic attack, which she had suffered aplenty after experiencing a traumatic loss. “Just keep taking deep breaths and I’ll give you a Xanax when we get home,” she offered. I managed to get through the next hour by cycling deep breaths and drinking cold water. Once we got home, she slipped me the pill that I quickly popped in my mouth.
Within twenty minutes I felt calm and grounded. I was no longer afraid that I perish at any moment. Frankly, I felt happy, and realized I had not felt much but despair in weeks. I felt a relief I had missed.
And so it began.
When the terrifying panic attacks, and what seemed to be a permanent tension headache, kept coming back over the next couple of days after the mall experience, I went to see the University recommended physician. After a few moments of speaking with her, she quickly wrote me a prescription for Xanax and sent me on my way. Unfortunately, she failed to mention any addictive side effects of the prescription drug, or it’s dangerous interactions with alcohol.
Blissful in my ignorance – and functionally sedated – I continued the school-boy-by-day-party-boy-by-night lifestyle that my friends and I had fallen into. But everything became much more intense. When I drank alcohol with Xanax I had intense blackouts that were like being roofied. I would wake up the morning with literally no recollection of the previous night. But, I didn’t care. I dissolved Xanax in my beer, and popped it recreationally as I took shots at clubs.
I had to be filled in about my outlandish behaviors; I lost a shoe at brunch when I blacked out at 2 pm; I woke up under my bed; I lost multiple wallets and cameras; I cried about being financially stressed as I spent hundreds of dollars on wine in a single night at the most expensive bar in the city; I had to be carried into my apartment by a driver who was employed by my friend, like a corpse he slung me over his shoulder as he hauled my limp body up the stairs.
Even on nights that we didn’t go out, my routine was seriously affected by my medication and alcohol intake. I was anxious all of the time. I couldn’t fall asleep unless I took increasingly higher doses of Xanax.
I felt nauseous every time I ate. I began taking Xanax multiple times a day; I wanted to ensure the calm mental wave carried me from moment I woke up until the moment I fell asleep.
My moods gradually became less varied. I was no longer anxious, but I was also never especially happy or sad; I was unexpressive, blank. I felt detached from the people I loved; I was emotionally cold in a way that I never knew was possible.
One day, as I sat in an auto-rickshaw on the way to meet my friends, I observed the scenery and life of the Indian streets. It felt like a movie I was watching more than my reality. I felt so far removed from my “real” life, as though I were in some dream that wouldn’t seem to end.
Now I was in a hospital bed recollecting how I had gotten there; feeling like the world’s biggest hypocrite for all of the times I had made fun of Lindsay Lohan’s “exhaustion” hospitalizations. Powering through the stifling post-sob headache that brought me back to childhood tantrums after being grounded from TV, I searched my bed for my wallet. I found it near the edge of the bed, where it had fallen out of my pocket. I picked it up and opened the “Land of Naughtiness.”
I counted my pills. 15. Just enough to make it through the last couple of days before I would finally board my plane back home.
I’ll stop taking Xanax then, I told myself as I swallowed one of the small white tablets and allowed myself to drift away.
* When, I got home, with psychiatric supervision, I was able to successfully end my addiction to Xanax with a medically supervised weaning and long-term transition to antidepressants.