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When Parker Posey’s character Victoria Ratliff first uttered “Lorazepam” on The White Lotus, I was flooded with feelings that ranged from wistfulness to horror. While some viewers were curiously Googling “What is Lorazepam?” I was wide-eyed and on high alert, wondering: How would the popular show portray a woman who was clearly addicted to—or at the least, reliant on—the prescription drug that almost ruined my life?
My relationship with the benzodiazepine Lorazepam, also known as Ativan, began when I was a teenager: In the beginning, when I was prescribed the benzodiazepine drug by my psychiatrist for my paralyzing anxiety, there were no warning signs of its dangerous side effects. I took it on an “as needed” basis when I felt the terror of a panic attack coming on—like when boarding a plane (I was also on antidepressants and in therapy). It worked like a charm, almost immediately calming my frayed nerves and queasy stomach. I carried the Rx bottle everywhere “in case of emergency,” my prescription safety blanket.
It wasn t until almost 18 years later, after I had my second child, a daughter born in 2018, that Lorazepam became a “problem” for me.
Benzodiazepines have been prescribed to treat severe anxiety, panic, and sleep disorders as well as seizures since the 1960s—the drug tells your brain to release a neurotransmitter called GABA (gamma-aminobutyric acid), which calms your body and mind, as well as sometimes results in drowsiness. “Outside of the hospital, these drugs are generally prescribed for anxiety disorders that don’t respond to other medicines,” says Daniel Morehead, MD, the Director of the Adult Psychiatry Residency Program at Tufts University in Boston and author of Science Over Stigma. “However, Benzodiazepines should not be a first line of treatment for severe anxiety,” he explains. “They should be used in conjunction with an SSRI, talk therapy, exercise, and other coping strategies such as meditation.”
This drug class colloquially called “benzos” is a controlled substance and includes Xanax, Klonopin, Valium, and Lorazepam or Ativan. Benzodiazepines have become polarizing in the psychiatry world—especially in the past few years as an increasing number of people take them: The percentage of adults in the United States who filled a prescription per year from 1996 to 2013 increased by about 30%, with an estimated 92 million benzodiazepine prescriptions were dispensed in 2020 according to the FDA. They are also more frequently prescribed to women, due to higher rates of anxiety disorders.
Benzodiazepines are, in fact, the third most commonly misused prescription drug in America, and they can be particularly dangerous when combined with other substances such as alcohol—something we saw on White Lotus when Victoria passed out during dinner after chasing a Lorazepam pill with wine. “We tell patients not to mix Benzodiazepines with alcohol because they can become much more impaired than they realize,” says Dr. Morehead. “Once you’re in that state it’s harder to control yourself.”
There’s also an ongoing debate as to whether benzodiazepines can be safely used in the long term: According to Dr. Morehead, the drugs are most commonly prescribed for four to six weeks. Because of their habit-forming nature, taking benzodiazepines for a longer period of time at minimum may cause dependence—with more extreme cases having side effects like impacted memory and cognitive ability. People who take them for longer also find it tough to stop because of withdrawal symptoms i.e., increased anxiety, panic attacks, and tremors (aka some of the very things you were taking the drug to avoid).
During my first pregnancy, I insisted on going off of all drugs including my SSRI because I was worried about their impact on the baby. Post-birth, I experienced crippling postpartum OCD, paired with anxiety and depression. I was defiant about not taking medication while breastfeeding, but my obsessive thoughts became so intrusive that I couldn’t function—so my psychiatrist encouraged me to go back on the same SSRI I had taken my entire life, and prescribed me Lorazepam again, on an as-needed basis. For the two and a half years I was on this drug cocktail between my babies, I didn t have any negative side effects. In fact, the opposite—I was able to focus on motherhood.
The same psychiatrist advised me to take Lorazepam every day after the birth of my second child to stave off the crippling postpartum anxiety. This time, I would not say it worked like a charm—mothering an infant and toddler still caused a painful amount of anxiety—but I was able to take good care of them, even enjoying some of the early days with my infant daughter that I hadn’t been able to enjoy with my son. I appeared to be a high-functioning, working mom in New York City, commuting daily to my high-stress job at a startup, scheduling and attending all of the doctor appointments and kid activities, going to barre class, and planning elaborate birthday parties. I was so grateful that this combination of drugs and therapy seemed to be “working.”
Until it wasn’t working. Around my daughter’s first birthday, I began to notice the downsides of taking Ativan over a long period of time: My memory had become patchier and patchier. This wasn’t just misplacing my phone and keys like most moms do—remember how Victoria can’t remember meeting Kate at a baby shower? Classic Lorazepam side effect. I noticed that my short-term memory in particular was disappearing, I simply couldn’t recall where I had parked the car or what I had for breakfast. Everything started to feel more hazy–bedtimes started to all blur together and I would pass out in the kids’ rooms sometimes. But it can be hard to parse the memory effects of a prescription drug versus the effects of being sleepless for years because you had two babies.
After I finished breastfeeding, I also started drinking more—the way I did before I had kids. On some semi-conscious level, I knew I shouldn’t drink after taking Lorazepam when I was around my kids—even a Benzo couldn’t quiet my anxiety that something bad would happen to them, something I would be devastated by. But there were a few adult nights out where I passed out in an Uber or couldn’t remember how I got home.
It was terrifying: I knew something was wrong and I needed to change but felt stuck in a vicious cycle. I didn’t like how reliant I had become on taking Lorazepam every day, so tethered to it. I would start panicking if I couldn’t fill my prescription. I really didn’t like that I had started taking these drugs so I could be less anxious and more present around my children–and now it increasingly felt like I was less present and more focused on when I could take the next pill. So around my daughter’s second birthday, I worked with my psychiatrist to “taper” my Lorazepam intake, slowly decreasing the amount I took every day until I was only taking it every few days. Benzos are notoriously difficult to get off of and can cause severe—even fatal—withdrawal symptoms when not guided by a doctor.
“Problem” solved, or so I thought. Then, during the pandemic I was laid off, caring for two children under five and overseeing remote Kindergarten. The final straw for me was when we had to sell our apartment and temporarily move into another apartment—this pushed me over the edge, and I started taking the pill every day—in a way not prescribed to me, and sometimes I took two. My desire to stave off the panic had become more insidious. After a weekend away with friends during which I passed out and became incoherent, I returned home and resolved to get off Lorazepam for good. I was embarrassed by my behavior and knew I had passed a point of no return—I was going to lose a lot more than my short-term memory if I continued down this dangerous path.
The withdrawal was awful—I would shake and sweat then get the chills, my heart raced, I couldn’t sleep, and felt suicidal at one point. My psychiatrist increased my SSRI and prescribed Klonopin to help take the edge off during the tapering period. I also started going to recovery meetings every day, which were invaluable. I would sit and listen, reluctant to share my story at first, scribbling down bits of wisdom on paper receipts that I carried around to help me wade through the withdrawal. I couldn’t have gotten through that period without the support of other people who suffered from addiction, it made me feel so much less alone. On top of the physical symptoms, I felt so guilty and ashamed. How had I “let” this happen as a mother?
It was only later—after months in recovery, a lot of therapy, and consulting experts like Catherine Birndorf, MD, a reproductive psychiatrist and cofounder of the Motherhood Center in New York City—that I learned I had serious risk factors that made me more likely to become dependent on Lorazepam: My anxiety diagnosis and childhood trauma that I had not dealt with made me more susceptible to addiction, as did consuming alcohol. “Most people don’t habituate to these drugs and they can be safely used even for a long period of time,” says Birndorf, noting that she would not want to dissuade vulnerable postpartum mothers who are already afraid to take medication, as I was once. Benzodiazepines did allow me to have a more functional, mentally healthy postpartum experience with my daughter. However, “a confluence of underlying factors predisposed you to misuse,” she explains, also noting that I was likely not taking a high enough dose of my SSRI.
On top of that higher dose, my current prescription for anxiety is regular therapy, exercise, acupuncture, and different forms of energy healing like reiki. I still go to recovery meetings sometimes. Lorazepam doesn’t have a place in my purse or in my life anymore, and I am so relieved to not be reliant on it. As much as a small part of me still wishes I could pop a pill and instantaneously relax, I don’t want to be panicking on a vacation because I don’t have enough. I want to be right here, which is actually on vacation with my children—a trip I very much intend to remember.