The Xanax Equivalency: Translating Medication Into Lifestyle

Jerry Gelbart, MD
Dec 14, 2014
9 min read

Updated: Aug 18

Back in the 60’s, according to Mick Jagger, Valium was “Mother’s Little Helper.” Other than alcohol, it was probably the #1 coping tool. An appropriate dose would relax and calm the recipient, make everything feel OK. Valium is very addicting. By the 90’s it was mostly replaced by Xanax. Although Xanax is even more addicting than Valium, it does have its benefits: it’s better at lifting the mood and less likely to accumulate in the body. Both are basically “band aids” to numb the recipient and manage symptoms simply, quickly, and temporarily.

Yesterday I was talking to a patient about the value of her yoga class, her swimming, and her social time. We got into comparing how she felt after these activities, versus how she felt after taking a Xanax. Of course these activities require prioritization, time, effort, and financial resources. Way easier and faster to take a pill. But it was clear that for her, these activities led to feelings of relaxation, inner peace, and pride. These and similar routines also begin to address areas that have been neglected in life.

Are you using chemicals, such as tranquilizers, alcohol, or caffeine, to help manage stress or anxiety? Would you rather use more natural and sustainable methods of regulating your moods? Shifting from chemicals to a healthier lifestyle takes some work but if it’s important to you, then you can modify your routines. Making these changes will not only reduce your need for chemicals, it will also elevate your quality of life to a whole new level!

Many activities and routines can help optimize body and mind. That means that if you prioritize and give these activities special attention you will function at your best, feel better, and live longer. Likewise, ignoring these important activities can cripple you.

Below is a partial list of activities. These activities can cover several categories at once. For example, outdoor recreation can be spiritual. As your going through the list, you can take an inventory:

1. Which of these areas are working well for you? Which need work?

2. What does it mean for you to take care of yourself biologically, psychologically, socially, and spiritually? (it looks different for everyone!)

3. Which activities are critical for your immediate wellness?

Biological

Nutrition/Diet

Healthy meal planning, shopping, cooking and eating

Exercise

Every other day, stretching, aerobic, cardiovascular, musculoskeletal

Outdoor Recreation

Your doses of sunlight and fresh air

Body/Mind

Yoga, Tai Chi, others

Sleep

Healthy sleep schedule and routines (look up “Sleep Hygiene”)

Psychological

Mindfulness practice

Routine practice of being in the moment and disengaging from judging

Self-soothing activities

On a regular basis!

Creativity

Music, art, dance, writing, inventing…

Self-Challenge

Stimulating activities that are challenging but do-able

“No self”

Activities that get you so absorbed you don’t think about yourself Life Of Values- Living and acting on your values

Love and Compassion

Giving and receiving

Social

Sense of community

Feelings of belonging and connecting with others

Relationship building & tending

Growing your network and improving/maintaining existing relationships

Setting boundaries

Getting some distance from relationships that are unhealthy

Family

Bonding time and fulfilling responsibilities

Fun Activities

Sharing your hobbies and interests with others

Spiritual

Meditation

Clear your mind and get clarity - doesn't have to be sitting still!

Contemplation/inquisitive

Asking “Why?”

Contemplation/appreciative

Accepting, gratitude

Religious/Spiritual practice

Feel connected to something/someone bigger than yourself

Living healthier includes examining your values… What’s important and what you consider the “right” way to live. If you’re considering making changes to your life, the best place to start is to examine and solidify your values. Everything will fall into place from there. When you live your values you can be guilt and anxiety free, and feel good about yourself.

When you do review your values, you will find that self-care is up there. That’s what this article is about. Most people can see it would be hard to be depressed or unhappy when living a life that includes these activities on a regular basis. When engaging in these activities, and for a time after, we often forget about our pressures, give our body a chance to unwind and rejuvenate. That includes stabilizing hormones and the immune system.

What gets in your way of making the lifestyle changes necessary in order to be “Optimally well?”

Let's explore some common excuses. Expand whichever ones seem relevant for you.

"I don't have enough time"

Let's do some math. Below I have used the average - you can plug in whatever numbers better fit your reality.

24 hours multiplied by 7 days = 168 hours in a week

Minus 56 hours for sleep each week (8 hours sleep per night)

Minus 40 hours of employment per week

Minus 20 hours padding (commuting, working extra, parenting, etc.)

168 - 56 - 40 - 20 =

52 hours extra

Where do those extra hours go?

Solutions

The right solution depends on what is the problem. Be honest with yourself about what the problem is and be realistic about what would help. Schedule your time wisely. Little by little learn what you need in order to function optimally, and prioritize those activities.

Are you spending lots of time doing something?

You may have too much on your plate, or you may not be doing things efficiently. If you have too many things going on, you may need to lessen your load.

Be honest with yourself and others about what you can realistically handle long-term.
Set boundaries, practice saying "no", and maybe ask for help.
Prioritize your physical and mental health. If necessary, practice in front of a mirror: “I’m sorry I can’t do that because if I don’t _________ (exercise, meditate, etc.) then "I won’t be able to function well.” Or “You won’t wanna be around me.”
Be more efficient with your time by combining activities to cross categories. For example: go on a walk with a friend, or listen to an audiobook while commuting.

Are you spending lots of time doing not much of anything?

There are several physical/mental health issues that could be contributing to a lack of motivation and energy, including (but not limited to) depression, anxiety, ADHD, thyroid conditions, sleep disorders, etc.

Speak with a medical provider about what you are experiencing to obtain a diagnosis and explore targeted treatment options.
Schedule the activities and do them even if you don't feel like it.
Pick activities that are easily accessible and enjoyable.
Start with adding and maintaining a couple routine activities, and then build from there.
Find some motivation with activity tracking devices and mobile apps, like smart watches and habit tracking apps.

"I feel guilty"

This is about self worth, and setting boundaries. It means that you consider needs of others, and deny your own.

Often people say they feel like they don’t “deserve” to put their needs before those of others. But...how can you do a good job of helping others if you are unwell?

In order to effectively help others you have to be functioning well, which requires taking care of yourself - physically and mentally. In this light, you are actually supporting your ability to help others by taking care of yourself.

But remember: You deserve to experience wellness, whether or not you're helping others! Work on that feeling of being deserving. I recommend listing out, in writing, the pros and cons of the activity. I have a bit of a different method of this than you may have seen. As an example we will use physical exercise.

What are the pros of prioritizing physical exercise?

Body works better: Less injury/illness, live longer
Mind works better: Happier, better social interactions, remember things better, better brain processing
I feel more in control of my life

What are the cons of prioritizing physical exercise?

I have to do things for myself even if I don’t feel like it
I have to plan my day, week and be more deliberate and intentional about my time
It requires time: Less time to give to others, have to say "no" more often to people

Now let's flip it!

What are the pros of NOT prioritizing physical exercise?

I don’t have to say “no” as much
No one gets mad at me
Just do whatever comes up
Seems easier
I don’t have to take responsibility for my body

What are the cons of NOT prioritizing physical exercise?

More stress, anxiety, depression, unhappiness
Experience illness/injury more often: Brain and body don't work as well
Worse quality of life
Feeling resentful
Probably have a shorter life
Not feeling in control of life

Summary

Prioritizing physical exercise leads to better quality of life and more able to effectively help others.
NOT prioritizing physical exercise leads to falling apart over time and less able to effectively help others.

"I'll fail"

The only way you can fail is to not try at all. You can define for yourself your own biological, psychological, social, and spiritual goals. Don't use someone else's measurements, but try to work your way up to the guidelines that are produced by scientific research.

For example, research suggests that spending 2 hours a week in a "green space" is enough to improve health and general well-being. A "green space" could be a local park or some other natural environment - whatever you have easy access to and will feel physically and mentally safe in. Maybe at first you can only muster up a 30 minute walk once a week in your neighborhood park, and that's a good start. What it means for you to engage with nature may look different than it does for other people, and that's okay!

If you have tried to engage in these activities and was unsuccessful, then whatever you tried may not have been right for you.

You may have taken on too much at once, got frustrated and gave up. It's better to start small, feel encouraged by building those habits, and work your way up.
Maybe the activity wasn't accessible enough, or you didn't enjoy the activity. Choose activities that you will enjoy more and that are more accessible.
If your schedule fell apart and you found it difficult to make time, see the other section above.

If you are really struggling - consult with a professional to explore the problem and brainstorm realistic solutions:

Doctors: Diagnose and treat physical and mental health issues
Psychotherapists: Diagnose and treat mental health issues, clarifying values, setting goals, executive functioning coaching

"It won't help"

There is plenty of serious scientific research that has shown, time and time again, that:

Click the links to view related research.

Research proves that engaging in these activities to any extent will improve your mind and body.

So...what makes you think that you are the exception? Is that logical? Challenge this thought by telling yourself:

"I am human, and this helps humans. It will help me too!"

Fake it till you make it

Pretty soon you will experience the benefits yourself, and then you will know from experience that it is beneficial!

"I don't have enough money"

Many healthy activities can be done cheaply or at no cost. You can spend a lot of money on a health club, or walk or jog for free. Similarly, you can pay for a meditation class, or many churches, synagogues, and Buddhist centers give free classes. Activities with friends can be expensive or cheap.

Free/Discount Fitness

Many Medi-Cal plans offer a gym membership at no cost.
Many other insurance companies offer free or discount gym memberships.
Some insurance companies offer discounts on fitness tracking devices and at-home fitness classes.
Check with your insurance company to explore your perks!

The Cost of a Gym Membership

The cost depends on your location and the quality of the gym. It could be as low as $10 a month, or $500 a month!

When choosing a gym and signing up for a membership, always double-check the fine print about how to cancel a gym membership. Some gyms make it really hard to cancel and then you are locked-in!

Cheaper gyms include:

Community recreation centers (these often have discount programs based on income and household size)
Planet Fitness
24 hr Fitness

It’s very easy to make excuses for not taking care of our basic needs, take a pill, and suck it in. It takes more effort to initiate lifestyle changes, but once you get going, it becomes easier to maintain long-term, and overall you will be happier and healthier.

Trading Pills for Lifestyle Changes

Which pills do we need, and which can we potentially get off of? When does this trade happen?

Most people have a lot of judgments about psychiatric medications, and those who take them. Medications can be useful, even necessary for some. They are not good or bad. Those who take psychiatric meds are not any more “defective” than those of us who don’t, and often they are less “defective” than people who are afraid to take meds because of how they’ll be judged. If you are on prescription medications you should work closely with a doctor and potentially a psychotherapist.

I see many people who would suffer less and be more effective if they were on the right meds. I also see many people taking medications who would not need them if they changed their lifestyle, priorities, and learned to be assertive about their needs.

We know what “Illness” is: you are sick and you have symptoms. “Health” is when you are not sick - but that does not mean you are well. “Wellness” is when you are actively living your bio-psycho-socio-spiritual program. Work out your Wellness Program and strive to stick with it!

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