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Tracey Marks, M.D. Headshot

Benzos, Stimulants and Sleeping Pills: The High-Performance Cocktail

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There is a popular Dolly Parton song from the '80s called "Working 9 to 5." At the time the concept of working 9 to 5 seemed standard. Today, you may not be able to keep your job if you expect to only work 9 to 5.

With the Internet, smart phones and tablets, you can work from anywhere at any time. Even if you are not working, you can take in new information, read articles, etc., in the 30 seconds you are stopped at a traffic light.

While surfing the Internet and keeping up with friends on social media may be fun, it has the net effect of producing too much mental stimulation, which can wreak havoc on your body.

Let's look at Lisa.

Lisa is a 38-year-old project manager who is on target to become a director at her company. She loves her work, but complains about having trouble keeping up with her responsibilities since the recent reorganization that left her team one person short. She has trouble completing tasks and usually needs to bring work home in the evening.

In response to her complaint of "not getting things done," her doctor prescribed the stimulant Adderall because Lisa said she has always had trouble staying focused. Lisa also has some marital problems. Her husband complains that she's always distracted and never wants to spend time with him. Lisa says all the stress of work and home causes her to have panic attacks. She then gets Xanax, a benzodiazepine, which helps her tremendously.

Lisa's company has a few large product launches each year and during this time, she stays up until midnight or later to finish her work and respond to emails from overseas. After a few years of this pattern, she now has trouble falling and staying asleep on most nights, even ones where she tries to go to sleep early. Her doctor recognizes the importance of good sleep and prescribes Ambien, which works on most nights.

Initially Lisa was pleased with how much better she was able to keep up with things, until she starting becoming more irritable, forgetful and unmotivated to work.

Lisa then wondered if she should be put on an antidepressant and sought a second opinion about this. When I asked Lisa about how she was doing at work, she said that although the Adderall helps her, she still finds that her attention starts to drop off around 10 p.m., making the rest of her evening unproductive.

This is a classic scenario I've seen with hard-working, ambitious people who have unrealistic expectations about how long a person should be able to sustain attention. If you start working at 9 a.m., your attention should drop off 11 hours later. Unfortunately, instead of living within her body's physical and mental limitations, Lisa was using medications to push herself harder. In her case, her cocktail of medications was serving the purpose of performance-enhancing drugs.

Lisa could keep up this pace in her 20s. After all, it's not uncommon for the college student to go to class all day, study until late in the night and pull all-nighters with no obvious mental or physical detriment. But nearing 40, Lisa was burning out her engine. Her medications carried her for a while, but eventually her body and mind stopped playing along.

As it turns out, Lisa did not need stimulants to be more productive; she needed downtime to recharge her mind. This was counter-intuitive because on the surface it seemed that taking breaks from work would only slow her down. A study from University of Illinois at Urbana-Champaign showed that taking mental breaks from intense work increases performance and helps your focus.

These breaks don't have to be very long. You could start with two five- to 10-minute periods during your workday where you do something non-work-related, such as listen to a music track or think about your last vacation. Here are some other suggestions to help you decompress your mind.

Stop cell phone use while waiting in traffic or standing in line. Use that "forced" downtime to be present in the moment. Reflect on your environment; focus on something pleasant around you like the phenomenal painting on the wall, or the smell of someone's perfume.

Set a bedtime and stick to it. Choose a time that allows for you to have between seven and nine hours of sleep. If you sleep well, you can think well. Stop working an hour before bedtime to wind down and prepare for bed. You may find that the fixed bedtime with the wind-down means you only have an hour or two after work before it's bedtime. So be it. This will be your weekday schedule. Make your weekend schedule more flexible to allow for quality time with friends and family.

Decompressing may also require you to eliminate some activities from your schedule so you don't overload yourself. It is very easy to pack too much into a day by seeing 20-minute snatches of time as opportunities to "get some things done." When was the last time you sat and stared into space? In this day and time that almost seems wrong, as if you are not taking advantage of an opportunity.

If you decompress, you become more efficient and less anxious, and you sleep better. Slowly integrating other healthy lifestyle choices such as exercise and good diet can help you rid yourself of the need for the high-performance cocktail.

For more by Tracey Marks, M.D., click here.

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