Residual Disequilibrium – I feel like I’m on a boat and everything is happening a second ahead of me

This happens because of a neurotransmitter system called GABA, that benzos act on, and it affects the vestibular system. Here it is in simpler terms, because this gets confusing!

GABA is gamma-aminobutyric-acid, and is the brain’s primary inhibitory neurotransmitter. It acts like a brake pedal for your nervous system. When GABA binds to it’s receptors, it calms down nerve activity. It helps regulate mood, anxiety, sleep, muscle tone, and your balance.

GABA is the body’s anti-anxiety and stabilization chemical. It keeps your nervous system from “running too hot” if you want to look at it like a car.

What Benzos Do

No drug makes GABA (this is why popular OTC supplements are bullshit – it doesn’t cross the blood-brain barrier well and these are mostly ineffective and there is no real way to get “natural” GABA) but drugs like valium can enhance it’s effects by binding to GABA-A receptors. This makes them more responsive to the GABA you already have. This leads to:

• reduced anxiety
• muscle relaxation
• sedation
• anti-seizure effects
• stabilization of inner ear signals involved in balanace

The Vestibular System and Balance

The vestibular system is your inner ear, brainstem, cerebellum and associated nerves. It controls balance, spatial orientation and movement awareness. To do this well, it needs very precise regulation of electric signals between your inner ear and brain.

Here’s when GABA steps back in: GABA dampens overactive signals in the vestibular system. It ensures your brain doesn’t overreact o normal head movements or minor sensory noise. This helps you feel stable, grounded, and upright.

What Happens During and After Benzo (specifically in my case, valium) Use

• when you take a benzo long-term, your body gets used to having that extra GABA effect
• your brain reduces it’s natural GABA sensitivity or production to compensate
• your vestibular system becomes dependent on valium to keep balance signals smooth

Then, when you taper off of, or stop a benzo, like valum:

• you, very suddenly, lose that buffer in the vestibular system
• there’s a period where signals are too strong, disorganized, or hypersensitive
• you may experience rocking, swaying, a floating sensation,- called disequilibrium – when when you’re standing still.

This is extremely common during withdrawal, but in some people, the imbalance lingers, and this is called residual disequilibrium.

Why It Feels So Strange

We don’t normally have to think about our balance. It’s something that happens naturally, automatically, and you don’t really notice it unless it’s disrupted. The feeling, unlike dizziness, can be really vague, unsettling, and is also very hard to describe. It’s like

• you’re walking on a trampoline
• the floor is moving beneath your feet
• your body is “lagging” behind your movements (this is the weirdest)
• and like your head isn’t connected to your body

It’s not visible, or measurable, on tests, so this strange condition is just brushed off as “just anxiety” – it is a real, neurochemical and vestibular disruption though. This happens due to CNS adaptation and rebound effects after withdrawal.

CNS Adaptation and Rebound

When you take a medication or a benzo like valium, the central nervous system (CNS) starts to adapt to the effects of it. This is called neuroadaptation and is the way your brain keeps thing in balance (called homeostasis)

CNS, or neuroadaptation happens because benzos have a calming effect on GABA, and adapts, and eventually your brain tries to counteract this by

• reducing GABA receptor sensitivity
• producing fewer GABA receptors
• increase excitatory chemicals like glutamate (which is the brain’s “gas pedal”, in comparison)

While you’re taking the drug, your brain is working behind the scenes to restore balance without overdoing it. When you stop, your central nervous system is still in it’s “adapted” state because

• too few working GABA receptors
• too much excitatory activity

This sudden imbalance causes a range of rebound symptoms, which are often the opposite of the drug’s effects. It can last for a very long time because the GABA receptors have to regenerate and become functional again. This can take weeks, even months. This is called protracted withdrawal. This isn’t just a psychological state – this is a physical, and neurochemical recovery process and some brains need more time and support to recalibrate after years of working under the influence of a powerful drug.

My experience

I started noticing this weird, spaced out, “dizzy but not dizzy” feeling a couple days after I completely stopped valium, maybe around day 5 or 6. I started noticing this strange sense of panic come over me when I was looking at things, and they seemed like they were happening a second ahead of me, and I’d get this dizzy floaty feeling like I were separate from my body and reality. I had no idea what was going on, except that it had to be related to benzo withdrawal and I thought I was going to lose my mind in an anxious way, not a psychotic way.

It feels like getting onto a boat in stormy waters and trying to stand and walk straight but you aren’t actually on a boat and the ground isn’t moving. I felt nauseated, like I was going to throw up, and everything was moving around me. If I got anxious, I’d get this floating sensation like I was observing from a second behind what was happening and my heat felt like it was floating off, and disconnected from my body. I felt like my balance was all out of whack and that I couldn’t do a sobriety test if someone asked, I wasn’t walking around like someone drunk, but I sure felt like it. I was scared, I didn’t know what was going on – nothing prepared me for this.

I was scared to ask for help and started looking online and found the terms “residual disequilibrium” and some people’s testimony, and realized that was happening to me, I wasn’t going to die, I wasn’t going to freak out, and I was going to be okay in a couple days to weeks. I learned some coping techniques and ways to ground myself, to realize that it wasn’t permanent, and I wasn’t in harm. I had no valium, and I didn’t want to go through this again, so I knew there was one way out and that way was to keep going without benzos and I might eventually get back to “baseline”. My baseline anxiety dropped after I found out about this and I was relieved I wasn’t going insane again and not going to end up psychotic in the hospital and watching myself as I deteriorated.

It’s been a month now and it still happens sometimes but not to the magnitude as before. I don’t know how I got through it except for goddamn stubbornness, not wanting to be wrong, and not wanting to bother anyone with my issues. I made myself keep functioning every day and do what I normally did, and get over it. It was hard, it was stupid, and I know the guilt and stubbornness are signs of depression, anxiety, and withdrawal. It’s scary, frustrating, and surreal all in one.

What helps, and what doesn’t

A couple coping strategies I used are difficult because I was essentially using CBT and other DBT type skills I’ve taken years to learn to kind of push myself through my own mess. I would challenge thoughts, make myself face them, make myself stay in the present reality, do grounding techniques (5-4-3-2-1, placing feet on the floor, being mindful of a couple things around me, and other stuff like that – staying with the now) and a couple other things I did that helped were to

• stop, take a drink of something cold, focus on it, plant my feet on the ground and relax, breathe, and drink more.
• eat something, healthy or not, because that helps your blood sugar and helps your mood inadvertently.
• I avoided triggers like bright lights and quick motion. Keep it steady, keep it easy
• focus on something else. Knit. Make dice. Do something with my hands
• get away from all the stimulation

I learned some things were coming back, sensations in my body, motivation, clearer thinking, and my anxiety baseline wasn’t getting worse than it was on valium, it was actually improving. I was more resilient and able to get through panic attacks when I normally would have grabbed a valium, and I wasn’t medicating myself when I was bored or restless. Propranolol helped the physical side.

What you should know:

Valium is a long-acting benzo that builds tolerance slowly, slower than other benzos, but it leaves your system really slowly as well. Withdrawal symptoms can be bizarre, protracted, and very, very physical. This isn’t “just anxiety”, this is your system recalibrating the chemicals you have and were “substituting”, and now the brain has to reset itself to “normal” and it can take a bit to reboot. This is something not well known, and it should be something considered before prescribing, deprescribing, and changing benzos.

For families and supporters

It’s real, it’s scary, and it doesn’t mean something is made up or wrong. Balance is so fundamental that when it’s disrupted, it’s hard to describe (since when is it disrupted, normally? rarely) that everything feels off. Be patient, show your support, don’t lay on guilt and blame, because they’re probably going to take that even harder, so save it for when the benzos are gone.

For others going through this

You aren’t crazy, you aren’t alone. This is a thing, a documented phenomenon, even if it feels unreal, or invisible. It goes away eventually, it’s going to get better. It won’t always be like this. There is hope, there is a positive, and it’s going to eventually fade down into the background and you’ll go back to whatever your normal is.

If you’re in crisis or need help, please reach out to someone you love or someone qualified to help you. This isn’t medical advice, this isn’t medical information really, this is just my experience and me describing things badly as a non-medical-professional. If you’re suicidal, call 911, depending on where you live, and get yourself to an ER, or your doctors. If you start getting confused, disoriented, hearing voices, or having seizures, get the hell to a doctor, not the internet. Don’t do what I did and get lucky.