Contributor: W. Travis Stewart, LPC, NCC writer for Addiction Hope
Imagine yourself sitting in front of a computer, your finger hovering above the Return button just about to click “Purchase” button for an airline flight across the country to attend your best friend’s wedding. You are sweating, shaking, your stomach is clenched and you are beginning to feel dizzy.
You know that your fear is irrational. You’ve heard the statistics that flying is safer than driving and yet, you can hardly breathe.
You aren’t even near an airport but your fear of flying is so intense that you are contemplating calling your friend to tell her that you can’t come to the wedding and she will have to find someone else to be her Maid of Honor.
Now imagine being told that taking a pill can relieve all of that anxiety – or at least make flying bearable enough for you to go to the wedding.
That is the promise of Ativan and why so many people are prescribed it when dealing with phobias.
How does Ativan work?
Ativan (or lorazepam) falls into the category of drugs known as benzodiazepines. It helps with anxiety and phobias by calming down brain activity and, in particular, targets the neurotransmitter gamma-aminobutyric acid. This produces a feeling of calm and reduces the irrational and anxious thoughts (it can have side effects including drowsiness, blurred vision, insomnia, nausea, constipation and skin rash). 
Is Ativan addictive?
As mentioned previously on Addiction Hope, Ativan can be addictive:
Of the benzodiazepines, Ativan has one of the highest risks for physical and psychological addiction. The intense feelings and promise of rewards creates the potential of using the medication more often and for longer periods than prescribed thus creating an Ativan addiction. Ativan’s high potency can more easily lead to extreme cravings than most other benzodiazepines. 
Because the drug can create such feelings of calm it has a very rewarding experience and it produces these feelings without much intentional effort on the part of the user. Because of this, one can begin to believe that the drug is the only way to relieve fear and phobia, resulting in the user becoming dependent on the drug. This can lead to an obsession about getting and using the drug and eventually lead to other behaviors typical of a substance addiction.
What else can I do about my phobia?
Some phobias are so rare that nothing really needs to be done. If you have Aulophobia (the fear of flutes) then you could reasonably avoid flutes and orchestras without causing too many problems in your life. If, on the other hand you have a fear of public speaking and your job requires that you do it on a fairly regular basis, then you will need to seek a remedy. Fortunately there are things you can do instead of relying on benzodiazepines.
Exposure Therapy for Phobias
A phobia or anxiety grows stronger through avoidance. In other words, if you begin to experience some anxiety as you approach the fear-inducing item (such as a spider) and you turn around and walk the other way, you will experience a brief sense of relief. This relief is powerful and your brain learns that avoiding the situation is preferred. This reinforces the idea that you should avoid the fearful situation and the phobia is reinforced. Exposure therapy works by reversing this process.
Rather than avoiding the fearful subject, the therapist guides you in progressively facing the fear and learning to tolerate the uncomfortable thoughts and sensations. During this process the anxiety increases and then eventually diminishes. As this happens, and no harm comes to you, your brain begins to relearn that the fearful situation is not actually dangerous and the brain gets retrained. In other words, “exposure therapy works by gradually increasing the level of exposure to your fear, which allows you to gain control over your phobia.”
Change Your Brain
Dr. Jeffrey Schwartz, a research psychiatrist at UCLA’s school of medicine was trained in providing exposure therapy but was uncomfortable with putting patients through the distress involved with exposure therapy. Over the past 20 years he has worked with his colleagues at developing another approach to changing anxious thoughts and behaviors. These methods are now outlined in his book, You Are Not Your Brain.
The premise of his work revolves around his 4 Step Method which is designed to harness focused attention and rewire the distressing thoughts. Dr. Schwartz’s colleague Rebecca Gladding states, “You need to learn how to activate your mind so that it can help sculpt your brain to work for, rather than against, you. One great way to learn how to do this is with the Four Steps.” She continues:
The key to the Four Steps is practice. You literally need to keep using the Four Steps over and over. By becoming more aware of what is happening and learning how to refocus your attention in healthier and productive ways whenever a deceptive brain message strikes, you teach your brain new, beneficial responses. With time, you will learn how to place your attention where you want it to go, not where your brain is beckoning you to follow. 
Change Requires Effort
Whether or not you do use a drug like Ativan to help with phobias you should not rely solely on medication to overcome your fear and anxiety. It is important to work on your fears psychologically as well. That requires focused effort, participation in therapy and a willingness to learn new skills. Phobias can be incredibly distressing and interfere with you quality of life but it doesn’t need to stay that way.
Community Discussion – Share your thoughts here!
Have you or a loved one struggled with phobias, what alternatives to Ativan have you tried? What advice do you have to share?
About the Author:
Travis Stewart has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future.
Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety and perfectionism.
Travis graduated from the University of Nebraska in 1991 with a degree in advertising and immediately began working with the international ministry of The Navigators, mentoring students. After 8 years, his desire to better understand how people change, and through his own experience of receiving help from a professional counselor, Travis decided to return to school. He earned a Master of Arts in Counseling (2001) and a Master of Arts in Theological Studies (2003), both from Covenant Seminary in St. Louis, MO. Travis is a Licensed Professional Counselor in the State of Missouri.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on August 24, 2015. Published on AddictionHope.com