When a person has an addiction to drugs or alcohol, the first step they need to take toward recovery is to detoxify. Their body is so used to their drug of choice that when it is stopped there can be extreme side effects. This can occur even when detox is done in a safe, medical setting. In most cases, the side effects will last only a couple of weeks and then the person will feel physically better. This is called the acute withdrawal stage.
However, for many people in recovery, the acute withdrawal stage of detoxification is followed by an emotional and psychological withdrawal that can occur a few weeks or a few months into recovery and can last from six months to two years. This is called post-acute withdrawal syndrome, or PAWS. The length of this withdrawal stage depends on the type of drug used, the amount taken, and the length of time the user used the drug. Post-acute withdrawal syndrome is one of the main causes of relapse because many people think that what they are experiencing is normal and do not seek treatment for it.
Symptoms of Post-Acute Withdrawal Syndrome
When a person has an active addiction to drugs or alcohol, there are many chemical imbalances in their brain. PAWS is the brain’s way of correcting those imbalances. To reduce the chance of relapse, it is important to recognize that many of the uncomfortable, worrisome feelings and sensations experienced in early recovery could be temporary symptoms of PAWS. The following are symptoms common to PAWS sufferers.
Physical:
Although most physical symptoms occur in the first two weeks of detox during the acute withdrawal stage, it is not uncommon for some physical symptoms to occur during PAWS. These can include headaches, exhaustion, fatigue, sleep disruptions, or insomnia. These symptoms occur as the nervous system continues to repair itself.
Mental:
As the central nervous system continues to recover from the damage caused by the addiction, memory problems can develop. The person may experience problems with focusing, processing thoughts, and fine motor coordination. They may have difficulty with cognitive tasks, such as learning, problem solving, or memory recall. These symptoms add to their feelings of frustration and helplessness.
Emotional:
The emotional symptoms of PAWS are often exacerbated by the other symptoms. For example, exhaustion and headaches can cause depression and anxiety. Feelings of sadness and anger can be caused by memory problems or lack of sleep. Increased sensitivity to stress, irritability, hostility, confusion, and mood swings can occur. There may be feelings of overwhelming grief, melancholy, hopelessness, or panic.
Additional Symptoms:
When a person experiences PAWS, they may exhibit obsessive-compulsive behaviors, have inexplicable chronic pain, or have a lack of libido. They often have difficulty maintaining social relationships, are pessimistic or apathetic, and show a lack of initiative. They experience urges and craving for the originally abused substance.
Although it is not possible to avoid post-acute withdrawal syndrome, it can be effectively managed. Tell your mental health professionals about your symptoms so you can learn to successfully manage them. You will improve your self-esteem, feel better emotionally and physically, and reduce your risk of relapse.
Coping Strategies for PAWS
- Talk to your sponsor, family, therapist, counselor, or anyone who will not minimize or criticize what you are experiencing.
- Go over the events in your mind that happened before the PAWS flare-up and think about how you reacted.
- Document your experiences in a journal to identify alternative ways to respond.
- Practice self-care by exercising, eating well, and establishing supportive, positive relationships. Avoid trigger situations whenever possible. Be good to yourself.
- Practice relaxation techniques such as meditation, yoga, or deep breathing. Go for a walk, play with your dog, or listen to relaxing music. When you are tense, it is easier to dwell on your symptoms, making them worse. When you are relaxed, it is easier to not think about them and thus decrease your chance of relapse.
- If you have memory problems, write things down or use your phone to set reminders.
- Don’t spend more than 15 minutes on one task if you have difficulty concentrating.
- If you are having difficulty sleeping, try to establish a sleep routine. Go to bed at the same time every night and wake up at the same time each morning.
- Break the cycle of circular thinking by doing something different: go for a walk, listen to music, or talk to a friend.
Be realistic. Recovery cannot be hurried. Remember that PAWS symptoms are temporary and are a part of your journey to recovery.
There is Help Available
The professional staff at Canyon Vista Recovery Center located in Mesa, Arizona, uses an integrated treatment approach to treat the whole person: body, mind, and spirit. By combining medical, clinical, psychiatric, and holistic therapies, we give our clients essential and valuable tools to travel the road to recovery. If you or someone you know is suffering from an addiction to drugs or alcohol, we can help.
