It is well known that when addicts give up their addiction they will usually experience withdrawals. These unpleasant symptoms can be both physical and psychological in nature. Most people will have seen movies or TV shows that included scenes where a character was going through cold turkey or delirium tremens. The symptoms of these withdrawals are unpleasant, but in the public imagination they only last a few days. In reality the individual in recovery can continue to experience withdrawal symptoms for the first couple of years into their sobriety.
Addiction withdrawals can be broken down into 2 stages: acute withdrawals and post acute withdrawals. The acute stage usually lasts for the first couple of weeks of recovery and the post acute stage can last up to 2 years – the symptoms will usually peak at about 6 months. The first stage of withdrawals is predominated by physical symptoms and the individual can experience flu like symptoms. The post acute stage tends to be less severe and mostly involves psychological symptoms such as problems with concentration.
The symptoms of PAWS can include:
* Fuzzy thinking (AKA brain fog)
* Inability to concentrate
* Problems with memory
* Inability to develop a normal sleep pattern
* Repetitive thinking
* Emotions that feel out of control
* Difficulties managing stress
* Problems with coordination
* Feelings of depression
* Feelings of anxiety
* The individual may feel like they lack initiative
* Feeling tired all the time
* Difficulty experiencing pleasure – this is also referred to as anhedonia
* Problems getting along with other people
* Obsessive compulsive disorder
* Feelings of guilt
PAWS can be dangerous for people in recovery because:
* The individual may decide that life away from alcohol and drugs is not satisfying.
* They can use these symptoms as a justification to relapse.
* Those people who do relapse might not be willing to give recovery another go because of their unsatisfying experience.
* The individual may react to PAWS by turning to maladaptive behaviors such as workaholism or exercise addiction.
* Some people use this as an excuse to not put any effort into their recovery and they develop dry drunk syndrome. In this situation they are physically sober but their behavior is much the same as when they were in the midst of their addiction.
There are a number of reasons for why people experience PAWS including:
* The individual has developed a tolerance for alcohol and drugs and this means that the body has adapted to functioning with these substances. It can take a bit of time before the body adapts to now functioning without these chemicals.
* Many individuals develop nutritional deficiencies as a result of their substance abuse. Until these deficiencies are resolved the individual can experience symptoms.
* Long term substance abuse interferes with the body’s normal ability to deal with stress. This means that initially the individual will have stronger reactions to stressful events.
* For years the addict will have used alcohol and drugs as a means to numb their emotions. It can feel as if these emotions are out of control in early recovery because the individual is not used to dealing with them.
One of the most common symptoms of PAWS is the feeling that the individual is on an emotional rollercoaster. They might swing from feelings of happiness to despair in a matter of minutes. These intense fluctuations in mood can be quite disturbing for the individual who is not used to dealing with feelings. In the past they will have been able to turn to alcohol or drugs to escape uncomfortable emotions. Now they are left to face them and this can take a bit of getting used to.
One of the common experiences that people have in early recovery is pink cloud syndrome. This is where they go through a period of feeling exceptionally happy. The pink cloud is an enjoyable experience, but there are also some hidden dangers associated with. One problem is that people can feel so good about things that they begin to neglect the work they need to do in order to remain sober. There is also the risk when the pink cloud ends the individual will feel terribly disappointed and they will use this as an excuse to return to alcohol or drug abuse.
In some instances these persistent symptoms in recovery will be a sign that the individual is dealing with some other issue alongside their addiction. It is now recognized that a significant number of addicts have a dual diagnosis, and they may be completely unaware of this. This means that as well as their addiction they have a problem such as depression, anxiety disorder, or bipolar disorder. It may have been this undiagnosed problem that drove the individual into substance abuse in the first place. They may have been attempting to self-medicate. There are also people who develop a dual diagnosis as a result of their substance abuse.
If people have an untreated dual diagnosis it can prevent them from finding happiness in recovery. Some people may just dismiss their symptoms as PAWS, and this means that they delay seeking treatment. It is always advisable to seek a professional opinion if the individual is finding it difficult to settle into recovery due to unpleasant symptoms. In most instances it will be possible to manage the dual diagnosis so that the individual will be able to build a successful recovery.
In some relatively rare cases the individual may have more significant problems that can result in continued symptoms in long-term recovery. Those who have developed conditions such as alcoholic dementia may have causes irreversible damage to their brain. The individual may be able to learn how to function at a higher level, but in some cases they will just have to adapt to living with this mental impairment.
Post Acute Withdrawal Symptoms do not tend to be there all the time. They come and go and most people will find that they have mostly disappeared within the first few months of recovery. The individual can help to speed the recovery process along by:
* Ensuring that they eat a balanced diet and taking nutritional supplements as prescribed by their doctor. If these symptoms are being caused by nutritional deficiencies then eating a balanced diet should help to address this.
* Exercise is not only good for physical health but also for mental well-being. It is important that people in recovery devote at least a little time each day to physical activity.
* Meditation is a wonderful tool for improving concentration and developing inner peace. Those who are dealing with PAWS can find it difficult to mediate, but they can begin by learning some simple breathing exercises.
* Those people who belong to a recovery group are likely to find that this provides them with support and advice.
* One of the important tasks for early recovery is for people to develop skills for dealing with stress. A good reason for attending rehab is that it gives the individual a head start in developing such coping mechanisms.
* It is important that those who are dealing with PAWS realize that these symptoms will almost certainly disappear once they are established in recovery.