Post Acute WITHDRAWAL SYNDROME

Have you recently stopped using substances (drugs and/or alcohol)? How are you feeling? How is your energy? Are you experiencing mood swings, irritability or disturbed sleep?

You may be experiencing Post Acute Withdrawal Syndrome, which many people do in early recovery. PAWS, for short, is a group of symptoms that can appear after acute withdrawal from drugs and alcohol. The symptoms appear seven to fourteen days into abstinence and can last up to two years, depending on your age, general health, what substances you were using and for how long. The first three to six months of abstinence are usually the hardest when symptoms are most prevalent.

The most common symptoms of PAWS are:

•  Mood swings

•  Anxiety

•  Irritability

•  Lack of enthusiasm

•  Emotional overreactions or numbness

•  Disturbed sleep and vivid dreams

The tricky thing about PAWS is that the symptoms come out of nowhere. One day you are feeling fine, and then you start experiencing some of the above symptoms for no apparent reason. The episode may last for a few days and then disappear for several weeks, only to reappear. There is no obvious trigger for most episodes of PAWS.

What causes Post Acute Withdrawal Syndrome?

PAWS is biopsychosocial. It results from the combination of damage to the nervous system/brain caused by alcohol and drugs and the stress of coping with life without substances. Depending on the severity of your addiction, once you stop taking drugs/alcohol, your brain is not used to dealing with life without the substances. Therefore, people can experience the symptoms mentioned above. Once acute withdrawal is over, our brains make initial adjustments to the absence of our drug of choice and the significant withdrawal symptoms ease up. However, the changes that have occurred in the brain because of substance abuse need time to revert to their original state. During this period, an individual can experience PAWS.

What can you do when you experience Post Acute Withdrawal?

Talk to someone: tell them how you feel; when we are in our heads and ruminate, our thoughts go around and around. Talk to a supportive friend, coach, counsellor, therapist, or sponsor.
Nutrition: eat well. Addiction often leads to unhealthy eating habits and nutritional deficiencies. Malnutrition contributes to poor health, and poor health contributes to stress. When our bodies and brains heal from substance use, they need proper nutrients to repair the damage.

Exercise: aim for 20 minutes a day. Exercise produces chemicals in our brains that counteract stress, anxiety, depression and irritability and can help with our sleep. This doesn’t need to be high-impact exercise. Just get moving. Always talk to your family doctor before starting anything outside your comfort zone or if you have physical limitations/illnesses. 

Be patient: recovery will not happen overnight. If you are dealing with PAWS, live one day at a time. Know that the symptoms will dissipate eventually. Learn about addiction and recovery: know what you are up against. Learning what your brain and body are going through will help to relieve the anxiety, confusion and guilt that tend to create the stress that intensifies PAWS. Information will help you realize what symptoms are typical in recovery.

Relax: take time for yourself. Self-care is crucial. Take time to relax, recharge and enjoy a hobby or activity. Read a book about personal growth, motivation, nutrition, exercise or spirituality. 

The goal in recovery is to live a balanced life. Balanced living requires loving and taking care of ourselves. When nutrition, rest and exercise all receive the proper focus in our lives – they provide us energy, stress management, freedom from illness and pain, and help rebuild our damaged bodies and brains.  Freedom from physical distress (which substance abuse causes) allows psychological growth. When we feel good, it is easier to do the work we need to do, eliminate denial, guilt and anger, and move on to self-confidence and self-esteem and to feel good about ourselves.

If you would like more information on Post Acute Withdrawal Syndrome or to talk to a recovery coach about early sobriety, please reach out to EPIC Recovery.  Sobriety does not always have to be challenging, but it is sometimes not easy. Someone with experience and an understanding of the process may be what you need.