How to Recognize the Relapse Warning Signs

How to Recognize the Relapse Warning Signs

Getting sober can be challenging, and you may stumble along the way. If you or a loved one is dealing with addiction and has recently found sobriety, it’s important to stay alert for any warning signs of relapse.

Because addiction is a chronic disease, you can experience relapse even after several decades of sobriety. Therefore, keeping an eye out for these warning signs, even if you haven’t had a drink in several years, could help you prevent relapse or recover faster.

The quicker you acknowledge a relapse, the sooner you can seek help and get back on track. Remember that relapse is common for addicts, and just because you have relapsed doesn’t mean you’ve failed. Whether you’ve been sober for ten years or are only a month in, keeping in contact with a mental health expert can help you recognize relapse warning signs and alter your course.

What is Relapse?

Relapse simply refers to the return of a disease. Several infectious diseases, including malaria, have long periods with no symptoms, then a relapse, or return, of the symptoms.

For addicts, relapse means a return to the addiction. Whether that’s consuming alcohol, taking drugs, or returning to the poker table, relapsing can be dangerous. Your tolerance for your drug of choice may have decreased during your sobriety, increasing your risk of overdose.

For this reason, you, your family, and your friends need to know the warning signs of relapse. If you relapse, remember that many people relapse and that it’s part of the process. It doesn’t mean that your treatment has failed, just that you need to continue with your program and therapy.

The Stages of Relapse

Is Alcohol a Drug and relapseRelapse isn’t a single event. Often, a relapse involves three stages: Emotional, mental, and physical. Each of these comes with its warning signs and problems.

Emotional Relapse

This stage often involves returning to the emotional state you were in when using. You may experience mood swings, irritability, or other negative emotions. A traumatic event, major life changes, or extreme stress might trigger you.

Mental Relapse

During this stage, you may justify drinking or using, often having internal arguments with yourself. Part of you will still feel committed to maintaining sobriety, while another part will want to return to the addictive substance. This internal argument can cause irritability and distraction. Eventually, you’ll notice clear thoughts directly about using, which often leads to the third stage.

Physical Relapse

Physical relapse is the third and final stage of relapse and the one most people think of when discussing relapse. In this stage, you’ve returned to using or drinking. The stage can last one day, one month, one year, or longer and often requires outside support to return to sobriety.

The Warning Signs: Before the Third Stage

Often, before relapse occurs, you may experience strong cravings. Whether you have dreams about drinking or reaching for a joint, you will notice yourself thinking more about your addiction than you have done in the past.

You may also experience negative emotions, including irritability, isolating yourself from your friends and family, or increased anxiety. Your family may notice that you become more secretive or that you disparage sobriety.

Another indicator of an impending relapse is depressive behavior. Even if a relapse doesn’t cause the depressive behavior, many addicts turn to drugs and alcohol to cope with depression and loneliness, which often go hand-in-hand. If you notice any signs of depression in yourself, including isolation, an unwelcome change in your sleep patterns, lost interest in your hobbies, or low mood, reach out to your therapist and addiction counselor for help.

In the emotional and mental stages of relapse, many find themselves thinking clearly about using, remembering how it used to feel. Often, people on the verge of a relapse romanticize drug use or drinking, remembering only the good times and ignoring the lows. As soon as you feel your thoughts turning to alcohol or using regularly, let your therapist know so they can give you more coping mechanisms.

The Warning Signs: Physical Relapse

Even one small drink counts as a physical relapse, although recovering addicts sometimes believe they can have just one. Unfortunately, one drink usually turns into several. If one of your loved ones has turned to secretive behavior, reconnected with friends from their old scene, or becomes defensive quickly, they may have relapsed.

Another warning sign of physical relapse is the appearance of withdrawal symptoms. These differ depending on substance but often involve shaking, insomnia, and irritation. While your loved one is in recovery, learn more about the specific signs of withdrawal for their addiction.

Withdrawal from some substances can cause intense discomfort and be dangerous or even deadly without medication.

What to Do

Support System for Your RecoveryIf you notice yourself romanticizing using again or dreaming about drinking, contact your sponsor or therapist as soon as possible. Get to a meeting, even a virtual one, to discuss your struggles. If you have trusted friends or family members, you could also confide in them for help.

If you notice any of these warning signs in a loved one, you could ask them to reconnect with their sponsor or therapist. However, it’s important not to make your loved one feel worse after relapsing. Statements like, “Why did you mess up?” can often increase the guilt your loved one feels, making the relapse worse. Try to be as supportive as possible. If you belong to a family support group, ask them for advice about supporting someone during a relapse.

Be Kind

It’s important to always be kind to yourself during the process of recovery. Relapsing is a relatively common part of the recovery process and beating yourself up over it can make it harder to return to sobriety. To reduce the likelihood of relapsing, stay in regular contact with your therapist, addiction counselor, friends, and family.

Triggers for relapse include high-stress situations and reconnecting with friends from the old days. To protect your sobriety, try to stay away from stressful situations or work through any stress with your therapist, and don’t contact old friends who are still using.

Remember, you attained sobriety once, and you can get there again.


Written by Sergey Zhitar, MD Medical Director

Native of Moldova, Dr. Zhitar is Board Certified in Addiction Medicine as well as Internal Medicine and completed his training at UPMC Shadyside, Pittsburgh, PA in 2000.

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