Relapse is a process, its not an event. In order to understand relapse you have to understand the stages of relapse. Relapses start weeks or event months before the event of physical relapse. In this page you will learn the stages of relapse. There are three stages.

  • Emotional relapse
  • Mental relapse
  • Physical relapse

Emotional relapse

In emotional relapse, you are not thinking about using. But your emotions and behaviors are setting you up for the possible relapse in the future.

The signs of emotional relapse are:

  • Anxiety
  • Intolerance
  • Anger
  • Defensiveness
  • Mood swings
  • Isolation
  • Not asking for help
  • Not going to meetings
  • Poor eating habits
  • Poor sleep habits

The signs of emotional relapse are also the symptoms of post-acute withdrawal. If you understand post-acute withdrawal it is easier to avoid relapse, because the early stages of relapse is easiest to pull back from. In the later stages the pull of relapse gets stronger and the sequence of events move faster.

Symptoms of post acute withdrawals

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 of withdrawals 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 post acute withdrawals can include:

  • Emotions that feel out of control
  • Repetitive thinking
  • Inability to develop a normal sleep pattern
  • Problems with memory
  • Inability to concentrate
  • Cravings
  • The individual may feel like they lack initiative
  • Feelings of anxiety
  • Feelings of depression
  • Problems with coordination
  • Difficulties managing stress
  • Obsessive compulsive disorder
  • Feeling tired all the time
  • Feelings of guilt
  • Difficulty experiencing pleasure- this also referred to as anhedonia
  • Problems getting along with other people

Mental relapse

In mental relapse there is war going on in your mind. Part of you wants to use, but part of you doesn’t. In the early phase of mental relapse you are just idly thinking about thinking. But in the later phase you are definitely thinking about using.

The signs of mental relapse are:

  • Thinking about people, places, and things you used with
  • Glamorizing your past use
  • Lying
  • Hanging out with old using friends
  • Fantasizing about using
  • Thinking about relapsing
  • Planning your relapse around other people’s schedules

It gets harder to make the right choices as the pull of addiction gets stronger.

Physical relapse

Once you start thinking about relapse, if you don’t use some of the techniques it doesn’t take long from going from there to physical relapse. Driving to the liquor store. Driving to your dealer. It is hard to stop relapse at that point. Thats not where you should focus your efforts in recovery. Thats achieving abstinence through brute force. But it is not recovery. If you recognize the early warning signs of relapse, and understand the symptoms of post-acute withdrawal, youll be able to catch yourself before its too late

References: The stages of relapse were first described by Terence Gorski. Gorski, T., & Miller, M., Staying sober: A guide for relapse prevention: Independence press, 1986.

My relapse trigger worksheet that I did while in rehab

What emotions or feelings make you want to use drugs or drink?

  1. Loneliness
  2. Fear/Worry
  3. Sadness

What situations/circumstances/or people make you want to use drugs or drink?

  1. Having no life after work
  2. No friends/ isolating myself too much. Although I need time alone for thinking, distressing from people
  3. Not able to take control of sudden urge or thought to spontaneously drink

My relapse prevention plan worksheet that I also did in rehab

High risk situation Likely ways of encountering How to avoid Escape strategies Coping strategies
Going home from work Using same route that has liquor store thus forming a habit of going into it Have multiple routes. Find a job that ends at the time alcohol is not for sale anymore Have someone to call to. Wait an hour before buying, that should decrease cravings and ect., Have a life before/after work
Routine Being bored and depressed with my routine Change up things, foods I eat everyday. Work towards my goals and self development <——– Going to support groups, be more social
Sudden sadness and big worry that I wont achieve anything in this life It can happen anytime, anywhere Work on self growth. Make an appointment with SCORE and finally start working on my self employment plan <——— Use dialectical thinking
Sudden impulse, though to drink It can happen anytime, anywhere I cant control my brain so I cant avoid it. Think how I will loose all the progress I made so far and about all people that put a lot of work and effort into helping me to get this far Move to half-way house (which I haven’t), limit stimulation when I feel overwhelmed. Acknowledge my feelings and use  dialectical thinking

Relapse Prevention Video: Early warning signs and important coping skills

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