Top Signs of Relapse for Addicts

First, I'll just put it out there: I'm an addict in recovery. I certainly don't fit the societal profile or images conjured up in people's heads about what that means. I've never lived on the streets, never lost a job, never drank straight out of the bottle, never sang strange songs in the middle of the night on a major city street (okay, maybe once or twice), and I've never had a D.U.I. or D.W.I. I have a college degree, a graduate degree, come from a respected family, I drive a mini-van with my three kids en-tow, I'm a soccer and Little League Mom, and a social worker. Heck, I even used to be a therapist at a VA hospital.  Whew, okay that secrets out now. I feel better.

Now, if I were to say: “I'm in relapse”, you'd think I was actively drinking or drugging again, right? That's what most people envision, even addicts themselves have this misconception. The truth is, a relapse starts way before that first drink or drug. It's a process that can develop gradually or fairly rapidly. Most addicts aren't aware of this. They think all is well if they're successfully abstaining from their drug(s) of choice (this includes alcohol since alcohol is a drug). But, they may be unwittingly on the road to relapse. Relapse happens before using the substance, so it's imperative one is looking for the warning signs/relapse cues before the actual use occurs.

 There are four changes that occur in an addict on the path to relapse.  They are:

1. Changes in thought
2. Changes in moods and feelings
3. Changes in attitude
4. Changes in behavior.

The following are common examples of thinking errors an addict on the relapse path may have:

• "I will never drink again." You may be thinking that sounds like a good, positive thought indicative of ones commitment to recovery and lifelong abstinence. Unfortunately, thinking one's immune and cured causes lack of vigilance. The addict might begin to see less of a need for a daily recovery program.
• Patterns of denial may kick in with thoughts like:

a) "I really wasn't that bad. I never got a D.U.I, I never went to jail, I didn't drink all day long like Bob.

b) "I deserve a break for one day. I can have just one drink and it won't hurt."

c) "I won't drink, but smoking a joint here and there isn't a problem."

Can you think of examples of how your thoughts may act as relapse cues?

Many, but not all addicts experience what's called a "honeymoon" period after getting sober. Everything feels wonderful and the sober life is novel. They feel great physically: no more hangovers, they're getting restorative sleep, they have more energy, their thinking is clear. Life is good. They don't have the guilt, self-hatred, embarrasment, black-outs, and regret after binging. However, after being sober a while the novelty effect wears off and they're left with feelings they weren't prepared for. Feelings resurface they might have been masking with substances for years. They may feel:

• Depressed. "Is THIS what this sobriety thing is all about?"
• Angry: "Why do I have to be an addict? It's not fair."
• Lonely
• Negative
• Useless
• Rejected

Of course, these feelings will differ from person to person. But, they usually originate from the honeymoon period ending and old thoughts and feelings reemerging. Unsolved relationship issues will undoubtedly resurface. Old life stressors come back into play. Untreated anxiety and depression disorders will rear their ugly head. Life on life's terms strikes again and the addict is unprepared. Being sober now feels "normal" and maybe not what one bargained for. They wonder: "Is THIS all there is?"

They have continued difficulty in managing their feelings and emotions. They fluctuate between overreacting and underreacting. They can experience emotional numbness and are even unable to explain or understand how they are feeling. The emotional rollar coaster causes mood swings, depression, anxiety, stress, and fear. As a result, they begin to find stuffing their feelings easier.

They may experience powerful shame, guilt and hopelessness. They begin to think they're inherently flawed as humans, emotionally disturbed, crazy, and not normal. As a result, they hide these feelings from others which serves to heighten and exacerbate these emotions culminating in the belief they are hopeless.

Can you identify any ways your feelings may serve as relapse cues?

Changes in attitude are a red flag that one is one the relapse road. A person may:

• Stop caring about recovery and it fades into the background. The addict may still attend meetings (AA, NA, SMART Recovery, Women for Sobriety, Rational Recovery, etc..), but the frequency may lessen or negative attitudes towards these groups may develop. They may say to themselves: "I've tried my best, but recovery just really isn't working out for me."
• Have a negative attitude about life and others: "I'll never be happy. Everyone else seems to be able to, but it's just too much work for me." They may have negative attitudes towards "normies". They want to "be happy" and have "things work out" without a clear definition of what that means. They don't know or haven't investigated what's necessary for happiness to even occur. They may begin to use "magical thinking". They dream of magic wands and miracles where their problems are solved without having to put forth any effort. They dream of being "rescued from it all". They develop an "I don't care" attitude. They begin to feel that they might as well be using since life is so miserable anyway. Life feels just as unmanageable now, if not more than when they were drinking.
• Decide the addiction can be handled on his or her own and stops asking for help.

Can you think of any example of your attitude being a relapse warning sign?

Finally, all of these changes in thoughts, feelings, and attitude culminate in behavioral changes. The addict may ultimately:

• Discontinue meetings or any recovery, for example group or individual therapy. They become complacent, a HUGE red flag.
• Begin isolating and stop participating in any activities.
• Become too busy. Addicts have a way of exchanging one addiction for another. He or she may become overly entrenched in work, hobbies, their kids, etc... They may become addicted to gambling, shopping, exercise, sex, etc...They display compulsivity and rigidity in the way they think or behave. Many people don't realize OVERINVOLVEMENT in AA or other support groups is part of this compulsivity and a red flag. They might be model AA members, chair meetings, go daily (or more), spend copious amounts of time on 12 Step work, or act like the residential therapist in their group therapy. However, social contact outside these groups is limited or nonexistent.
• Display impulsive behavior. They are like leaves blowing aimlessly around in the wind, they act on their whims without thinking about any consequences. They may make extravagant purchases, changes in their appearance, make poor relationship decisions (break-ups or hook ups), etc.

Can you think of any behavioral changes you're displaying that might be relapse signs?

The relapse road will be different for each person. There is no "set progression". It's not necessary to display all of the above signs to be in relapse. I want to drive home the idea that relapse doesn't begin with taking that first drink or drug! It's a process and fortunately there are signs before the addict is back to using. Relapse may begin hours, days, weeks, months or even years before he or she even begins using again. Even if you are in relapse, IT DOESN'T MEAN YOU HAVE TO TAKE THAT FIRST DRINK OR DRUG!!! This is when you ask for help from your sponsor, therapist, doctor, or friend. Nip it in the bud now.

It's up to each individual to identify what those signs are. This is a guide to help you pinpoint them. Consider the questions asked above very carefully. I've had a relapse, it's not pretty, folks. If I'd been armed with the above information, it might never have occurred.

"Nearly every man who develops an idea works at it up to the point where it looks impossible, and then gets discouraged. That's not the place to become discouraged." -Thomas Edison

"Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time." - Thomas Edison