Key Takeaways
- Post-acute withdrawal syndrome (PAWS) is a set of symptoms associated with stopping substance use that continue on for months to years in recovery.
- PAWS can generate feelings of anxiety and depression that complicate early sobriety.
- Managing PAWS involves seeking clinical treatment, participating in holistic therapies, following a relapse prevention plan, and adopting healthy coping strategies.
- Defining Wellness can help you stay the course with your sobriety and stabilize your mental health with our comprehensive addiction treatment programs.
Sure, early addiction recovery has its challenges. But when you’re dealing with unexpected anxiety, depression, or mood swings, you’re probably wondering what’s going on. Is this normal?
For some, these symptoms can indicate post-acute withdrawal syndrome (PAWS), a common challenge in the beginning of the recovery journey. While your current recovery experience may feel unpredictable and even emotionally overwhelming, you can learn to manage PAWS, achieve emotional stability, and continue to make progress with your sobriety goals.
What is Post-Acute Withdrawal Syndrome (PAWS)?
Many people experience acute withdrawal during the very early stages of recovery. This is essentially the detox phase, after all, where your body is adjusting to the absence of the addictive substance. Signs and symptoms of acute withdrawal are usually the opposite of the intoxication effects of your substance of choice, shares the Substance Abuse and Mental Health Services Administration (SAMHSA).
The signs and symptoms of acute withdrawal will occur within hours or days of the last substance use and gradually resolve. However, this isn’t always the case. As mentioned previously, post-acute withdrawal syndrome (PAWS) can remain a continued struggle for some beyond the normal cessation period of withdrawal symptoms. Anyone who’s had a substance use disorder may experience PAWS. But it’s a greater risk factor among those who’ve used heavily and/or for a very long time.
When you experience PAWS, you may deal with a handful of psychological and mood-related symptoms that persist for months or even years. Also known as protracted withdrawal syndrome or prolonged withdrawal syndrome, PAWS can occur especially in those overcoming addictions to the following substances:
- Alcohol
- Benzodiazepines
- Opioids
- Marijuana
- Stimulants
- Nicotine
- Caffiene
- Antidepressants
- Antipsychotics
SOURCE: The Journal for Nurse Practitioners
Recognizing PAWS Symptoms
Behind the scenes, PAWS symptoms are the result of brain dysfunction as it chemically recalibrates after being used to the presence of drugs or alcohol for so long, according to UTHealth Houston. Consequently, PAWS can seriously challenge your sobriety in this vulnerable season of recovery. Any momentum you may think you have can easily get thrown off, leading to discouragement and even relapse.
Considering the danger of PAWS to your long-term recovery, it’s important to recognize common PAWS symptoms so you can take any action needed to prevent relapse. Depending on your addictive substance, symptoms may vary. But typical PAWS symptoms you may encounter include:
- Anger and irritability
- Mood swings
- Emotional outbursts
- Anxiety
- The inability to think clearly or brain fog
- Short-term memory lapses
- Insomnia or disturbed sleep
- Dizziness
- Low energy
- Depression
- Balance problems
- Coordination issues and sluggish reflexes
- Experiencing panic attacks as a result of stress
- Headaches
- Physical aches and pains
SOURCE: Mental Health America
PAWS and Anxiety in Early Sobriety
Experiencing the PAWS symptoms above can make anyone’s recovery journey feel unpredictable and mentally overwhelming. No doubt your mental health can suffer as a result, leading you to develop anxiety in early sobriety. A study by Alcohol, Clinical and Experimental Research found that one in three people will experience both anxiety and depression in the early stages of recovery from alcohol addiction, for example.
Anxiety could very well be one of the persistent symptoms of post-acute withdrawal syndrome that you continue to experience on a regular basis. Your anxiety can also arise from the combination of varied PAWS symptoms and the major life adjustment you’re making in the recovery journey. You’re probably encountering several challenges as a result, from navigating addiction triggers on a daily basis to learning healthy coping strategies and trying to repair broken relationships. Early recovery can be a tough road, PAWS or not.
Anxiety disorders can also exist as co-occurring disorders alongside addiction. Your anxiety may have even led to you using drugs or alcohol in the first place as a way to cope. If you do have an anxiety disorder alongside an addiction, it’s important to seek dual diagnosis treatment to address both issues at the same time.
PAWS and Depression in Recovery
Experiencing depression in recovery can also be a common outcome of PAWs, making your sobriety journey feel more complicated. Even if you’re making good progress, restoring relationships, or establishing new peer connections in a support group, you may still feel sad, hopeless, or unmotivated.
Depression, like other PAWS symptoms, can be the result of your brain adjusting the absence of substances in your body. Dopamine levels in your brain, which are often abnormally high when on addictive substances, will rebalance to natural levels in recovery. This change in dopamine can cause you to have a depressed mood in response.
You may also feel depressed due to the life changes that occur in early recovery. Up to this point, your addiction has been a major part of your daily existence. Leaving it behind may honestly feel like you have a void in your life. Your feelings of depression can occur for other reasons as well, but you no longer have substances to self-medicate for these negative feelings.
Managing PAWS: Healthy Strategies in Recovery
The good news is that post-acute withdrawal syndrome will eventually subside. Or it may come and go for a time before phasing out. Everyone’s experience with PAWS is different. If you’re in the thick of it right now however, it’s important to take proactive steps to manage PAWs well, as symptoms like anxiety and depression can lead to relapse if you’re not careful. Some of the healthy strategies you can pursue for managing PAWs and supporting your mental health include:
Seeking Clinical Care
It’s important to partner with professional treatment during your recovery, especially in the early stages. A treatment center can provide specialized clinical care that you couldn’t otherwise get on your own.
At Defining Wellness Centers, we’re experts at managing PAWS so that you can stay the course in your recovery. We utilized evidence-based treatment practices like cognitive-behavior therapy and medication-assisted treatment to reduce PAWS symptoms and prevent relapse.
Participating in Holistic Therapies
Comprehensive treatment at addiction recovery programs like ours at Defining Wellness will include experiential, holistic therapies that help address some of the deeper issues within addiction. As a result, mental health challenges like anxiety and depression are stabilized and healed in the recovery process. Examples of holistic therapies we offer include:
- Cold plunge therapy
- Equine therapy
- Art therapy
- Sweat lodge therapy
- Adventure therapy
- Breathwork
- Yoga
- Music therapy
Creating a Relapse Prevention Plan
Creating and following a relapse prevention plan is crucial to maintaining your recovery goals back in the real world. At Defining Wellness, we help you build a plan with holistic relapse prevention techniques that give you the confidence you need to reclaim your life. A typical plan will list your known addiction triggers, as well as provide guidelines for self-care, coping mechanisms, and support systems that reinforce your recovery.
Adopting Healthy Coping Mechanisms
Coping mechanisms are vital in the recovery journey, especially when navigating PAWS and any ensuing anxiety or depression. There are numerous healthy coping strategies you can learn that aid your mental health, such as mindfulness meditation, yoga, exercise, spending time with loved ones, and pursuing hobbies you enjoy. At Defining Wellness, we’ll equip you with the coping skills you need to manage your mental health well in the recovery journey.
Heal Your Addiction and Mental Health With Defining Wellness
Having PAWS is a normal part of the healing process in recovery. You aren’t to blame if you’re dealing with it now. With that said, if you are experiencing addiction recovery challenges like anxiety or depression, we can help at Defining Wellness Centers in Mississippi with our holistic, comprehensive addiction treatment and continuing aftercare. By partnering with us, you can achieve both lasting recovery and healthy mental wellness. To get started, call our team today.
Frequently Asked Questions
How long does PAWS typically last?
Post-acute withdrawal syndrome can occur for a period of a few months to up to two years. Its duration will depend on how often you used substances, as well as how much you used. The timeline of PAWs can also be affected by your overall health, as well as your recovery practices. Typically, however, PAWS symptoms will start to decline after a few months.
What are addiction triggers?
PAWS symptoms can act as one of many addiction triggers you may encounter on the road to recovery. Addiction triggers can be anything associated with your substance use that may drive you to relapse in response. Common addiction triggers include certain feelings, places, people, smells, sounds, objects, or experiences.