The nature of addiction makes relapse common. According to the National Institute on Drug Abuse, about 40 to 60 percent of people who receive treatment for addiction relapse within the first year of recovery. That relapse rate might appear intimidating but keep in mind it also means that 40 to 60 percent of people don’t relapse during the first year. And once you make it through the first year, the second is a bit easier.
Just as addiction is different for everyone, relapse is different for everyone. There is research suggesting that it might be different for men and women. For example, one study of people recovering from cocaine addiction found that men were more likely to relapse following positive experiences while women were more likely to relapse following negative experiences, especially interpersonal conflict. That study also found that men were more likely to plan a relapse then rationalize it after the fact and women were more likely to relapse impulsively. This complicates the stereotypical picture of someone in recovery giving in to temptation following a traumatic experience, or just a really bad day.
While there’s no one way relapse happens, there are often common features. What’s more, relapse is often a process that often takes weeks or months. It may follow several months—or even years—of an apparently strong recovery. It typically starts with emotional relapse, proceeds to mental relapse, then finally to physical relapse. Here are what each of those stages looks like.
During an emotional relapse, you probably have no intention of drinking or using drugs again. You remember how bad life was before you went into treatment and you have no desire to go back there. However, you’re not feeling great either. Perhaps your recovery has stalled a bit and your motivation is waning. Perhaps you have gotten a bit complacent and begun to let some important aspects of your recovery plan slide.
Typical signs of emotional relapse include bottling up emotions, isolating yourself, not going to 12-Step meetings or going but not sharing, being preoccupied with other people’s business, and poor eating and sleeping habits. Poor self-care, in general, is a major warning sign of emotional relapse. It suggests you’re not following your recovery plan and it can quickly lead to deteriorating mental health. Good sleep habits are particularly important for mental health. Without adequate sleep, you quickly suffer cognitive impairment, including poor attention, memory, and self-control. Over time, poor sleep increases your risk of anxiety and depression. Studies also suggest that diet plays an important role in mental health too. A diet high in sugar and processed foods is especially bad for mood and focus. Letting bad habits creep in is likely to adversely affect your mental health and make recovery harder.
If you notice the symptoms of emotional relapse, the best thing to do is go back to basics and pay attention to self-care. Go to 12-Step meetings, get plenty of sleep, exercise, and talk to your sponsor or therapist. At this point, you probably still have a genuine desire to stay sober, so do everything you can to get back on track.
At the stage of mental relapse, your position is more precarious. In the beginning, you still want to stay sober but you also feel conflicted. You may not feel like recovery is everything you hoped it would be. Perhaps you’ve gotten pretty negative or cynical. Perhaps your mental health has deteriorated to the point where you wonder whether it’s worth the effort to stay sober.
Typical symptoms of mental relapse include having drug and alcohol cravings, thinking about people, places and things associated with drugs and alcohol, minimizing the consequences of past use or glorifying past use, bargaining, lying, thinking of schemes to use drugs or alcohol in moderation, looking for excuses to relapse, and finally, planning to relapse. At this point, you’ve basically decided to give up on recovery and you will probably relapse at the next opportunity.
At the beginning of the mental relapse stage, it’s still possible to correct course but the farther you go, the harder it is. When you get to the point where you’re planning a relapse, someone might have to intervene if you are going to stay sober.
If you start to notice that you’re glorifying past drug or alcohol use, it might help to “play the tape.” This is when you think beyond the immediate gratification of using again to all the consequences that will follow. Imagine as vividly as possible how disappointed you would feel after relapsing. Think of the people who will feel let down. Remember the feelings you had just prior to getting help when you felt like you were at your lowest point. Vividly imagining the consequences of a relapse can motivate you to ask for help when you’re struggling with sobriety.
Physical relapse is when you actually start drinking or using again. This may be more of a slip or a full relapse. Both are serious but a slip is much easier to come back from and exposes you to less danger. Often, people fall into the trap of thinking, “Well, I’ve ruined my recovery, so I might as well go all out.” That’s an example of black-or-white thinking. If you have a slip, the best thing you can possibly do is get sober again as soon as possible.
Contrary to popular belief, relapses don’t typically come out of the blue. They often happen when you get complacent in recovery and your mental health starts to slide. Everyone has ups and downs in recovery and learning to correct course when you’re down is part of the deal. Perhaps most importantly, a relapse, if it happens, doesn’t mean you’ve failed. Many people have a long recovery after several tries. The important thing is not to give up. At Steps Recovery Centers, we aim to be there for our clients during treatment and beyond. If you do slip up, we’ll help you try again. To learn about our alumni services, call us at 385-236-0931.