Many people think of alcohol and drug withdrawal as the physical discomfort you have over a short period of time after quitting drugs or alcohol. While it’s true that in most cases physical withdrawal symptoms subside within three to seven days, psychological withdrawal symptoms may linger for weeks or months after withdrawal and detox. This is known as post-acute withdrawal syndrome.
Post-acute withdrawal syndrome or PAWS refers to drug or alcohol withdrawal symptoms in early addiction recovery that are psychological in nature. This happens as your central nervous system works to rebalance itself without the addictive substances it’s grown to depend on to function.
Drugs and alcohol tell your brain to produce more of its feel-good chemicals. That’s what creates the high or relaxed feelings you get when you drink or use drugs. When you continue abusing a substance, it depletes your natural supply of those chemicals. The brain then begins to depend on alcohol or drugs to produce normal levels of chemicals, which are tied to many of the body’s functions. That’s why quitting addictive substances throws your system into shock as it tries to rebalance itself without drugs and alcohol. What results is the physical withdrawal symptoms people associate with detoxing like tremors, vomiting, and others. Physical withdrawal symptoms usually ease up over a few days or a couple of weeks at most. PAWS symptoms can last weeks or months.
Post-acute withdrawal syndrome is protracted withdrawal. It’s the longer-term aftermath of substance abuse. Addiction leaves a chemical imbalance in the brain that causes physical withdrawal, but can also cause mental illness symptoms. That’s because chemicals play a central role in mental health disorders like depression and anxiety disorders. PAWS symptoms usually kick in about two to four weeks after drug or alcohol detox and gradually get better over time.
Common post-acute withdrawal symptoms include:
- Mood swings
- Depression symptoms
- Anxiety and panic attacks
- Sleep disturbances
- Irritability
- Confusion and fogginess
- Low energy and motivation
A common PAWS risk is relapse. Feelings of depression, anxiety, boredom, or apathy can drive you to self-medicate with substance abuse. Drugs or alcohol was likely how you coped with these emotions during active addiction, so they can be very triggering during recovery. It’s important to remember that while using or drinking may numb these feelings for a few hours, substances ultimately make mental health symptoms worse.
How Do You Treat PAWS?
Symptoms of post-acute withdrawal can be treated through a combination of medical and behavioral approaches.
Medication
Sometimes prescription drugs like antidepressants and anti-anxiety medications can ease depression or anxious symptoms that accompany PAWS. They help correct some of the chemical imbalances left by overstimulation of neurotransmitters like dopamine and serotonin.
Behavioral Therapy
Research shows that behavioral therapy and medications can work together to ease mental health symptoms. Evidence-based addiction treatment like cognitive behavioral therapy can help you regulate your emotions and address unhealthy thinking patterns that can trigger relapse. Antidepressants or anti-anxiety medications can help you feel good enough to put behavioral therapy tools into practice.
Support Groups
Attending 12-step groups or 12-step alternatives provide an important sense of support and accountability in early recovery. When PAWS symptoms are threatening your sobriety, having peers or sponsors you can lean on is critical.
Exercise and Nutrition
The mind-body connection is real. Studies have long touted the benefits of exercise in preventing or easing psychiatric symptoms. Research also underscores the importance of proper nutrition in recovery. When you take care of your body, it has a positive impact on your brain and overall well-being. When you feel good, it’s easier to resist triggers.
Mindfulness and Spirituality
Meditating, yoga, and other mindfulness practices help you stay grounded in the moment. This can ease ruminating and negative thoughts. Spirituality gives you a sense of being part of something bigger than yourself. Both of these are good for your behavioral health.
Self-Care
In addition to eating well and exercising, other forms of self-care can support your sobriety. Getting enough sleep can have a huge impact on how you feel and your ability to cope with difficulties. Participating in hobbies or hanging out with people you enjoy are mood boosters. Self-care also means keeping up with your aftercare plan. That may include things like medication-assisted treatment, therapy appointments, alumni groups, 12-step groups, and checking in with sponsors regularly.
Post-acute withdrawal syndrome is sometimes a normal part of recovery. Not everyone will experience it and the severity of it depends on a lot of factors like the severity of your addiction and your individual physical make-up. Reminding yourself that PAWS is temporary and gets better with time may help you get through this time.
Looking for Help?
Whether it’s your first time in a rehab center or you’ve relapsed several times, we can help. Footprints to Recovery offers evidence-based treatment for substance use
disorders that is individualized to your needs and background. Your personalized treatment program will be relevant to where you’ve been and where you hope to go. You’ll recover alongside peers who understand what you’re going through and receive care from compassionate treatment providers who are experts in their fields. We help you address the underlying issues of addiction like co-occurring disorders and trauma. You’ll learn healthy coping strategies and leave with a toolbox of recovery skills for long-term sobriety.
Our addiction treatment centers offer:
- Medical detox
- Inpatient rehab
- Partial hospitalization program
- Intensive outpatient program (IOP)
- Outpatient treatment
- Sober-living residences
Call us for a free, confidential consultation.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268458/
- https://pubs.niaaa.nih.gov/publications/arh314/348-361.htm
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712746
- https://pubmed.ncbi.nlm.nih.gov/28806640/
Footprints to Recovery Editorial Staff
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