Warning Signs of Relapse: Depression, Stress, and Other Triggers
The potential for relapse is always there, but knowing the warning signs that could foreshadow a relapse can help to avoid it. It’s important for friends and family to be educated on what to look for as potential triggers for relapse, and it’s important for those in recovery to be able to monitor themselves as well.
Individuals recovering from any kind of addiction often experience at least one relapse, according to the National Institute on Drug Abuse (NIDA). Relapse can be especially dangerous for someone who has abstained from drug use for a long time. Those who have been in recovery for a lengthy amount of time will lose their tolerance for the drug of abuse, and taking the amount they were accustomed to consuming during the height of their abuse could result in overdose and even death.
Addiction is a chronic disease, making relapse a possibility no matter how long a person has abstained from substance abuse. Once relapse occurs, it can be difficult for an individual to get back on the road to recovery. They will likely feel the strong desire to continue to use once they do even one time. As a result, getting someone back into treatment as quickly as possible following relapse is crucial to their long-term health and recovery.
The Stages of Relapse
Relapse is more of a process than the singular event of resuming use. It’s broken down into three stages:
Emotional relapse is often the first stage of relapse, and it occurs before someone in recovery even begins to consider using again. The individual usually starts to experience negative emotional responses, such as anger, moodiness and anxious feelings. They also may begin to experience erratic eating and sleeping habits, and their desire for recovery often wanes due to a lack of using their support systems. These are the initial warning signs that a person in recovery could be entering the process of relapse, and it is important to recognize them as quickly as possible. This stage occurs before a person is even aware that they could be in danger of relapse, and intervening now before they enter mental relapse can prevent the issue from taking hold.
Mental relapse is the second stage of the process. This is often a time of internal struggle for a person in recovery, as part of them wants to remain on the road to long-term sobriety; however, that part of them is embattled in a tug-of-war of sorts with another side that wants to return to using. There may always a part of a person that wants to use again, which is why addiction is considered to be a chronic condition. As this phase of the relapse process progresses, direct thoughts about using eventually arise, and at this point, it’s very difficult to stop the process. When someone dealing with addiction decides they are going to use, it’ usually just a matter of time until they do it.
Mental relapse is a very difficult stage to come back from, and it often gives way to the third and final stage of the relapse process.
Once mental relapse has occurred, it usually does not take very long to progress to the physical relapse stage. This is the stage that is most commonly thought of when one hears the term relapse. Physical relapse occurs when a person consumes the substance, breaking their sobriety. Using just one time can result in intense cravings to continue to use, and the potential to enter back into consistent substance abuse is prevalent. Getting a person back into treatment as quickly as possible is vital.
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Recognizing the warning signs prior to a relapse is the best way to prevent one from occurring. A very common warning sign is romanticizing of drug use. A person in recovery may begin to relive the days of their drug abuse and look back on them in a positive light. A positive view of all the perceived good times they had can be a dangerous trigger that plants the idea of using again in their mind. This is a foray into mental relapse, which can quickly result in physical and full relapse. It’s easy for an addicted individual to remember only the positives of their abuse and forget all the anguish it may have caused them.
A person in recovery may begin to believe that they can use again without falling back into their addiction. However, an addiction never goes away; it is a chronic condition that needs to be dealt with continuously. An individual may think they are prepared to use casually due to what they’ve learned in recovery, but recovery only comes with full abstention from consumption of the drug. If an individual in recovery begins to talk about their ability to use again without falling back into addiction, it is often a sign that relapse is on the horizon.
Monitoring who a person in recovery interacts with can help to prevent relapse. If an individual is revisiting old relationships that involved drug use, it can be a trigger that results in substance abuse. Negative environments can have a serious impact on a person in recovery due to their vulnerability to such influences.
Behavior is often a clear warning sign of relapse as well. Sudden changes in the way someone in recovery is acting often precedes a relapse. This may be evidenced by increased isolation and avoidance of one’s sober support system. A person may also cease the pursuit of interests and hobbies they have developed in recovery.
Perhaps the most glaring warning sign is if an individual in recovery starts to doubt the effectiveness of the recovery process.
If they begin badmouthing the process or showing disdain for recovery, it could be an indicator that they are on their way to relapse.
Triggers for Relapse
There are many things that can trigger a relapse in an individual. One of the most common triggers is depression. Depression and substance abuse are often linked. People battling depression commonly use drugs to combat the depressed feelings they are experiencing. In addition, substance abuse can often lead to depression, thus beginning a vicious cycle of using drugs and subsequent depression.
Depression puts a person at a higher risk for suicide, as does substance abuse. Combine the two, and the risk for suicide increases dramatically; while those who suffer from depression have a 10 percent chance of committing suicide, that risk rises to 25 percent for those who suffer from depression and also abuse substances, according to Psychology Today. This is why it is paramount to recognize signs of depression in someone in recovery, as the stakes are as high as they get.
Some symptoms of depression are:
- Low energy
- Significant appetite fluctuation
- Feelings of being worthless
- Problems concentrating
- Anxious feelings
- Change in sleep patterns
- Lack of interest in things
Stress can be another common trigger for relapse. According to Medical News Today, stress is the feeling experienced by someone who is under pressure. For many people, stress is part of everyday life, and most individuals need an outlet to deal with their stress. For those prone to addiction, substance abuse is a common way for them to cope with stress. A study published in the Annals of the New York Academy of Sciences even suggests that stress early in life can lead to a bigger risk for addiction down the road. This shows the dramatic impact that stress can have on addiction.
According to European Neuropsychopharmacology, research suggests that people who have used drugs in order to mitigate stress in the past are likely to return to this behavior when future stressors arise. This would suggest that someone in recovery could be prone to relapse due to an elevated level of stress in life.
Exhaustion can be another trigger that results in relapse. Lack of sleep often leads to self-neglect, which can make a person more vulnerable to using again. Recovery is a day-to-day process that requires a focus on healthy living. If someone is not operating with all of their faculties due to exhaustion, they are less likely to be employing the techniques they learned in treatment.
Isolation can be another trigger for relapse. A positive support system is crucial to ongoing recovery.
This can mean being surrounded by supportive loved ones, going to counseling regularly, or attending a peer support or 12-Step group. Isolating oneself from these support resources can put one at a greater risk for relapse.
Addressing mental urges can be an effective tool for preventing relapse, at least on a short-term basis. Speaking to someone about the urge to use can often help to reduce that urge and bring rational thinking to the forefront of the equation. This is a reason that a lot of support programs employ the use of a sponsor; it can be critical to have someone to talk to when the urge to use arises.
Thinking about the full scenario after romanticizing substance abuse can also help. When a person in recovery is romanticizing their past use of a drug, they are often simply thinking of the early stages – the consumption of the drug. It can be helpful for an individual to continue to “play the tape through” and think about everything else that accompanies using, specifically all the consequences that come along with it. This can help an individual remember why they sought recovery in the first place.
Reentering a residential treatment facility is sometimes a necessary step to preventing relapse. If the urge to use has become strong enough, reinserting someone into the very environment in which their recovery began could be what is needed to keep them on the path to recovery. Therapy in an outpatient setting could be sufficient as well.
Again, the support of friends and family can be paramount in preventing relapse. It’s important for such people to be educated on the process of recovery, as well as the risks and warning signs of relapse. Their ability to monitor their loved one in recovery can be crucial in preventing a relapse.
Relapse rates for substance abuse mirror those for other chronic conditions, such as asthma and diabetes, meaning that relapse is a common occurrence. However, a relapse not mean that someone has failed at recovery. It’s simply part of their process – an obstacle that must be overcome.
Prompt action is the best way to address a relapse. The individual must recognize that a relapse, while not a failure, is a serious thing. Each relapse presents the potential to fall back into continuous abuse, which can lead to serious health problems and even death.
Pinpointing the reasons for a relapse is key. By identifying why a person used, proper safeguards can be put in place to prevent those same triggers from resulting in another relapse. The more an individual knows about their personal triggers and warning signs, the easier it will be for them and their loved ones to recognize any signs of a relapse. A relapse prevention plan, often devised with the help of a therapist, can be an effective tool in ensuring another relapse does not occur. While there is no way to guarantee that a relapse will not occur, there are certainly steps for prevention and recovery that can increase the likelihood of a long and successful recovery.
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