Warning Signs of Relapse: Depression, Stress, and Other Triggers

Understanding Relapse

Relapse is not uncommon for individuals in recovery. That’s because the chronic nature of addiction means that, for some, a return to drug or alcohol use after an attempt to stop, can be part of the process. That being said, newer treatment approaches are designed to help individuals prevent relapse.¹ 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 lose their tolerance, so taking the amount they were once accustomed to consuming during the height of their use could result in overdose and even death.

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 their substance use. 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 substance use, and it’s important to understand that relapse doesn’t indicate a moral failing or that treatment failed. Similar to other chronic health conditions, addiction treatment should be ongoing and adjusted based on the individual. A relapse signifies that a different or more intense treatment may be needed.

Relapse generally happens in stages, which include:

• Emotional.
• Mental.
• Physical.

Emotional Relapse

Emotional relapse is often the first stage of relapse, and it occurs before someone in recovery even begins to consider returning to substance use. 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 relapse, and it is important to recognize these signs 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 them from returning to substance use.

Mental Relapse

Mental relapse is the second stage of relapse. This is often a time of internal struggle for a person in recovery, as they may want to remain sober but may be embattled in a tug-of-war of sorts with also wanting to return to substance use. Part of them may always want to use the substance again, which is why addiction is considered to be a chronic condition. As this phase of the relapse progresses, direct thoughts about substance use eventually arise, and at this point, it’s very difficult to stop. When someone dealing with addiction decides they are going to use, it’s usually just a matter of time until they do.

Physical Relapse

Once mental relapse occurs, 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 recovery. Taking the substance just one time can result in intense cravings to continue use, and the potential to enter back into consistent substance use is prevalent. Getting a person back into treatment as quickly as possible is vital.

Common Warning Signs of Relapse

Recognizing the warning signs prior to a relapse is the best way to prevent one from occurring. For some, that involves romanticizing substance use. A person in recovery may begin to relive the days of their drug use 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 returning to substance use again. This is a foray into mental relapse, which can quickly result in physical relapse. It’s easy for an individual who struggles with addiction to remember only the positives of their use and forget all the anguish it may have also caused.

A person in recovery may begin to believe that they can use again without falling back into the cycle of addiction. However, an addiction never goes away; it is a chronic health condition that requires ongoing care. An individual may think they are prepared to use the substance casually due to what they’ve learned in recovery, but for many, the only way to sustain recovery is remain substance free.

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 use. 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.

Is Relapse Part of Recovery?

As previously mentioned, relapse is not uncommon. In fact, relapse rates for substance use mirror those for other chronic conditions, such as asthma and diabetes. Approximately 40%-60% of individuals with substance use disorders relapse. When someone in recovery relapses, it does not indicate a moral failing or even that treatment doesn’t work. It means that the individual needs to consult with their doctor to resume treatment, modify it, or try another type of treatment.¹

So while relapse may be part of someone’s recovery process, for some substances, relapse can be dangerous and even deadly. For instance, if someone with an opioid use disorder relapses after abstaining from opioid use for a period of time, they could overdose if they used the same amount of opioids they once did because their body is no longer adapted to that level of drug exposure.¹

I Relapsed, Now What?

As previously mentioned, relapse can be an indication that you need to return to treatment or that your treatment plan needs to be adjusted. So if you relapse, you should consult your doctor. You can also call American Addiction Centers (AAC) at to speak to one of the knowledgeable and compassionate admissions navigators—many of whom are in recovery themselves—who can listen to your situation, explain your options, and help you get back on the path to recovery.

Relapse Prevention

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 return to substance 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 use can also help. When a person in recovery is romanticizing their past use of a drug, they are often simply thinking of the early consumption of the drug. It can be helpful for an individual to let the entire memory play out and think about everything else that accompanies the substance use, 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—or stepping up to inpatient care from an outpatient program—could be what is needed to keep them on the path to recovery. For others, therapy in an outpatient setting could be sufficient as well.

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.

Recovery from a Relapse

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 the cycle of addiction, which can lead to serious health problems and even death.

Pinpointing the reasons for a relapse is key. By identifying why a person returned to substance use, 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.

Professional treatment can help manage addiction, promote lasting recovery, and minimize relapse. AAC operates treatment centers throughout the United States, provides the complete continuum of care, and offers evidence-based therapies and individualized treatment plans. Additionally, AAC has a 90-day promise, which provides 30 complimentary days of rehab if you should relapse after completing 90 consecutive days of treatment at one of the AAC facilities.

Whether you are going to rehab for the first time or have relapsed, AAC can help find a treatment program that’s right for you and your needs. Call to connect with an admissions navigator, verify your insurance coverage, and learn about the admissions process so you can find lasting recovery.