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Health Centre

What Exactly is a Relapse?

It is a process.

Relapse is not an event, but a process. An ‘event’ is something that has already happened and therefore cannot be changed. On the other hand, ‘process’ refers to any ongoing situation that takes place stage by stage, and therefore can be interrupted and stopped at any stage. You can interrupt and stop a relapse, only if you are aware of the negative thinking patterns, which indicate the onset of a ‘slip’.

Relapse occurs within your mind

‘Relapse patterns’ are formed by your attitude and thought process. You begin to ‘slip’ at the thought level. The following are some examples of “relapse indicators”. They are similar to “dry drunk’ problems.

  1. Changes in attitude
    • Not caring about sobriety
    • Becoming too negative about life
  2. Changes in thought
    • Thinking that you ‘deserve’ a drink because you have been sober for quite some time.
    • Thinking that you can use substitute drugs
    • Thinking that your problem is ‘cured’ since you have been abstaining for sometime.
  3. Changes in feeling
    • Increases moodiness or depression
    • Strong feelings of anger and resentment
    • Increased feelings of boredom and loneliness
  4. Changes in behaviour
    • Increased episodes of arguing with others
    • ‘Forgetting’ to take Disulfiram
    • Skipping Alcoholic Anonymous (AA) meetings
    • Stopping in a bar just to socialise and drink soda or other soft drinks
    • Increased stress symptoms such as smoking more cigarettes
    • Threatening to drink to have our way
    • Talking repeatedly about the pleasures associated with drinking

Coping Problems

There are several problems associated with abstinence. Here are the five major problems you may experience during the initial stages.

Inability to think clearly

The first problem you may experience is thought process impairment. It will appear as if your brain sometimes works right and sometimes does not. You will not be able to concentrate for more than a few minutes. You may not be able to understand abstract reasoning. You will not be able to take decisions or solve problems. Everything around – even minor problems will look threatening. You feel incompetent and embarrassed. Low self-esteem and fear of failure become evident.

Another common problem is rigid and repetitive thought pattern. The same thought may go round and round in your head and you will be unable to break through this circular thinking in order to put thoughts in an orderly way.

Memory problems

You may not be able to remember things. You may hear everything and understand them thoroughly, but within 20 minutes, you will forget parts of it.

You keep misplacing things. You keep forgetting new telephone numbers. Such incidents result in stress, and this stress aggravates short-term memory impairment. Because of such memory problems, it becomes difficult for you to learn new skills.

Emotional over reaction or numbness

Some tend to overreact during abstinence. When things happen that requires two units of emotional reaction, you react with ten. That is, you feel much more anxious or tensed up than what you have reason to be. This is sometimes followed by emotional numbness. You are unable to express any feeling when there is a really stressful situation. You swing from one extreme to another without knowing why.

Over–reaction on the one hand, and total passivity on the other, cause a lot of confusion and concern for you and for the others close to you.

Physical co-ordination problems

The common problems experienced are trouble with balance, problems with co-ordination between hand and eye and slow reflexes. These result in clumsiness. This often makes you feel humiliated and extremely low.

Stress build–up

You fail to take action at the appropriate time and later on when stress builds up, do things that are completely inappropriate.

To complicate things further, all the above mentioned problems become worse during times of high stress. There is a direct relationship between elevated stress and the severity of these problems. Each intensifies the other. The intensity of these problems creates stress, and stress makes the problems more severe. At times of low stress, the symptoms get better or may even go away.

Conditions that put a person in high risk of experiencing these problems are usually lack of care or attention to the recovery programme. Also certain life situations such as marriage, taking up a new job, starting on a new business venture, or moving to a new city, are stress-producing events. These have to be consciously avoided during the first few months of abstinence. However, there may be other unanticipated events like the death of a family member, termination of one’s job, etc. Since one cannot remove oneself from all stressful situations, you have to be prepared to handle them when they occur. It is often not the situation that bothers a person, as much as his reaction to the situation. Managing stress can be achieved through open sharing with someone you trust. Relaxation exercises also help in stress reduction.

You should realise that these problems are a normal part of recovery and are reversible with continued abstinence and a recovery programme. With proper guidance and support, you will be able to manage the problems and get out of them in course of time. Relapse is preventable.


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