Recovery from addiction is part and parcel of mental health for a person with a history of addiction.

For a recovering addict or alcoholic, as well as for family and loved ones, relapse can be more painful and unsettling than the initial realization and admission of being an addict or alcoholic. Falling back into old patterns that lead to picking up a former drug of choice can drive home an awareness of powerlessness over the disease.

Addiction is a chronic brain disease. It is as though a dark figure is lurking in the background, sometimes unnoticed, waiting for a vulnerable moment. One medical consequence may be overdose. Death may occur quickly if the relapsing addict returns to a dose, which the body can no longer tolerate.

Relapse may be intertwined with feelings of despair and spiritual emptiness.

Change leading to recovery has a spiritual element. One tradition might call it salvation, another enlightenment. Awakening shines new meaning on life, leading to stronger, better relationships, which in turn strengthen recovery in a healthy cycle.

Perhaps two-thirds of all relapsers do so during their first 90 days of recovery. The first three months of recovery is recognized as a period of high risk when the most intensive supports are needed. Twelve-step programs often recommend daily support group attendance during the first 90 days of abstinence.

Psychologist Terry Gorski describes symptoms common to addicts new in recovery, whether clean for the first time or after a relapse, called “post-acute withdrawal syndrome:” inability to concentrate, impaired abstract thinking (values, meaning, purpose), rigid and repetitive thinking, poor short-term memory, over reaction or emotional numbness.

The longer a person was sober prior to a relapse, the less severe the above symptoms are likely to be. In the first nine months, such symptoms are present in virtually all newly recovering people. Over 10 years, the problems that persisted longest were depression, obsessions and compulsions, shame, irritability, insomnia, restlessness, loneliness and distractibility.

A study by Richard Dunn of 202 relapsing addicts and alcoholics, each with a minimum of six months abstinence preceding relapse (33% female, 23% Black/Hispanic), lists what it found to be the most common triggers for relapse. Among them are loneliness (psychological, existential isolation, not necessarily physically alone); stress and conflict at home (strife over money, intimacy, or absence of communication); boredom or lack of challenge at work, or unemployment; anger (the “screw you” relapse); secret disappointment with sobriety; not feeling “right with God” (meaninglessness, unresolved/unforgiven personal guilt); euphoric recall of being high; depression (particularly in women); reactivation of denial; and secret thoughts of drinking or drugging.

The opposite of relapse is personal growth.

To prevent isolation, decide who you want to make contact with. What are you doing about it? Addiction is an isolated, withdrawn, lonely experience. Actively combat loneliness, looking for ways to make amends to others and to society. Family or couples therapy may help.

Be conscious of nutrition and stimulant use, including caffeine and nicotine.

What works for anger and depression apart from psychotropics is much the same as what works for stress-reduction. There is something absolutely magical about personal talk. Other ways to reduce stress include physical exercise (for some people), yoga, love, meditation, prayer, deep breathing, walking, jogging, singing, dancing, athletic activity, martial arts, recreation and play.

A recovering addict who is afraid of relapsing needs to talk about it. Loved ones can offer support by listening without judging and not interpreting what the person fears as meaning they will relapse. Simply having someone to talk with may prevent relapse from occurring. For those who find the wisdom of using a 12-step program, a close relationship with a sponsor, generally someone of the same gender with a lot of experience in recovery, is critical. To find meaning in life—purpose, values, ethics—work the steps, and stay close to your sponsor.

[Tom Rue is a Licensed Mental Health Counselor in New York. Contact 845/513-5002 or choicesmhc.com.]