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Harvard Health Blog
How to avoid a relapse when things seem out of control
- By Peter Grinspoon, MD, Contributor
There is no one who would deny that this has been a stressful year. As the Grateful Dead said, “If the thunder don’t get you, the lightning will.” If you manage to avoid catching COVID, then you are probably at least contending with some mixture of financial and childcare stress, the nail-biting political divisions we see daily on television and social media, and a constricted social universe. Our society already suffers from an epidemic of loneliness that has been cruelly worsened by the physical distancing required to keep the pandemic at bay.
Even people not struggling with addiction are finding their drug and alcohol use rising, along with other unhealthy habits. In a perfect world, we’d all reach for the yoga mat, go for walks, eat tofu, meditate, and practice mindfulness, but… we’re only human. Stress can lead us to excel, but it can also lead us to harmful habits, whether it be ice cream or potato chips, or that extra beer we know we don’t need. The additive, multifactorial, unrelenting stress that the year 2020 has brought would challenge even a Zen master to keep his or her cool.
For those struggling to stay in recovery from a drug or alcohol addiction, each day can be a challenge, even on a good day. That’s why the saying from Alcoholics Anonymous, “one day at a time,” has withstood the test of time, and has proven so helpful as a way to make facing the stresses of each day seem manageable, without relapsing to your mind-numbing crutch of choice.
What can you do to stay in recovery when the world seems to have gone crazy?
People joke on Twitter about how the year 2020 has been the longest decade they can remember, but in truth, it is hard for anyone to retain their equanimity with this steady drumbeat of frightening news. What can someone do to protect their hard-earned recovery?
The answer to this question relies on a deep understanding of what recovery from addiction truly is. Recovery is not a negative, the mere absence of taking drugs. Rather, recovery is a positive way of being in the world that substitutes healthier ways of coping with problems and interacting with people, so that the drugs and the alcohol don’t really have a foothold in your life anymore. Recovery is about connecting with others, and about asking for help when you need it, as much as it is about not just obliterating negative feelings with a drug or a drink. These are two sides of the same coin. Recovery is about being grateful for what is going well in your life, rather than focusing on what you don’t have, what you did wrong, or what could have been.
It is often said that when a person relapses, the act of taking the drug or the drink is the final manifestation of the breakdown in their recovery process. That is, people lose sight of — and stop practicing — the positive ways of being and interacting that have supplanted their drug use. The drug or the drink is left to fill the vacuum, and to erase the pain. For example, one might stop going to meetings, stop seeing other people, and then start to feel lonely and hopeless. Next thing, they are reaching for a fix. Or they might fall out of their exercise routine and, as a consequence, stop sleeping well, which leads to their anxiety symptoms returning. Soon enough, they are miserable enough to say, “forget this, I’m getting some vodka.”
The greater the stress, the more important it is to practice healthy habits
To combat stressful times (which are inevitable in life), we must rededicate ourselves to our healthy habits. The more stressful the times, the more important — even lifesaving — these habits become. It is critical to check in with yourself daily, to be honest with yourself if you are slipping, and to have techniques for getting back on track.
Some of the habits that keep my recovery on track
- Remember to be grateful. In rehab we had to write a daily gratitude list. While I’m too lazy to actually write this out anymore, I do make a mental list every morning, and it grounds me in the fact that there are plenty of reasons to be optimistic.
- Daily exercise. Even just a short walk a few times a day is good. Exercise lowers stress, improves sleep, and boosts mood.
- Pay attention to your needs. An acronym for things that trigger relapse is HALT, which stands for “hungry, angry, lonely, tired.” Stay on top of these things, so you don’t find yourself getting so miserable that you act impulsively.
- Have a mantra that you say to yourself to give yourself a boost when you’re feeling down. One recovery mantra that I like is “progress not perfection,” meaning you’re doing your best to head in the right direction, and that no one is perfect.
- Ask for help! There is no shame in this, at all. Imagine a friend of yours, any friend. Now, imagine they are lonely, suffering, and are so miserable they are about to drink themselves into oblivion. Wouldn’t you want them to call you and ask for help? Of course you would! That’s how any of your friends or family members would feel if similarly you were in need of such help.
- Volunteer, get involved, and help others. When you are helping other people, it is much harder to focus on and wallow in your own misery.
- Take news breaks. This is a tough one, because we have an obligation to be informed citizens in these challenging times, but sometimes enough is enough. The other day, driving home from a complex day in primary care clinic, I turned off NPR — about the pandemic — and started listening to the Beatles. It was a fantastic choice, and it turned around my entire day.
Most of all, if you do slip up — whether it be drugs, alcohol, your diet, your New Year’s resolution, gambling — don’t beat yourself up. Self-compassion is what is going to get us through these tough times. Just reach out for the help you need and realize that this is a marathon, not a sprint. With a continued focus on healthy habits, sustaining relationships, and ways of being in the world, we will help each other — and ourselves — get through these seemingly impossible times.
About the Author
Peter Grinspoon, MD, Contributor
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No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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