In medical terms, a relapse occurs when a disease in remission returns. Addiction itself is a disease of the brain reward system, and extended substance abuse causes physical changes in critical brain pathways. Rehabilitation centers offer the best treatments to reduce symptoms and restore neurobiological health, but addiction is a chronic disease with a perpetual risk of relapse. The Journal of Psychoactive Drugs published a study in 1990 that said most relapse-prone addicts have the motivation and commitment, but other factors contribute to their setbacks. Often in connection with other mitigating factors, the holidays can play a role in motivating a lapse or relapse. In either case, recovering addicts should address the problem immediately.
Better Understand Relapse
When addressing a relapse it helps to understand the process behind it. Resource materials posted by the United Nations Office on Drugs and Crime note that relapse and renewed substance use are not the same. Drinking or using again is an event, but relapse is a series of stages that lead to the event if not properly addressed. Typically the process starts with an emotional relapse in which feelings of shame, anger, anxiety, doubt, and stress return. Recovery techniques might have kept these negative emotions at bay, but the person now struggles to get them under control or simply does not try. Insomnia, concentration problems, social isolation, and increased sensitivity are common symptoms. In time the emotional relapse leads to a mental relapse in which the person starts to fantasize about substance use again. The mind starts to dwell on the excitement of past highs or the euphoric promise of future ones. Like a seed planted in the mind, the thoughts become obsessive, and the person succumbs to a complete relapse that includes drinking or using drugs again. The three-stage process can be quick or drawn out, but situations and environments like the holidays can contribute to the problem.
Relapse Risk and the Holidays
Recovering addicts need to recognize the risks commonly associated with the holidays. They epitomize a situation that can contribute to relapse in several ways including the following:
- Psychology Today says negative history can trigger bad emotions at family gatherings.
- The majority of holidays are largely associated with drinking and partying.
- Holiday-related work and social events often take place at bars or involve alcohol.
- Spending holidays alone can fuel feelings of inferiority, loneliness, and depression.
- Prescription drugs belonging to friends or family might be accessible during holidays.
- Holidays might involve increased stress at work, with children, or from family members.
- Traumatic past events might have a special association with a particular holiday.
- Winter holidays in northern locales might involve bad weather that saps energy.
Biological factors can also play a role during holidays. If it is a summer holiday, Psych Central noted in 2011 that heat waves appear to increase substance abuse rates. If it is a winter holiday, the recovering addicts might struggle with the seasonal affective disorder (SAD). According to the Mayo Clinic website, the appropriately named SAD is a type of depression triggered by reduced sunlight and falling temperatures. The seasonal changes affect melatonin and serotonin levels and circadian rhythms, especially in people who are genetically predisposed or have a family history of mental health disorders. The symptoms include excessive sleep, concentration problems, and lethargy as well as classic symptoms of depression and anxiety. The combination of mood swings and holiday stress can make it more difficult to curb relapsing thoughts and emotions that lead to renewed substance abuse.
How to Respond to Relapse
Even if the holiday or family gathering is still in progress, a relapse necessitates an immediate response. Do not let the substance use roll through the holiday with the intention of getting help when it is over. In terms of specific ways to respond, there are several including the following:
- Do not hide the relapse even if friends and loved ones will be disappointed or angry.
- Immediately remove the drugs, alcohol, or paraphernalia from your possession or home.
- Speak with your recovery sponsor and/or counselor as soon as possible.
- Consider crisis counseling if the sponsor and regular counselor cannot be reached.
- Move to a new place or setting that provides less temptation and more accountability.
- Renew one’s commitment to the group, and share the experience at the next meeting.
- Rejoin aftercare therapies or healthy activities that had been ignored or set aside.
- Get screened and pursue treatment for mental health disorders like SAD if diagnosed.
- Take note of people, emotions, situations, and other factors that possibly contributed.
As previously noted it is important to understand the relapse process because recovering addicts must learn to recognize the early emotional and mental stages that precipitate falls. Likewise, if mental and emotional issues are at play, the person should consider additional treatment in a residential or outpatient rehab center. A 2011 Treatment Episode Data Set (TEDS) report shows that nearly 57% of treated patients had at least one previous stint in rehab. Many recovering addicts seek additional care, and it can make a significant difference in getting the recovery back on track.