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PAWS Part 2
Emotional Overreaction or Numbness
Persons with emotional problems in sobriety tend to overreact. When things happen that require two units of emotional reaction, they react with ten. It is like holding the “times” key down on a calculator. You may find yourself becoming angry over what may later seem a trivial matter. You may feel more anxious or excited than you have reason to be. When this overreaction puts more stress on the nervous systems than it can handle, there is an emotional shutdown. If this happens to you, you become emotionally numb, unable to feel anything. And even when you know you should feel something, you do not. You may swing from one mood to another without knowing why.
Sleep Problems
Most recovering people experience sleep problems. Some of them are temporary; some are lifelong. The most common in early recovery is unusual or disturbing dreams. These dreams may interfere with your ability to get the sleep you need. But they become less frequent and less severe as the length of abstinence increases.
Mike was a periodic drinker. Periods of sobriety usually lasted for several months. During the time he was not drinking, he had dreams that severely disrupted his sleep. His wife said, “I never realized the nightmares Mike was having had anything to do with drinking or not drinking. He would frequently jump out of bed, screaming in terror. When I was able to awaken him and calm him, he couldn’t remember what he dreamed, but he remembered being afraid. After a year of sobriety, he seldom had the dreams. Only then did I realize that they were related to his drinking.
Even if you do not experience unusual dreams, you may have difficulty falling asleep or staying asleep. You may experience changes in your sleep patterns; sleeping for long periods at a time or sleeping at different times of the day. Some of these patterns may never return to “normal,” but most people are able to adjust to them without severe difficulty.
Physical Coordination Problems
A very serious PAW problem – though perhaps not as common as the others – is difficulty with physical coordination. Common symptoms are dizziness, trouble with balance, problems with coordination between hand and eye, and slow reflexes. These result in clumsiness and accident proneness. This is how the term “dry drunk” came into being. When alcoholics appeared drunk because of stumbling and clumsiness, but had not been drinking, they were said to be “dry drunk.” They had the appearance of being intoxicated without drinking.
Stress Sensitivity
Difficulty in managing stress is the most confusing and aggravating part of post acute withdrawal. Recovering people are often unable to distinguish between low-stress situations and high-stress situations. They may not recognize low levels of stress, and then overreact when they become aware of the stress they are experiencing. They may feel stressful in situations that ordinarily would not bother them, and in addition, when they react they overreact. They may do things that are completely inappropriate for the situation. So much so that later on they may wonder why they reacted so strongly.
To complicate things further, all of the other symptoms of post acute withdrawal become worse during times of high stress. There is a direct relationship between elevated stress and the severity of PAW. Each intensifies the other. The intensity of PAW creates stress, and stress aggravates PAW and makes it more severe. At times of low stress, the symptoms get better and may even go away. When you are well rested and relaxed, eating properly, and getting along well with people, you will probably appear to be fine. Your thoughts will be clear, your emotions appropriate, and your memory all right. At times of high stress, however, your brain may suddenly shut down. You may begin experiencing thinking problems, inappropriate emotions, and memory problems.
If your thoughts become confused and chaotic or you are unable to concentrate, if you have trouble remembering or solving problems, you may feel you are going crazy. You are not. These symptoms are a normal part of your recovery and are reversible with abstinence and a recovery program. If you do not understand this you may develop shame and guilt which leads to diminished self-esteem and isolation which creates stress and increased PAW. It is a painful cycle that is unnecessary if you understand what is happening. As your body and your mind begin to heal and as you learn ways to reduce the risk of post acute withdrawal symptoms, productive and meaningful living is possible in spite of the very real possibility of recurring symptoms.
Recovery from the damage caused by the addiction requires abstinence. The damage itself interferes with the ability to abstain. This is the paradox of recovery. Use of alcohol or other drugs can temporarily reverse the symptoms of the damage. If alcoholics drink, or drug addicts use, they will think clearly for a little while, be able to have normal feelings and emotions for a little while, feel healthy for a little while. Unfortunately, the disease will eventually trigger a loss of control that will again destroy these functions.
Persons with emotional problems in sobriety tend to overreact. When things happen that require two units of emotional reaction, they react with ten. It is like holding the “times” key down on a calculator. You may find yourself becoming angry over what may later seem a trivial matter. You may feel more anxious or excited than you have reason to be. When this overreaction puts more stress on the nervous systems than it can handle, there is an emotional shutdown. If this happens to you, you become emotionally numb, unable to feel anything. And even when you know you should feel something, you do not. You may swing from one mood to another without knowing why.
Sleep Problems
Most recovering people experience sleep problems. Some of them are temporary; some are lifelong. The most common in early recovery is unusual or disturbing dreams. These dreams may interfere with your ability to get the sleep you need. But they become less frequent and less severe as the length of abstinence increases.
Mike was a periodic drinker. Periods of sobriety usually lasted for several months. During the time he was not drinking, he had dreams that severely disrupted his sleep. His wife said, “I never realized the nightmares Mike was having had anything to do with drinking or not drinking. He would frequently jump out of bed, screaming in terror. When I was able to awaken him and calm him, he couldn’t remember what he dreamed, but he remembered being afraid. After a year of sobriety, he seldom had the dreams. Only then did I realize that they were related to his drinking.
Even if you do not experience unusual dreams, you may have difficulty falling asleep or staying asleep. You may experience changes in your sleep patterns; sleeping for long periods at a time or sleeping at different times of the day. Some of these patterns may never return to “normal,” but most people are able to adjust to them without severe difficulty.
Physical Coordination Problems
A very serious PAW problem – though perhaps not as common as the others – is difficulty with physical coordination. Common symptoms are dizziness, trouble with balance, problems with coordination between hand and eye, and slow reflexes. These result in clumsiness and accident proneness. This is how the term “dry drunk” came into being. When alcoholics appeared drunk because of stumbling and clumsiness, but had not been drinking, they were said to be “dry drunk.” They had the appearance of being intoxicated without drinking.
Stress Sensitivity
Difficulty in managing stress is the most confusing and aggravating part of post acute withdrawal. Recovering people are often unable to distinguish between low-stress situations and high-stress situations. They may not recognize low levels of stress, and then overreact when they become aware of the stress they are experiencing. They may feel stressful in situations that ordinarily would not bother them, and in addition, when they react they overreact. They may do things that are completely inappropriate for the situation. So much so that later on they may wonder why they reacted so strongly.
To complicate things further, all of the other symptoms of post acute withdrawal become worse during times of high stress. There is a direct relationship between elevated stress and the severity of PAW. Each intensifies the other. The intensity of PAW creates stress, and stress aggravates PAW and makes it more severe. At times of low stress, the symptoms get better and may even go away. When you are well rested and relaxed, eating properly, and getting along well with people, you will probably appear to be fine. Your thoughts will be clear, your emotions appropriate, and your memory all right. At times of high stress, however, your brain may suddenly shut down. You may begin experiencing thinking problems, inappropriate emotions, and memory problems.
If your thoughts become confused and chaotic or you are unable to concentrate, if you have trouble remembering or solving problems, you may feel you are going crazy. You are not. These symptoms are a normal part of your recovery and are reversible with abstinence and a recovery program. If you do not understand this you may develop shame and guilt which leads to diminished self-esteem and isolation which creates stress and increased PAW. It is a painful cycle that is unnecessary if you understand what is happening. As your body and your mind begin to heal and as you learn ways to reduce the risk of post acute withdrawal symptoms, productive and meaningful living is possible in spite of the very real possibility of recurring symptoms.
Recovery from the damage caused by the addiction requires abstinence. The damage itself interferes with the ability to abstain. This is the paradox of recovery. Use of alcohol or other drugs can temporarily reverse the symptoms of the damage. If alcoholics drink, or drug addicts use, they will think clearly for a little while, be able to have normal feelings and emotions for a little while, feel healthy for a little while. Unfortunately, the disease will eventually trigger a loss of control that will again destroy these functions.
This is Kim Avisg when i read the above i thought you had been reading my mind. I was starting to get really worried about James. In fact i am extremely worried as he seems to be suffering the more serious patrs of it. But our docs here are useless and have probably never even heard of PAWS. I will go to the doctor 2 see him but i honestly dont think hewill even be interested but i will give it a try and see how it goes but i honestly dont think itlll work. I may actually take up the small laptop with me and actually show him this as i think he is suffering from quite a severe case of this. Thanks Avis as i was staring to get really worried about him and some of the things that were happening but i think this could well be the answer Kim
When I first stopped drinking and smoking, I had the extreme irritability and overreaction. I think that's part of the reason the tramadol was such a relief. I hated being so reactionary and aggressive. Particularly with my husband. It's something I have to watch for now that I know and I'm fully clean again! :) Jenny
It's as though this was written about me! I had extreme reactions to stressful situations while I was tapering. I would become angry and aggressive in an instant. I still have problems with this and it happens so unexpectedly and suddenly that I can't seem to control myself. It seems to come out of nowhere. I have said and done things that I'm so ashamed of because of this. Done things way beneath my dignity, I think things are getting better, but I dread having to hunt for work because I'm afraid of what the stress will do to me.
And the physical symptoms were so bad that my Dr. thought I had Multiple Sclerosis. I still have numbness and detached feeling in my left side and wierd sensations all over my body.
It's been 6-1/2 months since I quit opiates. I was only taking 40mg a day. I don't understand why I have had such a difficult time with PAW since my dose was so much lower than a lot of others. I just have to accept what it is and try to cope as best I can. My therapist says that it can take a year to recover. I sure hope that in another 6 months I can function normally. Because if I can't I don't know what I'll do. This is really scarey!
And the physical symptoms were so bad that my Dr. thought I had Multiple Sclerosis. I still have numbness and detached feeling in my left side and wierd sensations all over my body.
It's been 6-1/2 months since I quit opiates. I was only taking 40mg a day. I don't understand why I have had such a difficult time with PAW since my dose was so much lower than a lot of others. I just have to accept what it is and try to cope as best I can. My therapist says that it can take a year to recover. I sure hope that in another 6 months I can function normally. Because if I can't I don't know what I'll do. This is really scarey!
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