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Relapse

The Risk of Relapse Is Greater Than Ever

Here are some things you can do to remain in recovery.

Many people started using drugs or alcohol to avoid feeling angry, anxious, or sad. But every time you use a drug to avoid a feeling you begin convincing your brain you are not strong enough to deal with that feeling. (Does the name Pavlov ring a bell?)

Wikimedia Commons Public Domain
Pavlov who discovered the conditioned response
Source: Wikimedia Commons Public Domain

If you don’t think you are strong enough to deal with being angry, anxious, or sad, those feelings don’t go away: they get worse. But your brain says, “Hey, what are you waiting for? You know how to get rid of those feelings. Use.”

And you begin creating the very feelings you were trying to avoid to begin with. But of course, you are strong enough to deal with those feelings.

Right now, with coronavirus, most people feel angry, anxious, or sad. That is normal. Part of our brain has activated survival mode. We are faced with a predator. Our brains go into the fight, flight, freeze mode. But for those in recovery, it could act as a trigger, a memory, a strategy to get rid of those feelings. Those feelings and memories come from the limbic system, the ancient, irrational, impulsive part of our reptilian brain where emotions live and addictions start. But the limbic system does not plan. Rational thought, solving problems, planning, executing the plan, and anticipating the outcome of that execution (anticipating the future), lives in a part of our modern mammalian brain called the prefrontal cortex. That limbic impulse to use has to then harness the pre-frontal cortex to make a plan: how to get the substance that your limbic system has been trained and conditioned to use to get rid of those feelings.

That is your moment to make a different plan. To anticipate what will really happen if you use it. I assure you, and you know, nothing good. (Reader participation moment: Put your hand on your forehead. Right behind there is your prefrontal cortex. How many times have you done something impulsively, limbicly, then slapped your forehead as if trying to jump-start your prefrontal cortex!?)

Having all these feelings now is normal. There is nothing wrong with a feeling. It’s what you do with it that matters. Make a different plan.

There are four things in general to help:

  1. Gratitude. Wake up grateful every day. Show someone else gratitude.
  2. Have a passion. It can be art, cooking, exercise, reading, writing, staying sober.
  3. Have someone to share that passion with.
  4. Take life day-by-day. Live in the moment, even as you plan for the future.

Never forget that you have value. We all want that same thing: To feel valuable to someone else. At every and any moment in time, you can remind someone of their value. And whenever you remind someone of their value, you increase your own value.

Today, if you are in recovery, find someone to say thanks to, or to let them know they are valuable. And for anyone reading this who knows someone in recovery, connect with them, and remind them that they are amazing. In these days of coronavirus, it is vital to remember that social distancing is not the same as emotional distancing. Now, more than ever, we need to have each other’s backs. Just six feet apart.

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More from Joseph A. Shrand M.D.
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