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Post Acute Withdrawal Syndrome 2 Jan 2018

Post Acute Withdrawal Syndrome

A lot of people wonder why when they get sober, they can often still feel like they “aren’t quite there”. We assume that when we get sober, we should be back in tip-top shape by the time we are out of treatment and that sometimes isn’t the case. This is not only completely normal, but there is actually a name for it! Post-Acute Withdrawal Syndrome.

What’d you Call Me?

That’s right, I said it, Post Acute Withdrawal Syndrome, or PAWS, for short. Everyone goes through it, but some people feel it a lot harder than others. Everyone goes through acute withdrawals, which usually lasts anywhere from hours to a few weeks after going through the initial detox phase. After THAT, comes Post Acute Withdrawal Syndrome.

This is usually more emotional and mental side effects rather than physical ones. This is when brain chemistry is slowly restarting itself back to normal. Depending on the length and severity of use, this can often last from anywhere between 3 months to 2 years to return back to normal!

Some of the main symptoms of Post Acute Withdrawal Syndrome are:

  • Mood Swings
  • Anxiety
  • Irritability
  • Fatigue
  • Abnormal Sleep Patterns
  • Difficulty Concentrating
  • Difficulty with Memory
  • Energy Swings

For many people, this can make the first year of sobriety a pretty stressful ride. Many people will have such intense mood swings, anxiety, and depression, and will want to go on medication with a doctors approval. However, it is pretty much guaranteed that after the initial post-acute withdrawal symptoms fade away, the person’s mood, energy levels, and mental function will go back to normal.

Everyone is Different

Just likely special little snowflakes, each person’s experience with Post Acute Withdrawal Syndrome will be slightly different. Because of this, it is important to remember to be GENTLE WITH OURSELVES AND OTHERS. Everyone did different drugs, and different amounts, and had different eating, sleeping, and social interactions during their use, so it can sometimes take people longer than areas to see certain areas improve.

It is actually a very common theme for people to realize that usually, their Post-Acute Withdrawal symptoms can be affected by how they are working a program, or that sometimes it seems like the program isn’t working. However, this is called a PAWS episode and can last anywhere from a few hours to a few days. For the most part, there is no real trigger, but many people can often find that their symptoms can be magnified by things such as:

  • Stress
  • Over-exertion
  • Relationships
  • Falling into Dwelling on the Past!
  • Bad sleeping habits
  • Poor diet

As we continue on with our sobriety and working our programs, we will often find that these episodes start to occur fewer and farther between. Many people will just notice how tired they are after a long work week, and others will find that when they aren’t doing enough, either recovery wise, or socially, that their PAWS symptoms can often pop up.


First of all, it is important to remember that PAWS is a real, scientifically proven phenomena that actually does happen. It is important to remember this because, we can often get pretty down on ourselves when we aren’t feeling 100%, so it is nice to be able to stop and realize, hey, maybe I am having a hard time juggling all of these blessings in my life because my brain and body are still catching up to all those years of drinking or shooting dope into my veins. Just a thought?

So, when we DO notice that we are having some Post Acute Withdrawal Syndrome symptoms popping up, besides remembering to be gentle on ourselves, it is also crucial to not STAY in the mental places that it can bring us. For example, if we find ourselves in a little depressive rut for a few days, to try our best to continue working a program, being social, and taking care of ourselves, so that few days don’t turn into a few months.

Here are some other helpful tips on how to help get our brains and bodies back on track when our Post Acute Withdrawal Syndrome decides to pop up in our sobriety:

  • Continue Working a Program!
    • No matter what, keep talking to God, keep going to meetings, keep calling your sponsor, and keep being of service to others!
    • This will make sure you don’t sit on that pity pot for too long.
  • Remember to Practice Self Care!
    • Whether that looks like taking a night off to stay in, watch Netflix, and take a hot bath, or even if that looks like going out to dinner with friends, do what you have to do to make your heart feel full.
    • If you are someone who knows that you isolate when you are down, then go out. If you are someone who surrounds yourself with others to ignore your own emotions, then stay in.

couple running on the beach

  • Exercise!
    • This doesn’t necessarily mean going to the gym and pumping iron, this could mean whatever you like to do that gets the blood flowing.
    • Swimming, yoga, hiking, kayaking, basketball, running, paddleboarding, rock climbing, skateboarding, or who knows, if you are a big fan of razor scooters, break out your sick knee pads and go rip it up.
    • Exercise increases blood flow, boosts serotonin and endorphin levels, helps promote brain functioning and even helps regulate sleep!

The Bottom Line

So the deal is, Post Acute Withdrawal Syndrome happens to everyone who gets sober. The symptoms and severity of the symptoms can differ from person to person. So remember, be gentle with yourself, meet yourself where you are at and don’t sit in it for too long! We don’t have the luxury of dwelling in our crap anymore, so do the things you know are good for you, get out of that comfort zone, and get back to your life!

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