Last Updated:
March 15th, 2024
The decision to enter alcohol addiction treatment is a difficult and brave one. Reaching out for help with alcohol is a huge step – and you will face challenges on the way. We’re going to explore these challenges in depth and provide some helpful information on how to face and overcome them.
Withdrawal
There are many and varied alcohol withdrawal symptoms, and they can be short-term or relatively long-lasting. Knowing what potential withdrawal symptoms you could face can be helpful to prepare for alcohol treatment.
Physical withdrawal
Not everyone who stops drinking alcohol experiences severe physical withdrawal symptoms. However, these symptoms are dangerous, and some are potentially life-threatening, so it’s important to seek help with alcohol withdrawal if you are physically dependent. Serious physical withdrawal symptoms include hallucinations, seizures and delirium tremens. Approximately 1 in 10 people with alcohol withdrawal syndrome experience seizures and will need to be monitored through the withdrawal process.
Milder but still unpleasant physical withdrawal symptoms include tremors, sweating, high heart rate, nausea, vomiting, loss of appetite, headaches, restlessness, irritability and insomnia. While this is difficult to go through, it’s short-lived – generally lasting about five days and peaking on day 3.
Post-acute withdrawal syndrome
Unlike acute alcohol withdrawal, post-acute withdrawal syndrome, or PAWS, is not dangerous – but it can be demoralising.
PAWS is the name given to a cluster of symptoms of alcohol abuse that happen after the acute withdrawal period, and they can last for a long time. Symptoms can include anxiety, irritability, depression, mood instability, tiredness, insomnia, difficulties concentrating and thinking, reduced interest in sex, and unexplained pains. A lot of people describe experiencing anhedonia, which is the inability to experience pleasure.
Not everyone experiences post-acute withdrawal syndrome, but it can be tough for people who do. Just knowing that post-acute withdrawal syndrome exists, is normal, and doesn’t last forever can be beneficial. Substance-induced brain changes do reverse, but this takes time. Committing to treatment and focusing on the path forward can get you through this tough period of the recovery process.
Cravings and triggers
The urge to drink can happen unexpectedly, and this can be challenging. Triggers to drink can be external – places, situations and times of day, or they can be internal – emotions, memories, frustrations. Everyone will experience cravings in recovery, and it’s important not to get demoralised – and to have a plan.
Some external triggers can be handled by avoiding them – but it isn’t possible to avoid every reminder of drinking. Talking to a therapist or trusted friend, distracting yourself, leaving overwhelming situations and challenging the thoughts that are driving the urge are all good techniques for beating cravings. It’s important not to beat yourself up when they happen – cravings are an extremely common part of the recovery process, and will start to subside with time.
Co-occurring mental health issues
Having a diagnosable mental health issue and a substance abuse issue at the same time is called a dual diagnosis. The National Comorbidity Study in the UK found a dual diagnosis rate of about 48%. They also found that in most cases, the mental health issue came before the alcohol misuse disorder – except for mood disorders like depression in men, which can often happen after the onset of alcoholism.
Treatment programmes that address both underlying or co-occurring mental health issues and alcoholism have a higher rate of success – so when you’re in treatment, it’s important to engage with therapy as much as you can. Therapy allows you to explore the feelings, experiences, beliefs and thought processes that drove or exacerbated the addiction – addressing these will give you more chance of success than just treating the addiction alone.
Psychological and emotional struggles
Even if you don’t have a dual diagnosis, therapy to address the struggles of addiction and recovery is extremely beneficial. Some therapies that directly address addiction itself include DBT (Dialectical Behavioural Therapy) and Motivational Enhancement Therapy (MET). These therapies help you to understand your addiction more clearly and can give you the motivation to keep going. This gives you a better chance of recovering.
Relationships
Some people may have flown under the radar with their addiction. In contrast, others’ behaviour may have been serious enough to trigger an alcoholic intervention – but addiction has a tendency to damage relationships no matter how obvious the addictive behaviours are. This damage isn’t necessarily going to disappear after you enter treatment. Like treatment itself, repairing these relationships is a process. Often, people in recovery become newly aware of the effects their addiction has on their loved ones and can experience guilt and shame as a result.
Mending these relationships means working on healing yourself. Addressing the difficult emotions that drove addiction, making amends and being accountable all take work and time. By being honest, listening to your loved ones and taking responsibility, you can start to repair your relationships.
Stigma and isolation
Alcohol misuse disorder is one of the most stigmatised medical conditions. This stigma keeps many people ashamed and less likely to reach out for alcohol help- so by entering into alcohol addiction treatment in the first place, you have already overcome a great barrier.
Surrounding yourself with supportive people and engaging with other people who are going through the same struggles can be powerful antidotes to stigma and isolation. It takes a lot of courage to seek treatment for addiction – cultivating relationships with people who have your back and know what you’re going through can be a great source of strength.
Sober lifestyle
Adjusting to a sober lifestyle is not easy. For many, quitting alcohol also means many of the places they used to go to, things to do, and people they used to see are now off-limits.
As well as fully engaging in alcohol treatment, structure, routine, and habit are good tools for maintaining sobriety. Treatment can provide some of this structure – participating in therapies that happen at the same time and place every week or committing to taking a regular class can introduce some of the structure you need.
Standard alcohol advice recommends replacing alcohol with healthy behaviours – and that can be helpful. Activities that allow you to relax, such as exercise, yoga and meditation, are often recommended, and this can be a good strategy. However, being kind to yourself is important when you’re in recovery. Your brain chemistry is readjusting after consuming a powerful dopamine-releasing substance for a long time. Many activities that previously felt good may not feel the same as they did in the past, and this can leave you feeling frustrated or flat. Being patient and reminding yourself that this is not permanent can help you get through these difficulties.
Relapse
Alcohol relapse when in recovery is always a possibility, and it’s very common. There’s no firm data on how many people in recovery relapse, but it’s estimated to be around 40-60%.
While it’s important to do as much as possible to reduce the risk of relapse, the most important thing to do is to keep working on your sobriety. Relapse does not mean a return to drinking – relapse is a setback, and many people who experience relapse go on to recover.
Keeping your eyes on the prize
Recovery can be hard. You may feel demoralised, frustrated, or that the way you feel right now is how you’re always going to feel – but none of this is true. It’s important to remind yourself that recovery is a process, and the way you’re feeling isn’t permanent. By taking the decision to detox from alcohol and enter alcoholism rehab, you’ve given yourself the best possible chance of recovery. These difficult feelings can and do pass, and a brighter future is possible.