You may or may not have heard of P.A.W.S. and if you haven’t, you might not have been able to identify your feelings or know that this is a condition that affects between 70% and 90% of us in recovery to some degree or other, both emotionally and psychologically.

So what is it?
P.A.W.S stands for Post-Acute Withdrawal Syndrome. It's symptoms affect those of us who were addicted to alcohol or drugs, but it doesn't happen so quickly as you might think, actually occurring after the initial withdrawal is over. In fact, P.A.W.S can occur two months or more after the substance has been removed from the system, and the affects can be felt for weeks, months or years, depending on the individual.

There has been much research into P.A.W.S in association with alcohol addiction, with medical reports being published since the 1990's so it isn't a new thing, but it isn't hugely common knowledge either. In fact, I think it is one of the most important factors of recovery, one that you should be prepared for, and I for one certainly didn't know anything about it beforehand.

The symptoms
As a sedative, alcohol decreases brain activity, and of course, the brain comes to see that as normal. Once you remove that inhibitor your nervous system can go into overdrive. There are a lot of symptoms associated with P.A.W.S, and each of them individually are quite normal and common. The accumulation and severity of them is down to physical differences in people, the type of substance that is causing the addiction and the amount that is taken. The effects come and go, lasting for a few days before easing up again, which can be a bit of a rollercoaster, but if you are prepared from them, it can make your recovery more successful.

Here’s a list of the main symptoms:

• Stress - The effects of P.A.W.S. can leave you with a low tolerance to cope with stress. Even the smallest thing to other people can seem like a really big deal, and considering you've probably given up your biggest coping tool, it is easy to understand why things are more difficult. New coping strategies are the way forward here, but believe me when I say, it takes time.
• Concentration difficulties - yep, I had problems stringing coherent sentences together at times, it seemed like I was losing my mind. I also used to forget what I was saying, mid-sentence. (I still do that sometimes!) It seems some of the neurotransmitters in the brain have to fight back and repair themselves in order for us to regain our ability to think clearly. The good news is, it is usually only temporary.
• Mood swings - I don't know about you, but I had them when I drank too. When I stopped they just got much more tearful.
• Cravings - Although the physical addiction might have worn off, there might (for some time) be psychological cravings which might try to tempt you back. Don’t give in to them, they get weaker with time.
• Anxiety - so not only is our brain learning to be without something that helped to keep it calm, but it is also having to adapt to function without it going forward. This can make you feel terribly anxious.
• Depression - these addictive substances have a lot to answer for! Your brain needs to readjust to learn to be without whatever it is you used to take. When you stop it is a shock to the system, however prepared you are. Again, it is normally just a temporary set-back.
• Insomnia and sleep disturbances - I was told I would sleep better when I stopped drinking. I do now, but it took a long time to get there. Not only do many addictive substances affect our sleep patterns, but our subconscious thoughts, like wanting a drink, can affect our dreams when we finally do drift off. It can be a bit of a nightmare. Sorry!
• Anhedonia - (the ability to find pleasure in normally pleasurable activities). Most addictive drugs affect neural pathways. When we stop taking them, it takes a while for the brain to balance out again and start to make normal levels of chemicals that make us feel good again. Until then things can be tough.


What can you do to help?
• Knowing that these symptoms are possible, and that they may be long term can help, if you aren’t expecting them, it can be easier to relapse.
• By gradually reducing the amount of alcohol consumed before stopping altogether, the intensity of the withdrawal may be lessened, although long term symptoms still seem to be quite strong. Try to remember that these symptoms may come and go, and although not pleasant, it is a normal part of recovery.
• Exercise can help, not only as it helps your body and brain recover, but as a bare minimum, it can work as a distraction to the way you are feeling.

It might seem a bit doom and gloom, but after I got to about two years of sobriety, I really began to wonder if my anxiety would ever get better. It got me down. I was meant to be healing and I still felt like a nervous wreck, in many ways, I actually felt at times worse than I did when I was drinking, which made me sad, because I was doing all the right things. Learning about P.A.W.S. helped. Having a reason, a cause, meant that I wasn't going mad and it wasn't my fault. It meant that my brain was healing. Other people might not understand, but I do and that helps. I would say after three years, I began to feel different and a lot better than I had in a long time. But everyone is different and not everyone will experience this for the same time I did. I think I am a minority in that!

If you are in recovery or experiencing any of this, then good luck, my thoughts are with you.

I write because I've been there, and I understand how it feels to be at war with yourself. You might like to read my blog posts here.