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The Natural Forces of Withdrawal from Alcohol or Drugs

Roger P. Watts, Ph.D.: Tue, Jul 16th 2013

Because alcohol and other drugs literally change the structure of the human brain in the process of causing an intoxicating "high" (see the How the Addicted Brain Hijacks the Mind), there are withdrawal signs and symptoms that are inevitable when a person stops using them.

depressed man with cigaretteMany newly recovering people discount the range and depth of the variety of withdrawal signs (things that are evident to others) and symptoms (complaints people themselves make) when they put down the alcohol or other drugs. To underestimate the power of the signs and symptoms is a mistake in early recovery because it is often the withdrawal itself that causes many people to relapse. In an attempt to avoid the unpleasant features of some withdrawal signs and symptoms, people will use alcohol and other drugs because they enhance the pleasure that may be missing in their life, or reduce the emotional pain that the withdrawal has caused.

Depression is a good example of this. To have a depressed mood occasionally is a common human trait. There are people, places, things, and situations in normal life that can get a person down. For someone just coming off a stint with alcohol or other drugs, such normal problems can cause a much sharper decline in their mood than in non-addicted people. Some people get morbidly depressed. They cannot stop sleeping and have trouble just getting out of bed. They stay up all night because they can't sleep and doze during the day. They eat too much or not enough. Nothing that used to give them pleasure can make them happy or improve their mood. They are listless and aimless, and feel worthless and hopeless.

Frequently they are suicidal. Sometimes, in an attempt to stop this slide into deep depression, a person will return to using drugs. Most often these are "upper" drugs that provide stimulation, but even alcohol, itself a depressant, will be comforting to a depressed person.

Anxiety is another sign or symptom that is common in withdrawal. To be worried about something, especially the future, is another normal process for human beings. We spend a lot of time in the future trying to control the outcome of events. But, for someone withdrawing from alcohol or other drugs, anxiety can be crippling. In its most extreme form a person can be frantic about their fears. They can build up a scenario of complete and utter failure over things that have very minor importance. They can exaggerate those fears and live in a world of constant arousal and hyper vigilance about what is going to happen next. In an all-out attempt to control the unknown future, these people will be frenetic in their attempt to arrange people, place, things, and situations to go a certain way. They will literally collapse when things don't turn out the way they expected. And, their unreasonable fear will be magnified as they take the worry to a new and higher level. They will have physical signs of distress: They will shake, cry, sweat, move a leg continuously, be unable to concentrate, or pace. They will have psychological signs of distress as well: They will either talk a lot or be totally silent about the problem, distort their own thinking, only express emotions of fear and dread, and lose sleep because of their ruminations.

There are now some medicines that help people with these two chronic illnesses. A psychiatrist needs to do an assessment of the person's circumstances and decide on the proper course of treatment, whether that be administering medicine or just psychotherapy. But, medicine can only chop off the low points of depression or the high points of anxiety of the cycle these people go through. In fact, talking still is the best cure for these illnesses. Finding some person - professional or close friend - to talk with about the experience of depression or anxiety can go a long way toward reducing the signs and symptoms of the illnesses.

It is also important for newly recovering people to recognize that it is entirely normal to have flare ups in either depression or anxiety when coming down from alcohol or drug abuse. The brain and body are adjusting to the new clean and sober experience, and this adjustment sometimes takes the form of chemical changes in the brain that is trying to develop balance again. Alcoholic Anonymous' sayings Easy Does It and This Too Shall Pass are two good mantras to adopt for the newly recovering person trying to cope with signs and symptoms of withdrawal.


Roger P. Watts, Ph.D.

Dr. Roger P. Watts, Ph.D., a psychologist and licensed alcohol and drug counselor, operates and currently provides substance abuse counseling to dozens of alcoholics and addicts. He has 23 years experience delivering health care to hundreds of patients through individual, group, and online counseling services. He has been in recovery himself for 24 years. He lives and works in Saint Paul MN, and can be reached at

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