For those tortured by PAWS (Post Acute Withdrawal Symptoms) and who fear they might go mad
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Join Date: Mar 2014
Posts: 46
I am not on this site a lot anymore, but when I am I always try to post on PAWS threads to give encouragement to people that they WILL go away. I had a horrendous time with PAWs (no cravings, but lots of mood swings, anxiety, depression like symptoms.). I thought I was going crazy. Fortunately I heard about PAWs.
I don't know where I even heard the word PAWS (maybe here?) but I googled it and found enough info about it to get me through. The most important points I remember were it could take up to 2 years to feel better again. (It took me just over that). I trusted that information and I thought if I could just keep on keeping on and stick with it until x date, I would be alright or go see a psychiatrist. Also I knew the symptoms were cyclical. Sometimes they were horrendous but I knew/ trusted that they would n't last forever, I just had to keep on. I think we do a disservice to people who want to quit drinking to not tell them about PAWs and let them know what they are getting themselves into when they quit. I am a nurse, there is a huge stress on your body every single time you quit drinking. I think making it sound like quitting drinking is a walk in the park and not giving people the tools to stay quit is worse for them than letting them continue drinking. I have researched the kindling effect, and have seen it in practice. It's horrible to see what going through DTs over and over again does to a person.
I don't know where I even heard the word PAWS (maybe here?) but I googled it and found enough info about it to get me through. The most important points I remember were it could take up to 2 years to feel better again. (It took me just over that). I trusted that information and I thought if I could just keep on keeping on and stick with it until x date, I would be alright or go see a psychiatrist. Also I knew the symptoms were cyclical. Sometimes they were horrendous but I knew/ trusted that they would n't last forever, I just had to keep on. I think we do a disservice to people who want to quit drinking to not tell them about PAWs and let them know what they are getting themselves into when they quit. I am a nurse, there is a huge stress on your body every single time you quit drinking. I think making it sound like quitting drinking is a walk in the park and not giving people the tools to stay quit is worse for them than letting them continue drinking. I have researched the kindling effect, and have seen it in practice. It's horrible to see what going through DTs over and over again does to a person.
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Join Date: Jun 2012
Location: Pacific Coast
Posts: 785
Originally Posted by slipped 
I am not on this site a lot anymore, but when I am I always try to post on PAWS threads to give encouragement to people that they WILL go away. I had a horrendous time with PAWs (no cravings, but lots of mood swings, anxiety, depression like symptoms.). I thought I was going crazy. Fortunately I heard about PAWs.
I don't know where I even heard the word PAWS (maybe here?) but I googled it and found enough info about it to get me through. The most important points I remember were it could take up to 2 years to feel better again. (It took me just over that). I trusted that information and I thought if I could just keep on keeping on and stick with it until x date, I would be alright or go see a psychiatrist. Also I knew the symptoms were cyclical. Sometimes they were horrendous but I knew/ trusted that they would n't last forever, I just had to keep on. I think we do a disservice to people who want to quit drinking to not tell them about PAWs and let them know what they are getting themselves into when they quit. I am a nurse, there is a huge stress on your body every single time you quit drinking. I think making it sound like quitting drinking is a walk in the park and not giving people the tools to stay quit is worse for them than letting them continue drinking. I have researched the kindling effect, and have seen it in practice. It's horrible to see what going through DTs over and over again does to a person.
I don't know where I even heard the word PAWS (maybe here?) but I googled it and found enough info about it to get me through. The most important points I remember were it could take up to 2 years to feel better again. (It took me just over that). I trusted that information and I thought if I could just keep on keeping on and stick with it until x date, I would be alright or go see a psychiatrist. Also I knew the symptoms were cyclical. Sometimes they were horrendous but I knew/ trusted that they would n't last forever, I just had to keep on. I think we do a disservice to people who want to quit drinking to not tell them about PAWs and let them know what they are getting themselves into when they quit. I am a nurse, there is a huge stress on your body every single time you quit drinking. I think making it sound like quitting drinking is a walk in the park and not giving people the tools to stay quit is worse for them than letting them continue drinking. I have researched the kindling effect, and have seen it in practice. It's horrible to see what going through DTs over and over again does to a person.
I agree with your post wholeheartedly except possibly for the bolded part. The fact is that the vast majority of people who quit drinking don't experience PAWS -- in fact, my unscientific guesstimate, based on what I read here and on other recovery sites, would be an incidence in the 10% range. I would be concerned that making too big a deal out of PAWS to everyone trying to quit drinking would possibly act as a deterrent rather than an encouragement. There's a high risk that the threat of PAWS might be just what those of a nervous temperament need for their Addictive Voice to convince them to continue drinking, or to talk them into relapsing.
That said, I agree that it would be nice if those of us in the 10% category didn't have to suffer in ignorance, wondering why we still have withdrawal-type symptoms after months of sobriety when everyone else seems to feel better within a week or two.
12 Step Recovered Alcoholic
Join Date: Apr 2012
Location: New Zealand
Posts: 6,613
Originally Posted by stillpooh19
THANK YOU! I don't feel so alone anymore. I was starting to think I was the only one going through PAWS at this severity. It really freaks you out when you think you are unique in your problems. I had no desire for alcohol after I quit nor did my symptoms quickly lift like every one else seemed to experience.
Being in AA, I don't understand why old-timers shy away from having these conversations with the new comers, it would really help give hope that everything is going to be alright. I even read where Bill recognized the physiological problems that caused people to relapse including depression and anxiety.
Anyway, thanks again! I wish more people would candidly share their experiences to help others.
Being in AA, I don't understand why old-timers shy away from having these conversations with the new comers, it would really help give hope that everything is going to be alright. I even read where Bill recognized the physiological problems that caused people to relapse including depression and anxiety.
Anyway, thanks again! I wish more people would candidly share their experiences to help others.
A couple of thoughts occur. Prescription drug addict alcoholics were around when I came in. They seemed to have a lot less trouble getting off those drugs than folks today. I never saw some of the awful consequences that go with benzos that I see today.
I didn't take those substances, I don't understand why anyone would, but I wonder if the addition of these potent drugs to the mix has an effect on the long term withdrawal pattern, I do know that chemical withdrawal from benzos is a lot longer than alcohol.
The other thing is perhaps we call PAWS by other names. On one occasion, my most serious effort to get sober on my own was derailed by PAWS like symptoms that have been described in earlier posts.
However, the way I look at it was that I was very passive in my recovery approach, refusing AA, did nothing to change when I had the opportunity and the spiritual malady returned. I became disconnected from the world, full of fear and miserable. Alcohol was the solution.
Or we might call it dry drunk, a term I don't particularly like, but it fitted the facts in my case. Basically trying to live alcohol free, but operating with alcoholic self centred instinct driven behaviour, my normal operating mode, I knew no other.
This always put me in conflict (internally or externally) with the world around me which, as I never understood the cause and effect, brought on PAWS like symptoms. Fear, resentment, feeling of impending doom, anxiety, panic, uselessness etc.
All of these issues were resolved by working the steps, which is the advice/experience I have to offer, and is the limit of what the AA program has to offer.
If there are deeper psychological, psychiatric or medical issues, there are experts to deal with that outside of AA.
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Join Date: Apr 2012
Location: northern michigan. not the U.P.
Posts: 15,281
" If there are deeper psychological, psychiatric or medical issues, there are experts to deal with that outside of AA. "
seems like a better solution than just saying its PAWS.
there could be problems that were there before the very first drink was ever taken.
__________________
seems like a better solution than just saying its PAWS.
there could be problems that were there before the very first drink was ever taken.
__________________
Member
Join Date: Jun 2012
Location: Pacific Coast
Posts: 785
Gottalife brings up an important point.
A great deal of the mental and emotional discomfort which is sometimes laid at the feet of PAWS can be greatly mitigated by focused, dedicated effort to a program of recovery. That was certainly my experience.
The downside to dignifying an amorphous group of loosely defined symptoms by giving it a name like "PAWS" is the risk of people adopting a "victim" mentality and assuming that because they "have PAWS," they're helpless to take action to improve their plight.
While I certainly had some irreducible neurological and physiological issues associated with PAWS which only sober time itself could heal -- no amount of treatment or "working a program" would have had much effect on my lingering shaky hands, aphasia, or forgetfulness -- I was able to make dramatic progress on my life outlook and my emotional stability by taking specific actions to change my thinking and my reactions.
I don't know whether it's 10% or 75% of former drinkers who suffer from PAWS -- it's impossible to assign a number to something so loosely defined by perception in any case. The point, however, is that while there's no magic pill that will make the symptoms go away, relief from at least some of those symptoms is possible through taking action.
For the rest, there's only patience -- and a solid recovery program will do a lot to improve that as well
A great deal of the mental and emotional discomfort which is sometimes laid at the feet of PAWS can be greatly mitigated by focused, dedicated effort to a program of recovery. That was certainly my experience.
The downside to dignifying an amorphous group of loosely defined symptoms by giving it a name like "PAWS" is the risk of people adopting a "victim" mentality and assuming that because they "have PAWS," they're helpless to take action to improve their plight.
While I certainly had some irreducible neurological and physiological issues associated with PAWS which only sober time itself could heal -- no amount of treatment or "working a program" would have had much effect on my lingering shaky hands, aphasia, or forgetfulness -- I was able to make dramatic progress on my life outlook and my emotional stability by taking specific actions to change my thinking and my reactions.
I don't know whether it's 10% or 75% of former drinkers who suffer from PAWS -- it's impossible to assign a number to something so loosely defined by perception in any case. The point, however, is that while there's no magic pill that will make the symptoms go away, relief from at least some of those symptoms is possible through taking action.
For the rest, there's only patience -- and a solid recovery program will do a lot to improve that as well
Member
Join Date: Nov 2012
Location: Colorado
Posts: 3,781
Detox is pure hell, no way around it! I went to a medical detox once and it was 5 days of hell too!
No one said getting clean was a walk in the park but it can be done!
Once you get clean, life's options are limitless!
I Just noticed I have a healthy 15 months sober today.. 2 years right around the corner.. life is good!
No one said getting clean was a walk in the park but it can be done!
Once you get clean, life's options are limitless!
I Just noticed I have a healthy 15 months sober today.. 2 years right around the corner.. life is good!
Forum Leader
Join Date: May 2012
Location: Wisconsin, USA
Posts: 16,945
Originally Posted by Andante
I don't know whether it's 10% or 75% of former drinkers who suffer from PAWS -- it's impossible to assign a number to something so loosely defined by perception in any case. The point, however, is that while there's no magic pill that will make the symptoms go away, relief from at least some of those symptoms is possible through taking action.
Having said that, the SYMPTOMS that are commonly associated with "PAWS" could be indicators of other medical or psychiatric conditions. For example, depression and anxiety are common in recovery, but those ARE diagnosable and treatable conditions. So the best solution to "PAWS" symptoms is to treat them appropriately as individual symptoms ( which they are ).
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Join Date: Mar 2016
Location: Atlanta
Posts: 125
Originally Posted by slipped
Andante I thought your 10% low and so I just googled PAWs. The first article I came up on said 75% of people who quit develop PAWs.
Member
Join Date: Mar 2014
Posts: 46
I think it helped me to look at it like PAWs as something I just had to endure to reach sobriety- kind of my punishment for getting myself into this predicament in the first place. One of the suggestions for dealing with them is to just go with them, and not fight them. I'm not so sure it would have been helpful for me to look upon it as occurring because I wasn't working hard enough or doing the right things. In a weird way it might have been a good thing my PAWs symptoms were so terrible- I hope I never forget how terrible they were. There is no way I want to go through that again.
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Join Date: Jun 2011
Location: The Deep South
Posts: 14,636
It relieved me to read about PAWS when I was quitting drinking. I had some of the listed symptoms, though not all. I wanted to educate myself on any potential pitfall that might cause a relapse.
I think it would be foolish to think there are no physical or psychological symptoms that are repercussions of ending prolonged, heavy drinking. It would be a mistake to assume everything is going to suddenly improve.
Whether it's labeled as PAWS, recognized by the AMA or APA, or no one at all, we've come across enough complaints and mentions of various physical and psychological ailments following cessation of substance abuse that I can't imagine sweeping it under the rug.
I initiated conversations often in early recovery about PAWS and relapse prevention. The book I recommend the most to newcomers to recovery is Staying Sober: A Guide for Relapse Prevention by Terence Gorski. My logic was that in order to stay sober, I needed to know about anything and everything that might cause me to fail. And it seemed that PAWS related symptoms were going to present as the worst of it, for me, anyway.
I think it would be foolish to think there are no physical or psychological symptoms that are repercussions of ending prolonged, heavy drinking. It would be a mistake to assume everything is going to suddenly improve.
Whether it's labeled as PAWS, recognized by the AMA or APA, or no one at all, we've come across enough complaints and mentions of various physical and psychological ailments following cessation of substance abuse that I can't imagine sweeping it under the rug.
I initiated conversations often in early recovery about PAWS and relapse prevention. The book I recommend the most to newcomers to recovery is Staying Sober: A Guide for Relapse Prevention by Terence Gorski. My logic was that in order to stay sober, I needed to know about anything and everything that might cause me to fail. And it seemed that PAWS related symptoms were going to present as the worst of it, for me, anyway.
Member
Join Date: Dec 2015
Posts: 501
Originally Posted by Soberpotamus
Whether it's labeled as PAWS, recognized by the AMA or APA, or no one at all, we've come across enough complaints and mentions of various physical and psychological ailments following cessation of substance abuse that I can't imagine sweeping it under the rug.
12 Step Recovered Alcoholic
Join Date: Apr 2012
Location: New Zealand
Posts: 6,613
Knowing why and what wasn't much help to me. This little quote illustrates my experience.
They are talking of a man who, having armed himself with all the available knowledge, and secure in his own will power, thought he could handle things on his own.
"That may be true of certain nonalcoholic people who, though drinking foolishly and heavily at the present time, are able to stop or moderate, because their brains and bodies have not been damaged as ours were. But the actual or potential alcoholic, with hardly an exception, will be absolutely unable to stop drinking on the basis of self-knowledge. This is a point we wish to emphasize and re-emphasize, to smash home upon our alcoholic readers as it has been revealed to us out of bitter experience."
This is more how it was for me. I had plenty of knowledge of alcoholism, I desperately wanted the misery to stop. Both sobriety and drinking were equally unattractive. But I could not prevent my own relapse. The defense mechanism just wasn't working.
They are talking of a man who, having armed himself with all the available knowledge, and secure in his own will power, thought he could handle things on his own.
"That may be true of certain nonalcoholic people who, though drinking foolishly and heavily at the present time, are able to stop or moderate, because their brains and bodies have not been damaged as ours were. But the actual or potential alcoholic, with hardly an exception, will be absolutely unable to stop drinking on the basis of self-knowledge. This is a point we wish to emphasize and re-emphasize, to smash home upon our alcoholic readers as it has been revealed to us out of bitter experience."
This is more how it was for me. I had plenty of knowledge of alcoholism, I desperately wanted the misery to stop. Both sobriety and drinking were equally unattractive. But I could not prevent my own relapse. The defense mechanism just wasn't working.
Member
Join Date: Jul 2016
Posts: 350
Thanks, Jack
I armed myself by studying up. But the reality of PAWS is still so devastating. I finally went to the ER because I had not slept more than 9 hours per week for over a month (still pretty bad). Doc said "I don't think you could have 'Prolonged Alcohol Withdrawal' (that's what he called it) because you only drank for 3 years." Right. OK,Doc. He said there was nothing he could do, but my MRI looked normal. Well, that was a relief anyways. I guess if they can't "see" it, it doesn't exist.
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Join Date: Jul 2016
Posts: 350
Originally Posted by slipped
Andante I thought your 10% low and so I just googled PAWs. The first article I came up on said 75% of people who quit develop PAWs.
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Thread Starter
Join Date: Feb 2015
Location: Kyoto
Posts: 81
I've had a few PMs by people struggling with PAWS and I decided to come back and have a look at how the thread has progressed. And while I'm glad to see that so many people have found it helpful, I wonder what the goal is for those who decided to come and doubt the existence of PAWS. Of course, you've the same rights as me to come and post, but I wonder what the end game is in telling people that something we all experience is not a real thing.
Yes, you cannot see it, and the medical community, without something to see in an x-ray or a petri dish, is often reluctant to recognize or diagnose it. However, I'd appeal to people's common sense and a simple knowledge of brain chemistry. Alcohol suppresses glutamate, which is an excitatory neurotransmitter. As you likely know, the body seeks homeostasis, and therefore pumps out more and more glutamate while drinking. Once the alcohol is removed, the body still pumps out the levels of glutamate it once did. This is the cause of strokes and death in alcohol withdrawal. Alcohol also binds to GABA receptors which makes the body produce less GABA. GABA is a calming neurotransmitter. These have deep effects on the brain, and the brain is the epicenter of emotions and the CNS and PNS.
I read in this thread that these symptoms are due to not working steps or that people didn't used to have PAWS in the past. This is confounding your anecdotal experience with speculation. Is it possible that people "didn't have PAWS" because they didn't feel comfortable coming forward with their symptoms? Is it possible that people who work the steps gradually get better, as we all do, and this correlation is mistaken for causation?
I have worked not a single step. I've been clean almost two years, 75% of which I white-knuckled my way through, and my symptoms have subsided to near normalcy. This correlates with time. It was suggested that calling these symptoms PAWS takes away people's agency, but the most popular recovery method, yet one of the least effective, asks you to admit that you're helpless and that you have to call upon a higher power. This requires some extreme cognitive dissonance. Or hypocrisy.
I take issue with religion, but I would never go to a thread about AA and God and tell people that they are whispering to a Sky Wizard and that it's harmful to do so, least of all when there is documented research that PAWS is real.
I just wonder what the point is of injecting this doubt. I don't see the positive angle or the benefit to anyone. As a materialist, I would take this far more amicably with some evidence or a citation. But as it is, this just seems like people who want to push their agenda in a thread where people are finally getting some commiseration during a long and prolonged a$$-kicking.
I never had any of my symptoms before drinking and I'm almost back to normal after twenty-two years of drinking without a step, a prayer, or working any program. How is this possible but the passing of time and the body's ability to heal? You might say it's all in our heads, and I'd say you're right. Not because we're imagining it, but because that's where our brain and its neurotransmitters are.
With all that being said, I'm very happy that people are getting something positive from this thread. I'm currently on vacation and have biked 180km in the past 16 days, along with tons of swimming and walking. My exercise intolerance is gone and I'm loving it. I felt like I was dragging a kettlebell for 18 months. It gets better.
Take care, everyone.
Matt
Yes, you cannot see it, and the medical community, without something to see in an x-ray or a petri dish, is often reluctant to recognize or diagnose it. However, I'd appeal to people's common sense and a simple knowledge of brain chemistry. Alcohol suppresses glutamate, which is an excitatory neurotransmitter. As you likely know, the body seeks homeostasis, and therefore pumps out more and more glutamate while drinking. Once the alcohol is removed, the body still pumps out the levels of glutamate it once did. This is the cause of strokes and death in alcohol withdrawal. Alcohol also binds to GABA receptors which makes the body produce less GABA. GABA is a calming neurotransmitter. These have deep effects on the brain, and the brain is the epicenter of emotions and the CNS and PNS.
I read in this thread that these symptoms are due to not working steps or that people didn't used to have PAWS in the past. This is confounding your anecdotal experience with speculation. Is it possible that people "didn't have PAWS" because they didn't feel comfortable coming forward with their symptoms? Is it possible that people who work the steps gradually get better, as we all do, and this correlation is mistaken for causation?
I have worked not a single step. I've been clean almost two years, 75% of which I white-knuckled my way through, and my symptoms have subsided to near normalcy. This correlates with time. It was suggested that calling these symptoms PAWS takes away people's agency, but the most popular recovery method, yet one of the least effective, asks you to admit that you're helpless and that you have to call upon a higher power. This requires some extreme cognitive dissonance. Or hypocrisy.
I take issue with religion, but I would never go to a thread about AA and God and tell people that they are whispering to a Sky Wizard and that it's harmful to do so, least of all when there is documented research that PAWS is real.
I just wonder what the point is of injecting this doubt. I don't see the positive angle or the benefit to anyone. As a materialist, I would take this far more amicably with some evidence or a citation. But as it is, this just seems like people who want to push their agenda in a thread where people are finally getting some commiseration during a long and prolonged a$$-kicking.
I never had any of my symptoms before drinking and I'm almost back to normal after twenty-two years of drinking without a step, a prayer, or working any program. How is this possible but the passing of time and the body's ability to heal? You might say it's all in our heads, and I'd say you're right. Not because we're imagining it, but because that's where our brain and its neurotransmitters are.
With all that being said, I'm very happy that people are getting something positive from this thread. I'm currently on vacation and have biked 180km in the past 16 days, along with tons of swimming and walking. My exercise intolerance is gone and I'm loving it. I felt like I was dragging a kettlebell for 18 months. It gets better.
Take care, everyone.
Matt
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