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PAWS and/or anxiety

Old 10-05-2016, 02:04 PM
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PAWS and/or anxiety

Hi folks:

I wanted to get some feedback about PAWS and anxiety - specifically whether you have been able to determine whether symptoms are caused by one or the other.

A bit of background - in a week I will have been completely abstinent for one year. It is a year during which I have been plagued by the most hellish symptoms. It all started a year before that. One day I had some kind of episode. I was speaking to a large group and suddenly everything went wonky. I was overwhelmed by terrible anxiety. I felt separate and detached from myself. I couldn't think clearly and got muddled. Somehow by force of will I finished my talk. I sat down and my teeth started to chatter and my hands started to shake. Things settled down a bit and an hour later it happened again. For the next few days I felt horrible. I went to see my doctor to tell her I was having panic attacks and she suggested that perhaps I had gone through a withdrawal. This had never crossed my mind. I was a nightly drinker who consumed a little less than a bottle of wine every day. While I had come to feel that this was too much, I never thought I was in danger of dependence or withdrawal.

I was supposed to follow up with her but never did. I felt terrible for a while and then things got better. I stayed away from alcohol for a while and then started drinking moderately and inevitably drifted back to my usual consumption.

On October 12 of last year, after Canadian Thanksgiving, I woke up feeling the same way I had a year earlier. No acute attack, but the same awfulness - brain fog, dizziness, fatigue, etc etc. From that point forward I have felt all kinds of awful. I gave up the booze and started to do research which led me to this site and the idea of PAWS. My long laundry list of symptoms matched the kinds of experiences that people were writing about and I felt for the first time I understood what was going on. A year later I am much better, but not out of it yet. I have pretty persistent derealization, a hard time stringing sentences together sometimes, constant tinnitus, etc. I have periods where it gets better and others where I feel awful. I am in one of the awful phases right now. Stress (physical or mental) - for example, having to speak publicly for a long time, driving on the highway, etc - makes things worse.

I recently went back to my doctor and had a full physical. Thankfully everything is great. I am physically in excellent health. We talked more about what I have been going through and I brought up the idea of PAWS. My doctor was not very receptive to this diagnosis. She feels that the situation wasn't caused by alcohol. She argues that I was likely medicating myself with booze for underlying anxiety issues and that it worked until it didn't and when it didn't I was overwhelmed by anxiety symptoms.

This has left me scratching my head. PAWS feels right in a way that anxiety doesn't. But I'm not a doctor and I don't know that I have good reasons to favour that diagnosis. I suppose that all the symptoms attributed to PAWS could just as easily come from anxiety disorder. But on the other hand, I know that PAWS is often misdiagnosed as GAD or depression or a host of other things.

Forgive this long post, but I am wondering whether others going through these symptoms have been able to determine whether they come from PAWS or anxiety and how. In many ways the treatment is the same. But in other ways I think it will differ significantly. For example, if it is PAWS then in the end I just wait it out and know that things will resolve over time. But if it is anxiety there is no guarantee on this score and it may be wise to look into medication.

Anyway, thanks for reading and let me know if you have any thoughts or insights.
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Old 10-05-2016, 02:20 PM
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There really is no way to say from a forum, but having underlying anxiety and depression issues are very often causes for many to abuse alcohol in the first place.
Once the booze is gone, many think that everything will be unicorns and rainbows in life, but unfortunately that isn't the case. Once the booze is washed away, the underlying issues will still be there. I personally agree with your doctor it may be a mental health issue that wouldn't be a bad idea of looking into with a therapist.
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Old 10-05-2016, 02:39 PM
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I'd agree with Forward, there's really no concrete way of diagnosing what the source of your symptoms might be from the internet. And even in reality, PAWS is not a medically or pscyhological condition that you can be officially diagnosed with. It is mostly a creation of the recovery community to be honest. Some doctors or addiction counselors do believe it exists, but even the ones that do agree that the treatment is to address the individual symptoms themselves ( anxiety, depression, fatigue, etc ).

What is know for sure is that anxiety can absolutely manifest itself as physical symptoms, so if you feel that might be possible I'd suggest seeing a counselor or a therapist. Anxiety is a very diagnosable and very treatable condition - I deal with both GAD and health anxiety and can attest to that 100%.
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Old 10-08-2016, 03:51 PM
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I agree it is hard to say whether it is PAWs or not. I can only tell you my experience. I am an anxious person period and 6 plus years sober still have anxiety off and on. However, it is no where near as bad as it was just after I quit drinking. I had a HORRIBLE anxiety attack close to one year after I quit drinking. It lasted for 3 weeks. My understanding is PAWS can last up to two years. My PAWS symptoms were mostly anxiety. I often wonder though - I quit drinking right before I started menopause. I wonder if that made things worse or not. Quitting drinking is very stressful. My anxiety did get better, but it took 2 1/2 years (I was a heavy drinker for over 30 years and my understanding is that length of drinking has an effect on length of PAWS symptoms). Fortunately for me it wasn't 2 1/2 years of continuous torture. But off and on it was really bad.
I think we have to learn to deal with our anxiety without alcohol.
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Old 10-08-2016, 05:01 PM
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PAWS hadn't been invented when I got sober, so no one suffered from it. We did sometimes have a thing about looking for some alternative to alcoholism to explain our problems.

When I was in the loony bin I latched onto the idea of a temporal lobe condition as an explanation for my behaviour. I tried my best to get the doctors to give me a brain scan. Unfortunately they were in possession of all my medical records, and I was in the bin die to the courts, so they could see clearly what my problem was. It was just that I did not want to stop drinking, and I would rather have been diagnosed insane than alcoholic. A little later I got onto the idea of allergies, another dead end.

Fear/anxiety is part and parcel of recovery for alcoholics. That is par for the course. Some, but not all, alcoholics also suffer other conditions caused or agravated by alcoholism. GAD and depression are two that have been mentioned. Interestingly a recent study in New Zealand showed that alcoholism can cause depression, but not the other way around. GAD wasn't part of that.

That might be good news for someone who has been self medicating a particular condition. It could mean that when the condition receives the appropritate treatment, the need for alcohol in such quantities will disappear.
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Old 10-09-2016, 01:32 AM
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You're getting great feedback, that I agree with. Many of us alcoholics have underlying anxiety and other issues that we found alcohol moderated to some degree. I know I remained plagued with anxiety (really bad over health concerns) for a long time and had to seek out other remedies. Proper diet, reduced caffeine, adequate sleep and exercise, and mostly learning to be aware of my thinking (bad filters) and reprogramming it. That was huge. Accepting that I am a sensitive person. And reconnecting to prayer and spiritual ways to gain acceptance, practicing gratitude, being of service.. really helped helped to get me out of my head and bring relief.
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Old 10-09-2016, 02:16 PM
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Thanks for the thoughtful replies everyone. In the end, I guess I may never know definitively what it was that happened to me and what was behind this hellish period I have been living through. Both anxiety and PAWS explain things perfectly well. And as some of you have indicated, these are not mutually exclusive. I can say definitively, though, that in spite of having a miserable time, my life is better in every way after knocking off a bottle of wine a night.

I am taking good care of myself. I have always ate well and worked out and I have really doubled down on those. I am taking good supplements, trying to get adequate sleep, have started meditating and doing guided relaxation, and have (as paradoxical as it might sound) started prioritizing having fun. It is easy for me to work, to push and drive myself, but not so easy to let go, enjoy and have fun. I see more and more clearly that a key to my recovery will be to remedy this.

My doctor has referred me to a psychiatrist. I am waiting for the appointment. We will see what this interaction will yield. Whatever it is I will continue to push on and hope that soon all of this will be behind me, or at least under control.
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Old 10-10-2016, 01:00 AM
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[QUOTE=BMunchausen;6161953]Hi folks:

"A year later I am much better, but not out of it yet. I have pretty persistent derealization, a hard time stringing sentences together sometimes, constant tinnitus, etc. I have periods where it gets better and others where I feel awful. I am in one of the awful phases right now. Stress (physical or mental) - for example, having to speak publicly for a long time, driving on the highway, etc - makes things worse. "

Good you're going for some additional follow-up with these symptoms. From my experience and extensive research, unresolved / unrecognised trauma/s can quite often manifest like this. All the best.
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Old 02-10-2017, 01:28 PM
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Same here..

Hi BMunchausen,

I just wanted to follow up. I've been in a similar situation. I'm early 40s. Have been fit all my life. Do a lot of Crossfit, run a number of 5ks. Had been for a few years a 3-4 night a week drinker. 3-4 drinks a night.

From Nov-Feb of 2015-2016 I upped that a bit with all of the holidays, and then after New Years was in Hawaii for 2 weeks. Was probably drinking a bottle of red wine most but not all nights. In bed by 930, up at 430 and guys for an hour before work at 630. Hawaii was followed by a weekend in Vegas with the college lads and 3-4 nights of heavy drinking.
2 days later got hit with awful anxiety, tachycardia, dizziness and insomnia for 3 days. After about 14 days was over anything acute, but up until 8 weeks I had awful dizziness and anxiety. Around 8 weeks it totally disappeared. I abstained for another 6 weeks feeling good. . Started drinking on weekends during the summer, only 2-3 drinks max. Those awful feelings would return and last 2-3 days. I thought Hey, maybe I do have an anxiety disorder.

Over New years 2016/2017 we had guests over. I drank 4 nights in a row. 3-3-3 5 drinks. 36 hours later hit with mild withdrawal again. It was not as bad as the first event, though the after effect has been awful.

constant low grade anxiety now at 5 weeks. A lot of dizziness during the day and some runs of tachycardia. I am sure it is PAWS. I tried an SSRI last spring after the first month and that was even worse for my anxiety. MD wanted to add a bento as I started and I said no thanks.

I'm hoping this all resolves in a few weeks. I had a cardiac workup and all was good. It is definitely anxiety, but I believe completely caused by the after effects of the booze.

Would love to hear how you are doing.
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Old 02-25-2017, 07:12 PM
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Follow up

7 weeks now. The anxiety is just about all gone. Not quite. But mostly.

I'm gonna go until 6 months and see how things are. Hopefully my GABA receptors have upregulated some, as well as giving all the other NT a chance to recover....

Never heard back from the original poster, but hopefully things are well.
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Old 03-06-2017, 03:53 PM
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Hi folks:

Sorry for the long radio silence. And my apologies to those who sent PM's. I don't yet have enough posts and can't answer those.

All in all things have been going pretty well. I am much better. Not 100%, but 75-80%, 75-80% of the time. Sometimes I feel completely normal. And I still have moments when I feel pretty rotten. But these troughs are pretty infrequent now. It has been a long road - I am coming up on 17 months.

I was pretty sure I had PAWS. I went to see my doc and got thorough testing and subsequently went to a psychiatrist and both were skeptical of that diagnosis. They both felt that my symptoms were a function of anxiety. In their opinion, alcohol was a means I used to control the anxiety and it worked until it didn't and when it didn't I was sandbagged with symptoms. I am still unsure what I think. Sometimes I am sure it is an anxiety disorder. At other times I gravitate to the PAWS diagnosis. In the end I suspect I won't know definitively, so I am doing good things for myself to give myself the best chance of full recovery and not worrying too much about what to call it. I haven't drank at all in 17 months. I eat well, limit caffeine, work out hard, try to sleep well, take a few good supplements. I have started a meditation/mindfulness practice that I do daily. The shrink suggested I try St John's Wort which I have been taking. All in all I am much better and hopeful that in the not too distant future I will be out of this altogether.

I sympathize with all those that posted or PM'd and are going through something similar. It is a hellish experience that I wouldn't wish on anyone. My hope is that all of you are moving forward as well. The one thing I would stress is that it is a long and slow process. When this first happened I was thinking about a recovery in terms of weeks. And here I am, still at it 17 months later. It will probably take longer than you think. Don't get worked up with time lines. Just treat yourself well and put one foot in front of the other.
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Old 03-06-2017, 04:27 PM
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i really dont think determining the causes matters.
what matters is solutions.

when i was diagnosed with cancer, i could have ran myself mentally into the ground lookin for causes.
but i decided solutions were a higher priority to focus on.

when i stop living in the problem a d start living in the solution, the problem goes away.
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Old 03-06-2017, 04:57 PM
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Originally Posted by BMunchausen View Post
Hi folks:

Sorry for the long radio silence. And my apologies to those who sent PM's. I don't yet have enough posts and can't answer those.

All in all things have been going pretty well. I am much better. Not 100%, but 75-80%, 75-80% of the time. Sometimes I feel completely normal. And I still have moments when I feel pretty rotten. But these troughs are pretty infrequent now. It has been a long road - I am coming up on 17 months.

I was pretty sure I had PAWS. I went to see my doc and got thorough testing and subsequently went to a psychiatrist and both were skeptical of that diagnosis. They both felt that my symptoms were a function of anxiety. In their opinion, alcohol was a means I used to control the anxiety and it worked until it didn't and when it didn't I was sandbagged with symptoms. I am still unsure what I think. Sometimes I am sure it is an anxiety disorder. At other times I gravitate to the PAWS diagnosis. In the end I suspect I won't know definitively, so I am doing good things for myself to give myself the best chance of full recovery and not worrying too much about what to call it. I haven't drank at all in 17 months. I eat well, limit caffeine, work out hard, try to sleep well, take a few good supplements. I have started a meditation/mindfulness practice that I do daily. The shrink suggested I try St John's Wort which I have been taking. All in all I am much better and hopeful that in the not too distant future I will be out of this altogether.

I sympathize with all those that posted or PM'd and are going through something similar. It is a hellish experience that I wouldn't wish on anyone. My hope is that all of you are moving forward as well. The one thing I would stress is that it is a long and slow process. When this first happened I was thinking about a recovery in terms of weeks. And here I am, still at it 17 months later. It will probably take longer than you think. Don't get worked up with time lines. Just treat yourself well and put one foot in front of the other.
paws technically isn't a "thing" so to speak and not recognized by medical professionals, so there is no real way to be diagnosed with it, but that's great to hear you are doing better and have 17 months clean!
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Old 03-06-2017, 05:04 PM
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By the way, I dont know if it's PAWS or just some kind of nerve damage, but I share your tinnitus. Started right after I got sober for the last time; I can't believe it's just coincidence.

3.5 years and still ringin' loud... guess I'll have this forever.

Thanks, alcohol!
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Old 03-06-2017, 06:08 PM
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I am 133 days sober and I was hung up on the PAWS thing for awhile.

Like the others said it is about moving forward and living right - that is the solution to the problem.

I felt really good the last few days but today I feel crappy; almost as bad as when I first quit drinking. It is a roller coaster ride and I figure I will always have these ups and downs.

The key is in how we react to these feelings.
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Old 03-06-2017, 07:30 PM
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I'm only 17 days this go round but all my symptoms are gone except my temper.. I seem to snap very easy for some reason.
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Old 03-07-2017, 02:18 AM
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I found this article very helpful in determining some things to add to my recovery to offset the PAWS symptoms. .. https://digital-dharma.net/post-acut...r-immediately/
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