GreenEggsAndHam

Tomorrow is my last day in rehab and I'm arming myself with information on how to stay clean and sober once treatment is over. Today I learned from my therapists that relapse actually occurs in our behaviors before the use of the alcohol/drug. This was very interesting as I can see after my relapses some behaviors that led up to the relapse in the days before.

I'm sure some of you have seen these, but I want to share for those who haven't. I have a print out of this that I will look over each day to be more self-aware of my behaviors and any warning signs in my behavior that I need to adjust or talk about.


taken from A Checklist of Symptoms Leading to Relapse | Pharmacists Recovery Network



A Checklist of Symptoms Leading to Relapse

1. EXHAUSTION: Exhaustion allows yourself to become overly tired or to develop poor health. Much of this is within our control. Some people in recovery are also prone to work addiction, perhaps they are in a hurry to make up for lost time! Good health and enough rest are important. If you feel well, you are more apt to think straight. Feel poorly and your thinking is apt to deteriorate. If you feel badly enough, you might begin to think a drink or a drug “couldn’t make it any worse”.

2. DISHONESTY: Dishonesty begins with a pattern of unnecessary little lies and deceits with fellow workers, friends, and family. Out of this may come significant lies to yourself. This is called rationalizing, making excuses for not doing what you do not want to do, or for doing what you know you should not do. Small deceits sow the seeds for major dishonesty.

3. IMPATIENCE: Impatience involves feeling that things are not happening fast enough, or that others are not doing what they should, or what you want them to do. Impatience involves having a hard time tolerating frustration and delayed gratification.

4. ARGUMENTATIVENESS: Arguing small and ridiculous points of view (“argumentativeness”) indicates a need to always be right. “Why don’t you be reasonable and agree with me?” Are you looking for a reason to take a drink or a drug?

5. DEPRESSION: Unreasonable and unaccountable despair may occur in cycles and should be dealt with and talked about. There are different kinds of depression. Some are part of the recovery process. All need to be talked out. Lingering and severe depression may need to be checked out by a professional familiar both with depression and the recovery process.

6. FRUSTRATION: You may feel frustration with people as well, because things may not be going your way. Remember everything is not going to be just the way you want it. You must develop new coping skills to cope with frustration.

7. SELF-PITY: “ Why do these things happen to me?” “Why must I be an addict?” “Nobody appreciates all that I am doing.”

Self-pity is a breeding ground for negative and low self-esteem.

8. COCKINESS: An attitude of “Boy, I’ve got it made, I no longer fear addiction!” may lead to entering drinking/drugging situations to prove to others you have no problem. Do this often enough and it will wear down your defenses.

9. COMPLACENCY: One may become complacent and have thoughts of “Drinking was the farthest thing from my mind.” Not drinking was no longer a conscious thought either! It is dangerous to let up on discipline because everything is going well. A little fear and constant awareness of one’s thoughts, feelings, and vulnerabilities are good things to develop. More relapses occur when things are going well than otherwise.

10. EXPECTING TOO MUCH FROM OTHERS: “I’ve changed; why hasn’t everyone else” It is a plus if they do, but it is still your problem if they do not. They may not trust you yet. They may still be looking for further proof. You cannot expect others to change their lifestyles just because you have.

11. LETTING UP ON DISCIPLINES: Daily discipline includes prayer, meditation, daily inventory, and AA/NA attendance. Varying from this can stem either from complacency or boredom. You cannot afford to be bored with your program. The cost of relapse is always too great.

12. USE OF MOOD ALTERING CHEMICALS: You may feel the need to ease things with a pill, and your doctor may go along with you. You may never have had a problem with other chemicals, but you can easily lose recovery starting this way. Is is about the most subtle way to have a relapse. Remember you will be cheating! The reverse of this is true for drug dependent persons who start to drink. Once addicted to one substance the potential to become quickly addicted to another definitely exists.

13. “IT CAN’T HAPPEN TO ME.” : This is dangerous thinking. Almost anything can happen to you, and is more likely to if you get careless. Remember you have a progressive disease, and you will be in worse shape if you relapse.

14. OMNIPOTENCE: This is a feeling that results from a combination of many of the above. You now have all the answers for yourself and others. No one can tell you anything. You ignore suggestions or advice from others. Relapse is probably eminent unless drastic change takes place.

Ethos23

Thanks for posting this. Good reminder to have no matter how much sobriety you have under your belt.

SoberLeigh

What a fabulous list. I am going to keep this close. Thanks, GreenEggs.

GreenEggsAndHam

It seems so obvious but I'm like the least self-aware person ever. Evidently in group I exhibited several pre-relapse signs today when I told them I want to take myself off my medication, that I don't want to extend my IOP treatment, when I cried about how nobody cares that I'm getting my 30 day chip soon, etc. It was a big eye-opener for me and hope this list can be useful to others as well. <3

SoberLeigh

I, among several hundred people here on SR, will be dancing for joy when you get your 30 day chip. You have earned it in so many ways other than just days. You have put your ALL into this process. Your chip is solid gold and very shiny.

Lovenjoy

That is a fantastic list, I too will keep it on hand. Does anyone know if there is a similar list of pre behaviors for substance abusers in recovery?

GracieLou

It is true that most relapses happen in the mind and thoughts way before the actual deed is done.

A comment from a friend of mine not to long ago that relapsed when asked why she didn’t call anyone, “I didn’t want to be a bother”. Bull$hit! you wanted to drink and you did not want someone to talk you out of it.

Yesterday that same friend called me after leaving an AA meeting. She did not want to drink. She called so I could talk her past the drive thru so she would not stop and buy alcohol. She did not bother me, we chatted, she got home safe and sober. 24 more hours under her belt!

You got tools, use them.

Also HALT, Hungry, Angry, Lonely, Tired. These can be triggers. If you are feeling squirrely, think HALT. If you are hungry, eat something. Tired? Get a nap or at least lay on the couch for a while and rest. Lonely? Angry? Call a friend. Even just to chat can wash away the lonely blues.

Get to a meeting! Get out of that squirrely little head.

I loved what someone posted earlier today about a brave new life. They said they were going to hang out in the brand new life (AA) and wait for instructions. I love that!

You have the tools and the support. Use them! You are doing great! Love ya chick You can do this!

GreenEggsAndHam

@SoberLeigh - Aww thank you! I'd say the biggest one for me to watch for is self-pity. The last thing I remember thinking right before I drank on my last relapse was "Nobody cares anyway," which is not true. I care, my kids care, my mom cares, etc. And I'm soooo going to post when I hit 30 days!! lol

Lovenjoy - I believe it's the same regardless of the type of drug. Someone can correct me if I'm wrong...

@GracieLou - Yep we went over HALT as well. Great one! It's funny because I can recognize these behaviors in other people when I see them, but not in myself. In my head I legitimately felt like the meds are making me drowsy and that I feel confident that "I got this" so why bother taking them anymore - I feel a lot better now than when I started them. I did not give myself the same advice I'd give someone else which is - duh you feel better because the meds are doing their job! lol The scary thing is that there are like 6 red flags or warning signs happening with me at once right now, but since I now know they are red flags, I can talk them out with a therapist and/or my sponsor, group, etc.

LBrain

yes, watch out for the signs. good to stay on top of things geah, it shows you really want this. keep up the good work and getting your chip. I haven't received any chips yet. To me it doesn't really matter. I may get a 90 day coin - I don't know. The chip I want is the one year anniversary chip. I want forty of those. I means I will live to 95! And hopefully I will be able to walk to a meeting that day.

Funny thing, I didn't read any of the posts before I came up with an example of relapse behavior. I thought to myself, arguing whether or not AA works and the percentages of success rate and this and that etc. Then I read your list and there it was. Argumentative behaviors.

GracieLou

You are correct, they are the same. Addiction is addiction is addiction.

I used to say "I have no idea what I am doing". I could not see that at some point my thinking changed but I have no confidence in myself to believe it. It took a lot of love and reassurance from some wonderful ladies to see that I did in fact have a clue...lol At least a little one. That I had learned some things, I had the tools and I used them. Remaining open to learn and the willingness to take suggestions was and is key for me.

I think it is the same for the relapse behavior. We are so used to looking outward at others, I know I was so scared to look at myself, that we tend not to point the mirror at our own reflection. It is a learned skill.

Anytime I feel angry, frustrated, arrogant, cocky, restless, irritable or discontent I stop and look at me. Sometime I have had to actually pull out a mirror and look at that scary person staring back at me. Keeps me honest. If I can do that, If I can look at me then I can also take a second and call someone and talk it out. I am not saying it is always me but I am playing some part even if I am only angry because I am trying to control something, still me. Had to let it go and when I did, the anger went with it.

You have come a long way baby. Use the tools (call people, go to meetings, take suggestions) and when someone looks at you can says "You okay, you seem like something is going on" tell them. A problem shared is a problem cut in half. Don't drink (Don't drink) and pray to whatever HP you understand and keep the words flowing to that HP. It does not have to be long drawn out meditation and prayer if you are not feeling that. My morning prayer takes 5 minutes. Starts with Thank you for keeping me sober and ends with your will, not mine. Simple but effective.

Keep the communication flowing!

Holli

Good tips! The first one is the one I am watching most closely right now at a couple of weeks in. My strategy is to start to work at home on Fridays. This option has been available to me for ages, but I basically mocked the people who actually used it. And now here I am!

Hevyn

Very good stuff GreenEggs - thank you so much.

GreenEggsAndHam

I'm struggling with a couple of these lately but otherwise doing well. I hope they help others.

Johnston

Very good list...

EndGameNYC

My relapse started at least ten years before I picked up the drink. And I quickly went straight to hell. Despite "losing" things all along the way, I made no meaningful adjustments in my thinking or in my behavior. I stayed out for three years and lost everything dear to me in life. Again.

I ticked off every item on your list.

QuitinMsp

Thanks so much for this. One of those take a good look at yourself checklists.

Pipefish

Thanks for posting GEAH, very good stuff.

All of the above for sure, and this more relapses occur when things are going well than otherwise. particularly stood out. From the outside looking in at least, my life was pretty dandy, and in pretty good shape, but for all that, on reflection what I really felt was lonely, angry all the time, hyper-critical, controlling (living in all of my defects, in other words). I was also quite unable to find a way to ask for help, and was full of pride, that I think past a certain point, I neither recognised I needed help, or would have known how to ask for it even if it had struck me I was in trouble. Being mindful of what is going on now with my day to day emotions and attitude wise, acknowledging it, talking it through, and taking on other's suggestions - all of that, is essential, and above all, being honest with myself when slipping into self-justification...that's one of the biggies for me.

Congratulations on graduating rehab. From your posts, it's clear you've really grown, and taken hold of the opportunity there with both hands. It's a brilliant thing to see. Rooting for you for your thirty days.

Tiptree

Thank you!

Stoogy

Excellent post GreenEggsAndHam, and a very useful list to look back on when feeling a bit out of sorts, well done by the way on the 30 day chip, excellent news you must be proud. Well done.
Stuart.