When recovering from an alcohol or substance use disorder, there are many factors that can contribute to relapse. Learning to avoid or adapt to these factors is key to your recovery. Below, you will learn about the stresses that can lead to relapse and how to avoid, prevent, and otherwise deal with them.
The most important thing to be cognizant of is that you don’t have to go this process alone—having a good support system in addition to good coping skills is your best armor against a relapse.
What Is Stress?
The National Institute of Health (NIH) defines stress as both a physical and emotional response, and it can manifest in many different ways. Stress can result from many different things, but one of the main factors can be if major changes have occurred in your life. For those who are recovering from a substance use disorder, they are leaning to adapt to a new way of life without the comforts of their drink or drug they used to self-medicate. Addictions can often cause great turbulence and disruption for both the person afflicted as well as everyone around them, so there is a lot of work to do and things to sort out. This alone can be overwhelming, which is why it’s best to take it in pieces, or in the case of the 12 Steps, step by step. This makes the process more digestible and easy to navigate. Not only is the person trying to organize their life, but they are also dealing with the raw and new emotions exposed once you take the substances away.
Another thing to keep in mind is that that stress is a normal feeling. Our abilities to deal with the stresses of life, both big and small, are called coping mechanisms, and in early recovery we must learn to do that in a way that doesn’t muffle our emotions or let us mentally withdraw. For someone in recovery, it is vital to develop, maintain, and nurture these healthy coping mechanisms to have a good system in place. This is critical when dealing with the anxiety often encountered in the beginning. By doing so, the temptation to cope with substances becomes less and less present in our mind until we come to understand that it is not an option for us anymore.
Stress and the Risk of Relapse
There are certain life stresses beyond early recovery that carry considerable risk for relapse. These sometimes are even the very reasons someone began abusing substances in the first place; they are often just unpleasant yet normal realities most adults must face. By being aware of them and being prepared for encountering them, we can mitigate the risk of a relapse.
Some of the most notable factors leading to stress include:
- Negative mood states can contribute to relapse, while positive mood states can help prevent it.
- Negative thinking is a factor that can result in relapse, while positive thinking related to avoiding substances and the support of family and friends diminish it.
- The greater the length of time the substance is used, the higher the risk of relapse. However, this is mitigated by ongoing abstinence from the substance and a strong support system.
- Undesirable events, ranging from moderate to severe, can increase the risk of relapse. Positive or even ambiguous (neither positive nor negative) life events can help diminish the chance of relapse over time. At the same time, social support in the form of therapy, groups such as Alcoholics Anonymous and Narcotics Anonymous, and the support of family and friends can almost completely mitigate the impact of negative life events.
- Reduced cognitive vigilance (awareness of stresses and substance use triggers) carries with it a high risk of relapse. However, cognitive vigilance such as self-inventory, understanding your emotions, and strategizing ways to avoid stress and substance availability are among the best ways to prevent relapse.
While some of these observations may seem obvious, one can lose sight of them in the midst of a difficult situation. That is why the last factor, cognitive vigilance, is so vital to recovery.
Stresses That Often Go Unrecognized
Other types of stress exist, but they are often overlooked because they seem minor or insignificant at the time. What they are and how powerful they can be may surprise you. As you recover, it is important to understand these stresses. It is also vital to know that, with the right help, you can overcome any of them and prevent relapse from occurring. These lesser-known stresses, as detailed by the NIH, are listed below.
Boredom, isolation, and loneliness are cited as the number one cause of relapse. Not knowing what to do with your time or whom to turn to is a risk during every stage of recovery. A consistent schedule and regular interaction with your support system are vital to staying sober.
Memories of events, people, or places associated with substance use can be triggers that cause people to focus on times when using was interesting, fun, or otherwise enjoyable. This is also called Euphoric Recall. Oftentimes, when people are recalling these things, they are not recalling or contextualizing the long-term negative effects of their substance use. This is why major positive life changes, including changes to your social circle and daily activities, can help you on the path to sobriety.
Co-occurring or comorbid disorders (sometimes referred to as dual diagnosis) are those that exist alongside a substance use disorder. Conditions like depression, anxiety, chronic pain, and anger management issues are related to substance use in many ways. They can be sources of high-level stress. By lessening and learning to deal with these comorbidities, it becomes easier to remain sober.
Guilt is an often-overlooked factor that can put you at risk. While it is important to understand the consequences and results of your substance use, feeling constant remorse can lower your self-esteem, lead to a negative mindset or depression, and ultimately take your focus away from the positive results of recovery. Recognizing the effects your substance use has had on others and making amends for them are a key aspect of AA and NA’s steps to recovery. However, in making amends and seeking forgiveness, self-forgiveness is just as important to recovery. This is because it raises self-esteem and improves one’s outlook on the likelihood of recovery. While feelings of guilt and shame are natural, feeling them persistently can ultimately do more harm than good. After all, guilt and shame are also sources of stress.
Close but troublesome relationships can also be a source of stress. An example of this is a family member whom you care about but who makes you anxious or tempts you to use. While cutting ties with that family member may not be an option, altering the relationship and setting up healthy boundaries can help make your permanent recovery far more likely. Learning how to set these boundaries or learning what to do when a relationship is too codependent or toxic to maintain is a vital coping skill in both recovery and life. Having a stable and safe environment, especially in early recovery, is also crucial, and the people you associate with, live with, and spend your time with can have a great deal to do with that.
Urges and cravings are stresses that can happen at any time. They can take you by surprise and occur at inconvenient times and places. It is crucial to seek out support whenever urges or cravings occur. It is also vital to recognize that craving a substance is not the same thing as relapse. Having strategies and a strong support system in place can help you navigate urges and cravings in ways that can help to reduce stress and maintain sobriety.
A person’s temperament or psychological makeup may make them more susceptible to stress. In this case, a person may run a higher risk of relapse. This is no cause to despair, though, and it is not a guarantee that a person will relapse. Instead, cognitive vigilance, therapeutic interventions like cognitive-behavioral therapy (CBT), and advanced coping skills should be sought out.
A lack of confidence in one’s ability to stay sober is the last of these lesser-known stresses. A person’s confidence in their ability to accomplish something is called “self-efficacy.” While this has been applied to sports and business psychology, it is also an important factor in the treatment of substance use disorders. Low self-efficacy has been shown to increase the chance of relapse, while high self-efficacy has been shown to contribute to long-term sobriety. The more strategies for coping and the more comprehensive the understanding of substance use an individual has, the higher their self-efficacy becomes.
Building and Maintaining Healthy Coping Mechanisms
Learning coping mechanisms for stress does not just occur in treatment. It can also be developed individually. Below are some tactics for coping with stress that are recommended by experts.
- Relaxation Techniques (sometimes called Relaxation Response Techniques) – These techniques can be as simple as deep breathing and thinking cheerful or pleasant thoughts. As shown above, positive thinking reduces the chances of relapse. Deep breathing, also called belly breathing and diaphragmatic breathing, helps reduce anxiety, lower blood pressure and heart rate, and boost energy.
- Mindfulness Meditation – Meditation has been proven to have many clinical benefits. It is also about far more than relaxation. By using controlled breathing and mental focus, one becomes more aware of even the smallest thoughts, urges, cravings, desires, and anxieties. Mindfulness meditation teaches you how to let go of these things, not judge yourself, and cope with unpleasant emotions, no matter how strong they are.
- Exercise, Stretching, and Yoga – Exercise has been proven to be especially beneficial in early recovery. It improves respiration and heart rate, reduces pain, releases the endorphins that create a natural “high,” and boosts positive mood. Stretching, much like exercise, is helpful in reducing pain throughout the body — something especially beneficial to those who are recovering from an opioid use disorder. Yoga combines the benefits of exercise and stretching with a focus that is similar to meditation. It helps you become aware of your body, which helps you to recognize and attend to pain and to understand the physical triggers that can lead to relapse.
- Support-Seeking – This is an action that can manifest in many ways. Calling a friend, spending time with family, joining a support group like AA or NA, and attending group therapy all fall under this category. Studies have shown that support-seeking increases the chances that you will enter treatment. It has also been shown to increase the likelihood of both short-term recovery and permanent sobriety. It is important for you to build and rely on the support system that you are most comfortable with whether it is among family and friends, people who are also in recovery, or specialists in a clinical setting.
Another Way To Look at Coping
The NIH has determined four major ways that people cope with stress while in recovery.
- Problem-Focused Coping – This set of coping mechanisms seeks to recognize and eliminate the cause of the stress. Strategizing stress reduction and avoidance, exercising self-restraint, and simplifying your schedule are three examples of problem-focused coping.
- Emotion-Focused Coping – These techniques seek to address the negative emotions that arise from stress and craving. Reducing negative emotions diminishes the chance of relapse. Examples of this type of coping are acceptance of negative emotions through self-forgiveness, the use of humor to boost mood and re-contextualize stress, positive thinking and reframing situations in a healthier context, and religious activities.
- Meaning-Focused Coping – Every stressful situation can have a greater meaning. Discovering and managing that meaning can also help eliminate the associated stress. Framing these difficult situations in the greater context of your life can be extremely helpful. Two examples of meaning-focused coping are positive self-talk and mindfulness practices.
- Social Coping – Isolation and loneliness can be stresses that lead to relapse. They can also indicate that the proper support system for recovery is not in place. Social coping involves seeking help from others whether they are friends, family members, or a group of people in recovery. Social coping is about building and utilizing a support system.
Finding Help in Learning These Coping Skills
You are never alone in your path to recovery. There are many groups, centers, and programs that are ready to help. Facilities like Granite Recovery Centers can be reached 24 hours a day, 365 days a year. Calling can be your first step in recovery, and our Admissions specialists are experts in coping with the many stresses that can lead to relapse. A wide variety of treatments are available, allowing you to determine your own best path to permanent sobriety and a better life. Please give us a call today at 855.712.7784.