Wednesday 27 May 2015

Post Acute Withdrawal Symptoms

Day 87, and I'm struggling.

I had been fine. Upbeat, energetic, seeing light at the end of the tunnel. But the last few days I've felt despondent and tetchy. And I'm tired. Physically tired and emotionally drained.

I sleep like a log - 7 hours - but wake up feeling exhausted. Then, by mid afternoon, I'm falling asleep in a chair. By evening I've run out of the energy to do anything except collapse in front of the telly.

So I googled something along the lines of 'fatigue after quitting alcohol.' I got all the usual stuff about withdrawal symptoms in the few days after stopping. I know that. I remember the total exhaustion of day 1-5. But this is DAY 87!

Then I found all this stuff about Post Acute Withdrawal Symptoms (here's a link to one of the best explanations I found). It's also known by its more cuddly nickname PAWS.

Oh bugger.

Apparently, PAWS is the second stage of withdrawal from alcohol (or any form of drug) and occurs after the initial intense physical withdrawal stage. As the brain chemistry gradually returns to a new equilibrium it tends to fluctuate causing emotional, physiological and physical symptoms.

These episodes appear to be cyclical - some people swear they are lunar, occurring every 28 days or so or literally at the full moon. Good God I'm a werewolf!

The 'pink cloud' phase followed by 'the wall' is the first episode of PAWS, but these symptoms can reoccur for up to two years!

The good news is that each episode gets shorter and less intense, disappearing within a few days. And if you're aware of them and ready for them you can cope.

Apparently, being unprepared for an attack of PAWS is a major reason for relapse. You think everything's getting better, then BAM! It feels like you're back to the beginning. You lose faith that it's ever going to get better and reach for the bottle.

Symptoms of PAWS include: mood swings, anxiety, irritability, tiredness, low enthusiasm, variable concentration and sleep disturbance (including bad dreams in which you drink heavily!).

I also read that a number of people experience terrible memory lapses during episodes of PAWS. This was actually a relief to discover, as two days ago I was asked in a shop for my postcode and couldn't remember it!

I've had that postcode for nearly a decade and am constantly using it. I had a panic that I was getting early onset Alzheimer's. Imagine - 2 decades fuzzy through drink, a few months lucid, then off with the fairies again!

So, what do you do about PAWS?

Here's some advice I found: You can't hurry recovery. But you can get through it one day at a time. If you resent post-acute withdrawal, or try to bulldoze your way through it, you will become exhausted. And when you're exhausted you will think of using to escape.

Basically, you just have to go with the flow. Ride it out. Like PMS. Each episode is short and gets shorter/easier. The good times get better/longer. So they say.

We had bad spells when we were drinking too, didn't we? Loads of them! Only this time we don't have the false friend to help us through.

Love to you all!

SM x

35 comments:

  1. thank you! am on day 90 something and have had this for last the couple of weeks i started wondering what was going on. sleeping awesome but very tired and mood swings from here to tokyo. i have been taking some extra vitamins which seemed to help (but maybe it's just the end of a period...) thanks again and keep going ;-)

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    1. Hi mefixingme, and thanks for posting! I'm glad it's not just me with the mood swings. You're just ahead of me, so do let me know what to expect! Keep in touch, and huge congrats on making it so far already SM x

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    3. Like many people, at the start of the year, I made a resolution to decrease my alcohol intake.

      Drink Less in Seven Days by Georgia Foster has really helped me stick to this resolution. Georgia is a clinical hypnotherapist and alongside the written version of the book, there are also 4 "Hypnosis Hub" recordings that readers are encouraged to access to help them with the program.

      One of the great things about Drink Less in Seven Days is that Georgia (and I"m going to call her Georgia because she kind of feels like a friend) is totally non-judgemental about how much you drink, why you drink, why you feel you drink too much etc. I feel that this is an area where people carry a lot of shame and negative feelings and to have someone who approaches an emotional issue like this with absolute objectivity is helpful in driving the desired behaviours. She's on your side!

      There are two main parts to Drink Less in Seven Days. The first is how your amygdala (the part of your brain that deals with emotions and fear/stress responses) can actually work against your efforts to quit or reduce your drinking. It shows you how to move your decision to drink away from this very instinctive part of your brain to your prefrontal cortex which is the part of your brain that is more concerned with considered decision-making.

      I found this part of the book fascinating, particularly the parts where she spoke about silencing your inner critic.

      However, it was the second part of the book, where Georgia broke down different personality types. what triggers them to drink and how to circumvent these triggers that I found most useful. (Also fascinating, if like me you love a good theory of behaviour and the ability to proclaim "Yes!!!! That's me!"). Because it makes total sense right? If you drink out of social anxiety (which is me a little bit) your methods to success will likely be different to someone who drinks because everyone around you is (also me a little bit).

      The biggest take away for me was starting to understand what triggers my wanting to drink and learning alternative strategies should I decide not to. I think a really important thing about Drink Less in Seven Days is that it is NOT about quitting drinking altogether. It is about cutting down to a level that you are comfortable with, whatever that is for you. And this feels more manageable than quitting altogether.

      The cru of this type of book though is does it work?

      So here's the real deal. I started this program in January. It's now March and I can count the times I have drunk alcohol on one hand. During this time I have been to pubs, bars and restaurants, entertained at home and been entertained at other people's homes so it's not like I have been hiding myself away. I have been around alcohol and people drinking as much as I ever was.

      Will I drink again? Almost definitely. For me, this experiment was never about giving up altogether. And I have far too much fun making cocktails for this to give it up completely! However, I feel that moving forward I will be able to drink in a more mindful considered way.

      Thank you to Georgia Foster for a thoroughly fascinating book that does exactly what it says on the cover!

      Here's a link to The 7 Days To Drink Less Online Alcohol Reduction Program.

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    4. You mentioned in your book, the wall. I didn’t know why I would relapse after every six weeks. Now I know, thanks.

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  2. I seem to have missed out the pink fluffy clouds and gone straight to this stage. I woke this morning feeling groggy and headachy - again (not helped by toddler joining us at 4am)! Half way to school drop off realised hadn't packed a book in son's bag so mad dash back to get it but it wasn't there. I had packed it but had completely forgotten (I have since remembered doing it!). Late for school. Stressed! To be honest was having these moments when drinking and worrying about dementia too as have recently read 'still alice'. I am committed to being AF but worried about how much worse the side effects are going to be before they get better. Thanks again for your timely post. Going to read up on PAWS. Forewarned is foreamed and all that xxx

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    1. You're doing great, EH! Keep at it! It'll get easier. I've had WAY more good days than bad ones, and so will you. Hugs SM x

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  3. From reading your blog the one massive thing I've learnt is to expect days like this. That becoming and staying AF is a roundabout of emotions, some of which are the wine witch trying to dupe you into sipping from her cup! That you just have to keep going, plodding along, doing what you can (chocolate, sleep, popcorn, nice candles), just to get through. I'm bleedin wrecked all the time (low iron count) and disappointed I don't feel less so after giving up but have to keep big picture in mind. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxMtts.

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    1. Thanks mtts. So true. Hadn't thought about popcorn - will try that ;-) xxx

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  4. Mmm popcorn. In the old days I used to grate cheese in and then add crisps too. Ugh! But also so gorgeous...

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  5. Your post today could not have been more perfectly timed. I am bawling my eyes out here for what I thought was no reason apart from tiredness. Hooray - I'm normal! I don't feel very normal though. I feel like a big freak. I don't get these mood swings. Psycho swings sums it up better. Grrrrr x

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    1. I know! I know! All these things too shall pass (apparently)....

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  6. Tiredness has really gripped me lately, to the point that I am actually having to have a small doze after I finish work. I am sleeping fine at night. In fact, better natural sleep than I ever remember having without that constant waking in the night with a dry mouth and raging thirst thing that comes with alcohol.
    I have been googling tiredness and have looked at underactive thyroid to food intolerance. I never really considered PAWS. I must look further into this. Thanks again for the gripping blog SM. x

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    1. Tallaxo! So glad you posted. I thought you might have gone on a bender. Following Anne's comments I've done a load of research on B vitamins. I'll do a post soon. I reckon our tiredness may be, at least in part, due to needing more vit bs. xx

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  7. Day 52 and your blog is a real lifeline. Thanks so much, particularly for today.

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    1. Welcome RCW, and thanks for posting! Huge congrats on day 52, and please stay in touch! x

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  8. A question...has anyone else suffered from tinnitus since going AF? I have and wondered if it was related to changing my chemistry so dramatically. Any thoughts!

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    1. Try magnesium supplements. Magnesium deficiency is common with drinkers and this can be a symptom.

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    2. Hi RCW, Anne is hugely wise. I also looked up B vitamins as a result of her comments, and vitamin B deficiency (common in ex drinkers) can also cause tinnitus. Try that too! Let us know if it works....

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  9. Yes. PAWS. apparently taking extra vitamin B helps. And magnesium before bed. Hubby and I both do that.
    Some of the forgetfulness is letting go of fear (I think). I used to make lists and ensure I never forgot anything, because I was working hard to keep up appearances and protect my drinking self.
    Now I obsess less, but it sometimes means I feel less sharp.
    That's ok. We all forget a postcode now and then!

    Laugh and let it go.

    Your body and brain heal for a LONG TIME. And drinking even a little supposedly hinders this. So I expect 2 years is a reasonable time frame. I knew I feel a million times better today than 18 months ago!

    Anne

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    1. Sorry to jump in, but I was wondering Anne, how much Magnesium do you take and which one? There are different types and combinations so wasn't sure which to get when I was in the chemist yesterday! Thanks, A x

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    2. thanks so much for the advice, Anne. I've researched vitamin B. Will do a post on it asap. Looks like it could really help. xx

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    3. I take magnesium citrate. Or whatever is on sale.
      2 250 mg tabs work for me. More gives me diarrhea, which is what they mean by taking to tolerance.
      I take it at night as it really helps with sleep. Seriously.

      The powdered version called CALM is also good.

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  10. Best advice I was given in the early days was to give myself time and not give myself a hard time. As I said in a reply to a blog last week I still feel annoyed and angry sometimes but I know it passes. I think it is very important to accept that it's perfectly normal and ok not to feel delighted about not drinking all the time. I used to voice this to family and they didn't understand and just thought I was yearning to drink. I wasn't. I just needed to say that at that moment it didn't feel brilliant. Hang in there, it's so much better than the alternative, even the not so great days. Xx

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    1. Hi moosey! Thanks so much for posting. I love that advice. So true. SM x

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  11. Hi Sm. It sucks that you can get to day 87 and still feel crappy. I've heard about PAWS, there is an excellent podcast about it on the Bubble Hour if you haven't listened to it already. But 'up to two years'?! That's so unfair! Alcohol really does mess with your life doesn't it? Even long after you've put down your last drink! Good luck, I hope you feel better soon. A x

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    1. Hi Angie! I keep hearing about the Bubble Hour. I must find a good car journey without the kids and get stuck in! Hope you're ok! SM x

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  12. hi testing my blog response

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  13. Yes, the range of emotions are insane! I remember drinking to curb all of my emotions high ones and low ones. Now raw with feelings I am learning how to cope with them all the time. It sucks but it helps others like myself aren't alone with this process. Remember the game where you have a heavy hammer and you hit the object that pops up and then another object pops up only to keep hitting it again? Drinking was like this for me. Only now as 90 days approaches these things don't pop as much...but when they do it sucks!

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    1. Great analogy Jen! Huge congrats on 90 days - I'm there tomorrow too! Xx

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  14. Hi, thank you for the PAWS link. This is massively helpful. The last few days have seen me experience just about every one of the symptom listed. Oh, it's been big drama in our house, but still, no booze.
    In addition to my bath time bubbles and candles I now have a bath time playlist and tonight I'm taking inspiration from Damon Albarn 'Come,come,come on, get through it...' Flossie x

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    1. Great to hear from you, Flossie. You haven't blogged for ages. I was worried you'd fallen off the wagon! X

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