Combating Post-Acute Withdrawal Syndrome (PAWS)

Combating PAWS
November 1, 2017
|   Updated:
November 11, 2021

Entering treatment and realizing you have the opportunity to regain control of your life is exciting. But once the initial withdrawal period has passed and the excitement has died down, recovering alcoholics can begin feeling disenchanted. They took the steps to stop drinking but they’re lives aren’t instantly perfect as a result. That’s when the depression, irritability, mental confusion and general malaise set in.

It’s not a failure in alcohol recovery, it’s not a relapse, it’s PAWS.

What is PAWS?

PAWS stands for post-acute withdrawal syndrome and most recovering alcoholics will experience it. Once the body has effectively gone through physical detox from chronic alcohol abuse, the brain has a hard time catching up. As it works to create new pathways and replace the old ones damaged by drinking, its other processes may slow down causing mental distress.

Strategies to Manage PAWS

Not every on in recovery experiences PAWS, but the ones who do may experience it periodically for several years. Thankfully, most are able to effectively cope with the symptoms using a number of self-care strategies. These strategies are similar to coping mechanisms people use to manage depression and anxiety.

1. Eat a Balanced Diet

Sugar, caffeine, and processed foods can make the symptoms of PAWS seem worse because your body is being deprived of essential nutrients.

Instead, go for fresh fruits, vegetables, and lean proteins.

Most importantly, stay hydrated and drink lots of water. Water is your body’s principle chemical component and it makes up roughly 60% of your body weight. The Mayo Clinic recommends 9 cups for women and 13 cups for men daily.

2. Exercise Regularly

At least 30-60 minutes a day 3 to 5 times per week.

It’s only a small fraction of your day and the endorphins you get from exercising are a mental boost that can’t be beat. Try a new sport, like racquetball, and invite your friends and loved ones to play regularly. Other good choices include jogging, yoga, swimming, or an aerobic exercise class. Sometimes just a leisurely walk can put you in a better headspace. Many community centers have free or reduced-price fitness classes.

3. Meditate

At least 5 to 10 minutes daily.

Your mental health is important to your recovery. Taking a few moments every day to center your thoughts and breathe deeply is essential. Whatever meditation looks like to you is fine as long is it’s a relaxing practice. Some people like to sit quietly, while others would prefer taking a walk in the woods or on the beach. Others find comfort in listening to music. The point is to sit and process your thoughts and try to be in the moment; accept your feelings as they come.

4. Self-Actualize

If you envision yourself as a success, you’ll be a success.

Find a job your passionate about or enroll in school as a condition of your treatment. This will give you a tangible goal to aim for, and will often draw you out of your shell. Self-actualizing activities range greatly from jobs to hobbies. You might focus on raising healthy children, or running a 5k, or volunteering for an organization that you find inspiring. The point of self-actualizing is to set goals and build a rewarding life outside of your addiction.

PAWS is Not Permanent

When dealing with PAWS, remember that it is not permanent.

It doesn’t have to derail your recovery.

Do all you can to avoid sinking into restlessness or depression and don’t let it become unbearable. If you begin to feel like you’re out of your depth in dealing with your mental health seek professional help, or confide in a loved one or trusted counselor. As soon as you recognize you are dealing with PAWS, talk to someone about it.

Once you’ve identified the problem, solving it – or pushing through it – becomes much easier.

“The best way out is always through.”

-Robert Frost

About the Author

Kathleen Esposito is a certified addictions counselor in the Pacific Northwest. She helps individuals recover from drug, alcohol and gambling dependencies through group and individual therapy and regularly speaks at treatment centers.

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