Relapse is a process that begins much earlier than when a person with alcohol dependency actually starts drinking again. The process of relapse causes pain and discomfort, which can be so intense that living a normal life without alcohol becomes almost impossible. The symptoms of the relapse process are commonly divided into ten phases:
1. Returning to Denial. In this phase, the person is unable to recognize or honestly share with others what they are thinking or feeling.
*Concern for Well-being: The individual feels anxiety and fear. This uneasiness comes and goes, usually lasting only a short time.
*Denial of Concern: The individual ignores or denies feelings of anxiety and fear, just as they previously denied their alcoholism. Even if these feelings are recognized, they are quickly forgotten when they pass.
2. Avoidance and Defensive Behavior. In this phase, the person avoids thinking about anything that would trigger painful or uncomfortable feelings, leading to the avoidance of anything that would force them to honestly look at themselves.
*Belief that They Will Never Drink Again: The person convinces themselves that they will never drink again and sometimes reassures others, but most often convinces themselves.
*Caring for Others Instead of Themselves: The individual focuses more on others' sobriety than on their own recovery.
*Defensiveness: The person is defensive when discussing personal problems or their recovery, even when the situation does not require it.
*Compulsive Behavior: Without any particular reason, there is a need to repeat the same things over and over. The person tends to overwork but avoids casual or informal contact with others.
*Impulsive Behavior: Occasionally, rigid behavior can be interrupted by spontaneous, uncontrolled actions.
*Tendency Toward Isolation: The individual spends more time alone. Instead of overcoming loneliness by trying to be around others, they become even more compulsive and impulsive.
3. Crisis Formation. In this phase, the individual begins to experience life problems arising from the denial of feelings, self-isolation, and inconsistent adherence to the recovery program.
*Tunnel Vision: The person cannot see the whole picture and focuses on one aspect, sometimes creating the false impression that everything is safe and going well, while at other times small problems are blown out of proportion.
*Mild Depression: The person feels exhausted, in a bad mood, and apathetic.
*Loss of Constructive Planning: The individual stops planning each day and for the future, devoting less and less time to details, becoming apathetic.
*Beginning of Plan Failures: As they ignore small details, plans start to fail, creating new life problems, leading to feelings of guilt and remorse.
4. Immobilization. In this phase, the person is completely unable to take action. They go through the motions of life but are more controlled by life than in control of it.
*Fantasizing and Wishful Thinking: The individual begins to imagine that they will be saved or released from all this by some event that is unlikely to happen.
*Feeling that Nothing Can Be Solved: Minor failures are exaggerated and blown out of proportion, leading to the belief that "I’ve done everything I could think of, and sobriety isn’t helping."
*Immature Desire to Be Happy: A weak desire to "be happy" or "get things in order" arises, without the person really knowing why this is necessary to be happy.
5. Confusion and Overreaction. In this phase, the individual is unable to think clearly and overreacts to insignificant things.
*Periods of Confusion: The person often feels angry with themselves for not being able to clearly understand their situation.
*Dissatisfaction with Friends: Relationships with friends, family and counselors become strained. The individual feels threatened when these people talk about changes in their behavior and mood.
*Easily Provoked Anger: The person feels anger, frustration, resentment, and irritation without any real cause, reacting more frequently to unimportant things.
6.Depression. In this phase, the person becomes very depressed and increasingly struggles with daily tasks. Sometimes, thoughts of suicide, drinking, or drug use arise.
*Irregular Eating Habits: The person either overeats or does not eat enough.
*Decreased Desire to Act: The individual cannot concentrate, suffers from anxiety, fear, and restlessness, and often feels trapped with no way out.
*Irregular Sleep Patterns: The person has difficulty falling asleep, and when they do, sleep is restless. Due to exhaustion, they may sleep uninterrupted for 12 to 24 hours.
*Disruption of Daily Routine: Daily activities become random. The person stops getting up and going to bed at the same time. It becomes difficult to be on time for scheduled meetings and to plan work with others.
*Inability to Follow Through on Plans and Decisions: The person feels anxious, fearful, disappointed, tense, and therefore cannot do what is necessary.
*Periods of Deep Depression: The individual increasingly experiences a state of depression. Depression deepens, lasts longer, and increasingly disrupts life. When depressed, the person tries to isolate themselves from others, as people provoke anger and irritation.
7. Loss of Behavioral Control. In this phase, the individual loses control over their behavior and can no longer manage daily tasks.
*Persistent Denial: Denial remains strong, but there is no certainty that behavior is uncontrolled.
*Irregular Attendance at Group Therapy: The individual stops attending group meetings regularly and begins skipping scheduled counseling or treatment sessions, believing that neither group attendance nor counseling improves their well-being.
*Adopting a “I Don’t Care” Attitude: The person tries to act as if they don’t care about the problems that arise.
*Open Rejection of Help: The individual distances themselves from people who could help them. They repel others with fits of anger, criticism, and belittlement of others.
*Dissatisfaction with Life: Everything seems so bad that the person begins to think that drinking is justified, as it cannot get any worse.
*Feelings of Helplessness and Dependency: The person finds it difficult to muster the energy to begin, to think clearly, to concentrate, and to think abstractly.
8. Acknowledgment of Loss of Control. In this phase, denial collapses, and the individual suddenly realizes how unbearable the problems are, how out of control their life has become, and how little power and strength they have to solve even one of these problems.
*Self-Pity: The person begins to feel sorry for themselves and often wants to attract the attention of counselors and family members through this.
*Thoughts of Moderate Drinking: The individual imagines that drinking or drug use will help them feel better and begins to believe they can drink normally and control their drinking.
*Feeling that Drinking is the Only Option: The individual feels that drinking is the only choice that can save them from going insane or committing suicide.
*Conscious Lying: The person begins to recognize their lying, denial, and excuses but cannot get rid of them.
*Complete Loss of Self-Confidence: The person feels trapped, helpless to think clearly and take action.
9. Narrowing of Choices. In this phase, the person feels trapped in a cycle of pain and inability to control their life. The only perceived escape is through drinking, suicide, or madness.
*Unfounded Resentment: The individual feels anger that they cannot act as they wish.
*Complete Cessation of Treatment: The person stops attending meetings; those who are on medication either forget or intentionally avoid taking it regularly.
*Extreme Loneliness, Frustration, Anger, and Tension: The individual feels completely overwhelmed and believes there is no other option except to drink.
10. Acute Relapse Episode. In this phase, the individual is completely unable to function normally and may revert to alcohol or drug use.
*Loss of Behavioral Control: The individual experiences increasing difficulty in controlling their thoughts, feelings, decisions, and behavior.
*Acute Relapse Episode: The person goes through periods when they can no longer function normally. These periods become more frequent and last longer.
*Difficulties in All Areas of Life: Alcohol or drug use, emotional exhaustion, physical exhaustion, stress-related illnesses, mental illness, suicidal tendencies, propensity for accidents, and breakdown of social structures may all occur.
Relapse is a serious and complex process, often beginning long before actual substance use resumes. Understanding the phases and symptoms can help in identifying early signs and seeking appropriate support before the situation worsens.