Rough waters in early-ish sobriety
April 16, 2015 9:21 AM   Subscribe

Posting for a friend: "My SO is several months sober, after a few decades of alcohol and drug abuse, and is having a rough time of it. They chose sobriety, and often say they're happy to be sober, that they know it's the right choice, etc. Basically, the sobriety was not court-ordered but a result of "enough is enough." They're seeing a therapist regularly, going to meetings, taking an antidepressant...and still feeling crappy. What can we do?

They've got a few big life stressors going on, but nothing really new besides the sobriety. Relapse has not happened, but they've come very close, which worries me. They're not sleeping well, feeling down and depressed, and struggling with powerful cravings. It's just a rough time and I don't know what to do (if anything) to help.

Their sponsor is good but not a perfect fit; I think SO isn't optimistic about finding a better one since the area where we live is fairly churchy and they're already having misgivings about being agnostic in the context of AA. There's lots of support from family and friends, and I've done my best to be supportive as well. Al-Anon has helped a lot, although I didn't know my SO through much of their non-sober times, so I find I can't relate well with the others in my group.

My question is twofold:

1) Does it get better? Is it normal (that is, not troublesome) for someone in early sobriety to feel tired, worn out, exhausted from the work of abstaining from substances? Is this a sign that relapse is inevitable, or is it just a bump in the road?

2) What can I do, as a supportive significant other?

Success stories are welcome, as well as general advice on being in a relationship with someone in recovery. Thanks!!"
posted by elken to Human Relations (17 answers total) 11 users marked this as a favorite
From personal experience I would highly recommend Gabapentin. According to my psychiatrist and literature, alcoholics can be quite deficient in GABA, which is the "feel good and peaceful" neurotransmittor. Alcohol mimics GABA by binding to and activating the GABA receptor. Removing a steady supply of alcohol will thus cause alcohol cravings since your brain is used to a certain level of GABA receptor activity. Gabapentin increases GABA receptor acctivity so that when alcohol is removed the receptor will remain at proper activation levels. My experience with Gabapentin was tremendously positivel--I was not able to remain sober for over 1 month at a time (or less) until I recieved this treatment along with therapy. Of course, YMMV.
posted by waving at 9:40 AM on April 16, 2015 [4 favorites]

Is it normal (that is, not troublesome) for someone in early sobriety to feel tired, worn out, exhausted from the work of abstaining from substances? Is this a sign that relapse is inevitable, or is it just a bump in the road?

One of the things about substance abuse issues is that people have a tendency to start to go to the drink/drugs instead of using their own stress-coping mechanisms. These mechanisms atrophy over time. So if something stressful is going on and the usual routine is to have a drink, then the sober person can (sometimes) be stuck in a double problem of having stress which is bad enough, but not having the toolkit to work on that stress because their one known avenue is closed to them. So yeah this is pretty normal, even though it feels crappy. Other stress reduction suggestions apply: get good sleep, exercise and eat right, stay hydrated, therapy.

That said, and just to be Real Talking relapse is often a part of sobriety for most people, that's just how it is. I know it's tough to be in a partnered relationship with someone who is grappling with addiction, but it's important to not make your own dread about them relapsing turn into its own relationship issue. Keep open lines of communication but don't turn it into an additional threat that the sober person has to deal with. This is tough and it's not for everyone, but it's also a thing to keep in mind as you are trying to be supportive and helpful. I don't know what "coming very close" means in this context, but that's worth talking about. It might be helpful for you to go to Al-Anon (or just read the websites/books, meetings aren't for everyone) just to get your own perspective, even though the person you are with was not drinking when they were with you. Best of luck.
posted by jessamyn at 9:41 AM on April 16, 2015 [10 favorites]

1. TOTALLY normal. This is a surfacing of all the awful feelings/thoughts that alcohol and drugs were helping them mask. It most definitely gets better, and the way it gets better is by going to meetings, meetings, meetings and by using the sponsor as best they can. Very frequently there's this thing where people search for "just the right" sponsor, "just the right" meeting. Again, totally normal, but people in early recovery need to recognize that their judgement is likely impaired and that they need to work the program, by which I mean take whatever good they can find in the meetings or in the conversations with the sponsor and leave the rest behind.

The mantra "one day at a time" can be really helpful. Sometimes it needs to be "one minute at a time!" If the person you're asking about is female, I'd suggest she check out this book by Stephanie Brown, an amazing therapist who has given this a lot of thought.

2. Keep going to Alanon! Again, use the meetings as a place to voice concerns, share stories, get wisdom. Know that relapse is a very common feature of recovery - it's by no means a linear path. There's not a whole lot you can do to prevent someone from relapsing and it can't be your responsibility to do so. Keep using the Alanon meetings as best you can. Stephanie Brown also wrote a book to help families - you might want to check that out too.

It's helpful if the therapist knows about addiction, as many don't fully understand it, so it might be wise to connect to the therapist and ask if they have any advice for the partner.

It's a rough journey, but totally worth it.
posted by jasper411 at 9:42 AM on April 16, 2015 [2 favorites]

I'm not an addict, but I come from a family full of 'em. I'm also not a medical professional, but I'm trying to BE one. So take my advice with that background info.

I've heard from family members (as well as strangers) that it's not the initial phases of recovery that's hard... it's the looooong slog afterwards of adjusting to post-substance-abuse life. From the (limited) research available (cite), it looks like using/abusing a substance kinda carves reward pathways into your brain. Imagine hiking a trail in the forest - if you take the same one every day, it gets beaten-down and easier to traverse, but the REST of the forest gets overgrown and tougher to traverse. Now imagine that the trail is your BRAIN, and that the "hikers" are actually neurotransmitters! When you block off access to the "easy" reward paths (the well-trod trails of drugs/alcohol), feeling happy/fulfilled/rewarded in OTHER ways is cruelly, paradoxically MUCH HARDER, because your brain is USED to getting its jollies the "easy" way, via substance abuse.

Just KNOWING that this is the case is helpful, because , 1. You know you're not "failing" at recovery, and, 2. You know that things WILL get better with time - that this is a transitional stage for you and your brain, NOT just the new normal.

I've also found that the single BEST predictor of a successful recovery in family members is having something, ANYTHING important and time-consuming in one's life... whether it's college, or caring for relatives, or a job, or whatever. People whose days are jam-packed with things that feel worthwhile are WAY less likely to relapse.
posted by julthumbscrew at 9:46 AM on April 16, 2015 [9 favorites]

I am in a very, very eerily similar situation, and I have found that it's crucially important to stay busy yourself, and not start thinking of yourself as any kind of caretaker. A relationship dynamic that's been part of a pattern for me is that I tend to "mom" my boyfriends, and having a bf in recovery has been a really tempting situation for my mom impulses--"Are you getting enough sleep?" "Drink some water," "Wear this sunscreen," etc. are all things I've said to him in the last week. But I have to knock it off and trust him to be an adult who knows how to care for himself.

I'm still in the weeds myself so this is by no means expert advice, but I think the best thing you can do is to trust your SO and not be overly involved, or invested, in their sobriety. Have your own life and take the Al-Anon advice about detachment, which I've found useful in this area.
posted by witchen at 9:57 AM on April 16, 2015

There is a stupid yet undeniably true saying: if it was easy, it wouldn't be so hard for everybody.

There's nothing weird about being exhausted from the effort of staying sober. But there's also nothing unusual about having health problems in new sobriety that are both a result of new sobriety and newly-uncovered old issues that were masked by the non-sobriety.

So, among all the other good advice here, I think your friend should encourage their SO to see the doctor, even if they have fairly recently, to discuss some of these specific issues so that the things that can be helped get helped. Every little bit of relief helps at this point.
posted by Lyn Never at 10:03 AM on April 16, 2015 [2 favorites]

One or both of you might find some use in SMART Recovery, if the agnostic thing isn't working out super-well in terms of your local AA groups and sponsor options. SMART Recovery has no formal religious component, other than whatever an individual may want to bring to his or her own sobriety planning. You may not have a local meeting but could find the online forums or chat meetings useful, either in addition to or instead of AA/Al-Anon.

That aside, what your partner is experiencing is not abnormal, but is for sure hard for both of you. Staying busy can be good. Finding new social outlets can be good (meetup groups, whatever, anything other than the same old places you used to drink with your friends). Finding a new way to satisfy some portion of what drinking or drugging used to provide can be good - if it was stress relief, maybe take up exercise or meditation or gardening or whatever soothes you. If it was partly about liking to experience all the interesting tastes and varieties of beer, maybe your partner can become a coffee snob or get into making interesting non-alcoholic flavored drinks or take up cooking.

As a supportive SO, first of all, take care of yourself. You also need sleep, exercise, good food, at least one or two people you can really talk to about the parts of this that are hard for you, a fun hobby, a social outlet, and some understanding from your partner when this is rough on you. Second of all, ask your partner what you can do to support them, and keep asking, because the answer may change over time as parts of this get easier or harder for your partner.
posted by Stacey at 10:08 AM on April 16, 2015

See if you can find a physician who will presribe narcan/naloxone, If you can get your hands on the April issue of The Atlantic magazine, take a look and see what you think.
posted by SyraCarol at 10:27 AM on April 16, 2015 [1 favorite]

First, know that Post-Acute Withdrawal Syndrome (PAWS) is a real thing. Depending on the number of months they've been sober, this could be playing a part in what's going on. PAWS goes away, but there's no real time frame that I know of. It stuck around for about a month to six weeks for me.

Secondly, how's it going with the work in AA? The actual program (the one outlined in the book), can make a big difference in an individual's experience with their recovery by giving them a sense of purpose, helping to raise self-esteem, and teaching them to get out of rumination. If they have a sponsor, they're likely on their way to doing this stuff already. If they aren't they would be well served to get started. Meetings are nice, but they're merely a place to be among fellows, and shouldn't be confused with actually doing the work of twelve step recovery.

Good luck! Yes, it really does get better. By lots.
posted by Gilbert at 11:23 AM on April 16, 2015 [1 favorite]

TL;DR: Drug use is often an attempt to solve some other problem. When you quit using drugs, the other problem remains. Helping your friend's SO identify that problem and find alternate solutions might help him or her feel better and not want to use drugs again.

In my own personal experience, chronic drug use is usually a response to some other problem that you're trying to fix. There's some kind of physical or psychological problem that drug addicts are trying to solve with drugs. The drugs may make them feel bad, but it's still better than how they feel without them.

In my own life, what's worked best is identifying what problem I'm using a particular substance to fix, and then finding alternate methods of fixing it. For example, for a long time I was using marijuana just because it made me feel better. I went back and forth using it several times, and each time I would pay attention to what my life was like when I was using and when I wasn't. Over the course of a couple years, what I realized is that the main problem marijuana was helping me with was a really screwed-up digestive system. When I was smoking pot I was regular and my digestive system felt good, but every time I quit it would all go to hell. Once I realized that, I started doing some research into the problem, and after a period of trial and error I realized that I probably had celiac disease. I cut out gluten, my intestines slowly began to heal, and over the course of a few years I became less and less dependent on marijuana, until I got to the point where it did more harm than good, at which point I cut it out entirely.

Now I'm going through the same thing with coffee. I've identified what problem I'm using coffee to solve (it's psychological this time), and now I'm in the process of figuring out alternate ways to deal with it. I'd thought that I'd figured out a good solution, but it didn't work, so it's back to the drawing board. But I'm definitely making progress.

The reason I'm saying all this is to point out that it's actually very normal for drug addicts to encounter serious problems with they quit, because there's almost always a problem or two that they're trying to solve by using drugs. The drug often feels like the problem itself--and in many ways it is--but in fact the drug is usually just the first problem of many. Often drug addicts feel like they just have to quit the drug and then the work will be over, but in reality once you quit the real work has just begun.

Maybe you can your friend do some problem solving, and figure out ways to feel better other than using drugs. When they're talking about wanting to use, then maybe you can direct the conversation towards figuring out why, and then brainstorming other ways to meet the same purpose. Even if these are just temporary withdrawal symptoms, there's still a lot that they can do to diminish them, if they do a little research and use a little creativity.
posted by sam_harms at 1:34 PM on April 16, 2015 [2 favorites]

Is it normal (that is, not troublesome) for someone in early sobriety to feel tired, worn out, exhausted from the work of abstaining from substances?


If you have been consuming a lot of something for a long time, it is a huge physical shock to the system to remove it, no matter what it is, no matter how much you feel it is the right thing to do. And it can take a long time for the body to physically adjust, even if there are no psychological issues driving the original choice to imbibe. For most people, there are also significant psychological problems that now need to be dealt with. But even without that, just the act of removing this strong chemical will have very significant physical impacts.

I have never been an addict but I have a serious medical condition and, at one time, I was on 8 or 9 prescription drugs. Those drugs most likely saved my life. But it took me 22 months to get off of them and then I was on OTC drugs for a long time after that. Some of those OTC drugs were some of the same things I had been on via prescription, but lower doses. Twice, I ended up "back in the ER"* and back on drugs because the physical stress was too much. I had to both take a supportive alternative medication AND taper off of one of the drugs to successfully get off of it for good without ending up back in the ER. Even so, when I finally stopped that specific drug, I laid around and did nothing for three months. This did not get better until I began aggressively treating for anemia with lots of extra iron.

So, yes, it is extremely normal to be exhausted when you stop taking a powerful drug. Your body is working hard on coping with a huge physical shock and there are substantial changes happening at the cellular level. Tolerance is something that develops because your cells change internally in order to be able to process more of a substance that you take regularly. So when you remove it, that process has to reverse. It is a very resource intensive process.

I was NOT dealing with psychological stuff. I was not taking any of these drugs for psychological reasons. It still took a long time for my body to adjust to being off of them and I was tired for a long time.

tldr: Exhaustion is normal and to be expected. It can sometimes help to take the right supplements. Beyond that, time and sleep are the big helpers for the physical part of this.

*Technically, I only ended up back in the ER once. The other time, I happened to have a regular appointment and let my doc know I was in trouble and needed something. I still ended up sick, bedridden and back on extra drugs.
posted by Michele in California at 2:03 PM on April 16, 2015

"It's a different world. You have to get used to a paler set of colors, a quieter lot of sounds. You have to allow for relapses. All the people you used to know well will get to be just a little strange. You won't even like most of them, and they won't like you too well." – Raymond Chandler, on sobriety
posted by zadcat at 3:37 PM on April 16, 2015 [4 favorites]

Pete Hamill, in "A Drinking Life", recounts returning to one of his NYC bar haunts to socialize (and drink non-alcoholic beverages), and being shocked at how repetitive and boring his old drinking companions were. He says that a long-time sober regular there advised him that "You won't have as much fun, but the fun you have will be REAL fun".
posted by thelonius at 4:15 PM on April 16, 2015 [2 favorites]

I heard a pithy thing at a meeting once: the steps don't make you feel better; they make you better able to feel. I was miserable and crazy my first year and a half (I also slept ALL THE TIME); at a little more than three years I'm rarely miserable, often feel crazy, and pretty much every day I'm blown away by the fact that I get to be alive. So the answer to 1 is (in my experience) yes, early sobriety sucks, sometimes for a long time, but what's on the other side is totally worth it.

As to 2, sounds like you already know. Be there. Take care of yourself.
posted by generalist at 4:46 PM on April 16, 2015

I quit drinking without AA, so can't speak to the sponsor issue, but yes it gets better. Much, much better. I drank for more than three decades and it took me a couple of years of wrestling to finally stop, but now at 1.5 years away not only do I not miss alcohol, my life is approximately a zillion times better without it, and I'm grateful every single day that I did manage to get free. I'm happier, just baseline happier, like a heretofore unknown happiness dial inside my soul got turned up a couple of notches; I'm much less shy, I sleep much much better, I've lost 25 pounds without trying, and some things have happened for me professionally that I've always dreamed of but never dared believe in. So, yes. The first months were by far the hardest, but they were worth it a million times over. In terms of resources, I have found the folks over at a site called "We Quit Drinking" very insightful and would suggest that your SO take a look over there, if they are so inclined. I have also found it helpful to read up on alcohol and what it does to the body, which helped me understand PAWS and my cravings (which went away after approximately 3.5 months). "Under the Influence" is a good book, as is "Beyond the Influence," and I loved "The Promise of Hope," even though I'm not a God person at all. As for relapse, I know that for me, deciding that I would never, ever drink again, no matter what, was the moment I set myself free. But there are a million ways to quit, and I wish your SO - and you - the very very best on this journey.
posted by hazleweather at 4:51 PM on April 16, 2015 [5 favorites]

Recovering alcoholic here. Nthing Post Acute Recovery syndrome. I didn't have any clue about why I felt so bad/memory was worse/no concentration etc until I learned about it. It took me most of a year to get mostly over it - no real cravings for alcohol during this though. I had had enough.
AA says take what you need and leave the rest. Good advice. The meeting I attended had atheists, agnostics, buddhists etc. It is often said that someone that doesn't believe in a "God" is asked to just figure out that, hypothetically, if there was such an entity, what would it be? There, presto, your own definition of God.
Another commonly told story is about a newby being told they needed a higher power, and picking the cross-town bus. The bus could go right by all the bars no problem, the person could not.
In my own search, I've come to a place where God is that still small voice within... maybe the same voice that told me a long time ago that I was an an alcoholic and I could get better.
posted by rudd135 at 6:42 PM on April 16, 2015 [1 favorite]

Sorry to hear this. It's a rough time. It will get better.

And the partner of the addict should know that "several months" is far from "recovered". Much like tendon damage, addiction recovery takes longer than you imagine a long time to be. But that doesn't mean healing isn't happening.
posted by IAmBroom at 6:19 AM on April 17, 2015

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