Why do people relapse?

Does merely returning to an older addictive habit is called relapse? Or is it a misconception?

People with addiction- be it chemical and behavioural addiction, keep struggling to deal with relapse. The other struggle is their constant warry of “why did I relapse?”, also something which people most commonly search on google to just understand about their relapse and what might have possibly caused it.

 In the process of recovery from addiction, relapse is a part of it. Certainly, the process of recovery is not an easy one. It brings about a host of challenges than just being away from the object of addiction.

The recovery process is most often accompanied by mental health challenges. Symptoms of depression, anxiety like disorders, emotional dysregulation, anger spells are considered to be most common.

Although people possibly have a misconception of the term relapse. Usually, in my experience of dealing with clients with addiction, they often come and report with remorse that they have relapsed.

When I prob to understand further about their situation, they explain that after a said period of abstinence and staying clean and tend to resort or indulge. Upon further probing about the frequency of use after the gap of abstinence, they say once or maybe twice!

But the question is, does it call Relapse?

What is relapse?

The recovery process being complicated lapse and relapse are most likely to occur. However, lapse or relapse does not refer to weakness or failure. These are ways to cope with the difficulties occurring due to the sudden deprivation the body is experiencing.

To understand relapse better, it is important to know what lapse is?

Lapse refers to a very short-term return to the addictive behaviour – possible in both chemical and behaviour addiction- causing a temporary setback or holding off of the recovery process.

This means that, all those people who happened to feel overwhelmed and feels pathetic and low about the short -term indulgence of the addictive behaviour doesn’t always mean “I have relapsed.”

It is important to understand and accept that the recovery path- way isn’t a straight line, obstacles are bound to occur. Lapse and relapse are not end of the journey, they can be resolved with persistent and determined efforts.

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Difference between Relapse and Lapse

Relapse, by definition means returning back to the point of consuming the addictive behaviour, before starting with the intervention or abstinence. i.e., going back to where it all started.

On the other hand, lapse is just one-off instance of returning to the addictive habit.

Relapse has been more concerning than lapse in the recovery process, for obvious reasons. In relapse the person in recovery will return to the addiction like before or even some cases worse.

What causes Relapse

To prevent oneself from relapse, it is important for people to understand what causes the relapse. When the person understands what probable events trigger the relapse, the first step towards the relapse management has been initiated.

Relapse

Following are some major reasons-

#1. Withdrawal Many individuals relapse within the first few days of abstinence, just in order to avoid the withdrawal symptoms. As the individual initiates to stay abstinent from the long-standing addiction- both in case of substance and behaviour, it becomes very difficult to maintain the homeostasis without the addictive object.

The addictive person indulges into the addictive behaviour to maintain the body equilibrium, and now without that addictive object there is increased craving, and restlessness to consume or resort to the addictive behaviour. These feelings of craving are very difficult and intense, and in order to avoid the withdrawal symptoms people return to their addictive behaviour. That’s how withdrawal can trigger relapse.

Mental Health – Addiction in itself is a mental health condition, and in addition to it there are multiple mental health underpinnings. Addiction – be it substance or behavioural, are related with number of psychiatric comorbidities.

Often, Anxiety Spectrum conditions, Depression and other mood related conditions and Personality Disorders are common comorbidities with addiction. A lot of times, the addiction is just a behavioural response to something that has a deeper root cause.

Therefore, rehabilitation of addiction requires adequate concern to the underlying mental health condition, which mostly goes un-noticed. Hence, relapse management would only be adequate when it is focused on the mental well-being of the addicted individual.

#2 Peer influence It is important to take care of the peer influence if someone is in the recovery process. Care should be taken to stay away from people who are into addiction or even who are into a habitual use of the object of addiction.

If surrounded with similar minded people, who have also been engaging into the addictive behaviour, will work like a major trigger. In an ideal recovery process, it is extremely important to maintain a healthy boundary with people, friends and relatives.

A lot of times a mere discussion and a leisure talk about it can cause the urge and might end up relapsing. Hence maintaining healthy social support during recovery is essential

#3 Places Some places often get associated with our addictive behaviour. For substance addiction, places like bar, casino, friends’ house become a strong place of association, whereas, for behaviour addiction, bedroom, bed, lone space, become an easy trigger.

While in the recovery process, it is necessary to identify the trigger places and adequately modify them. For example, choosing to shift to another room, or changing furniture orientation of the existing room, avoiding casino, planned outings which are not likely to trigger any urge and at the same time works as a socially healthy distraction.

#4 Poor self- care- Self- care is one of the most important components in the recovery process from addiction – of any sort. The focus of the individual is on the self in terms of well- being, managing time well, self- pampering, doing things the person is passionate about. The deal is, self-care instils positive emotions, which works as a protective factor in relapse management.

On the other hand, poor self- care- unhealthy eating habits and patterns, poor sleep cycle, maladaptive habits all lead to feeling guilt and generating a low mood and negative emotions. Low mood and negative emotions lead to craving. A lot of times, people believe that addictive behaviour will make them feel better.

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#5 Aloofness and Boredom– Aloofness and boredom are the trickiest things to deal with during addiction and recovery. A person with addiction mostly reports that they feel the urge when they are alone.

Addiction has always been found to be a maladaptive mechanism to deal with negative emotions. Hence a lot of people by the loop of habit indulge in addiction when alone. In the process of addiction, people tend to become secluded and stay aloof, and on the other hand, staying aloof triggers the urge to indulge in addiction.   

Aloofness and Boredom - relapse

The other issue is boredom. Most individuals report that they mostly feel the urge to indulge in addiction when they are bored. Inadequate planning for the day and improper time management often leaves them without doing any productive task. It is such moment when people resort to addictive behaviour.

Thus, one major step towards relapse management is to engage in meaningful activities and follow a routine to stay active and productive.

 It is important to take note of these major causes of relapse, which are not the only causes though, but major enough to be reported by most people. Having an understanding of these probable reasons, people in the recovery journey would initiate their first level of awareness of what things they have to be cautious about.

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