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12 Things You May Not Realize Are Post Acute Withdrawal Symptoms (PAWS)

Post Acute Withdrawal Syndrome (PAWS) is also called Protracted Withdrawal Syndrome, the term protracted meaning “lasting for a long time or longer than expected or usual.” This is a more accurate way to describe PAWS because many people, myself included, are misled by the more common name (post-acute). That’s to say, PAWS can last for two or more years after you stop using.

Most people seem to know about the symptoms that happen right away: shakes, sweats, insomnia, cravings, anxiety. But, I’m willing to bet that a lot of you, like me, didn’t know that PAWS can include longer-lasting symptoms that affect us in less obvious ways. Here are 12 things you may not realize are post acute withdrawal symptoms (PAWS).

#1. Impaired interpersonal skills

This means that you might experience difficulties with developing and using the types of social skills that help with interacting and communicating with others.

#2. Difficulty experiencing pleasure

This is a good one to be aware of. Many people in recovery might start feeling discouraged because they can’t enjoy the “normal” things in life without the use of drugs to somehow enhance everything. Knowing that ‘this, too, shall pass’ should help. Things might seem a little flat and boring but that will change as your brain heals – over time.

#3. Depression

You might experience feelings of depression as well as pessimistic thoughts as a result of your active addiction. It might be challenging to stay positive when you are being bombarded with negative thoughts. Remember that there are things you can do to overcome this, such as talking to your sponsor, working the steps, meditating, eating right, and exercising – to name just a few. Some people benefit from taking an antidepressant, which if taken as prescribed, does not compromise your sobriety.

#4. Memory problems

This has been a big one for me. I’ve been getting a lot of feedback from friends and acquaintances, such as being told I’m re-telling the same story for like the fourth time or, upon “meeting” someone and introducing myself, they tell me we’ve met before – on three different occasions. This can be really embarrassing but, I laugh it off because I know it’s just going to take some time.

#5. Sleep disturbance

By now, you’ve probably experienced ‘using dreams’ or drug dreams but, did you know that this is actually a symptom of PAWS? There are a whole slew of reasons that we experience using dreams and they all stem from physiological, neurological, or psychological changes in the brain that are now healing.

#6. Difficulty with motivation

There will be times when you’re feeling lethargic, lazy, and unmotivated and this could be a result of PAWS rearing its ugly head again.

#7. Inability to think clearly

A big part of PAWS that probably lasts the longest is the cognitive impairments you’ll notice. These are aspects that relate to mental function such as difficulty with concentration and thinking clearly. So, just be patient and gentle with yourself when this happens. Getting frustrated will only add to your stress and will make matters worse.

#8. Feelings of guilt

It’s natural to experience feeling guilt and shame about our addiction and the things we did to support our habit. We might have stolen from other people, committed other crimes, and probably hurt our loved ones. But feelings of guilt might last after you’ve made amends and might even seem amplified – as a result of PAWS. Again, it’s important to be aware of what’s going on and that this is something that will improve over time.

#9. Physical coordination problems

You might have noticed that, at times, you’re a lot more awkward or clumsy than other times. Yes, even physical incoordination can be affected by PAWS.

#10. Stress sensitivity

There will be times that you feel extra stressed out and you might not even know why – nothing has changed and you’re under the same amount of stress with work, family, etc. as usual. This, again, is a symptom of PAWS that can come and go as it pleases. There will be times that you feel easily stressed out. Just remember that it’s part of the healing process and then be sure to exercise, eat right, and get plenty of sleep.

#11. Increased sensitivity to pain

This was another one that surprised me. There are times that people in recovery with PAWS will be more sensitive to physical pain than others. This is extremely important to remember since many of us will be tempted to use this as an excuse to use.

#12. Panic disorder/Generalized anxiety disorder

Even if you didn’t experience anxiety before, it’s possible – as a result of PAWS – that you might feel anxious at times, even without a reason, it seems.

Again, it’s said that symptoms of PAWS can last anywhere from two years after you get clean to several years and even a lifetime. This isn’t to say that it will always be this challenging or frustrating. There are things you can do to lessen your symptoms and improve your quality of life – things such as brain teasers, reading, meditation, praying, yoga, exercise, nutrition, etc. It’s best to be well-informed about this condition so that you can recognize it for what it is and then choose a healthy way to cope.

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