Working as an addiction counselor, I’ve come to recognize some common early warning signs of a relapse. A large part of recovery is maintaining momentum toward healthy positive habits while effectively coping with difficult thoughts or painful emotions. Since relapses begin long before they happen, it is important to be able to spot the signs in one’s thoughts, emotions, and actions.
Catching a relapse early allows one to pivot back toward recovery before getting caught up in the downward spiral. Since relapse prevention is such an important area of recovery, I decided to compile a list of common early warning signs.
I created this list by collecting responses from 75 individuals in recovery and professionals in the addiction field. I then clustered the responses into a list of 12 themes. I wanted to capture a wide variety of experiences since everyone’s recovery looks different, and not everyone will share the same warning signs.
Here is the list of early warning signs of a relapse:
- Isolating oneself
- Becoming irritable and reactive
- Becoming dishonest and deceptive
- Worrying about other people
- Overconfidence in one’s recovery
- Shifting back into unhelpful networks
- Feeling increasingly apathetic
- Increasing boredom and entertainment seeking
- Falling out of healthy habits
- Increasing suicidal thoughts
- Getting stuck in your head
- Avoiding positive and negative feelings
According to a 2015 study on relapse prevention, these are common symptoms associated with post-acute withdrawal syndrome (PAWS), which may last up to two years.
Unlike acute withdrawal, which I wrote about here, PAWS consists of the longer-term emotional and psychological effects of discontinuing an addictive substance or behavior. A person may initially have no symptoms for weeks, falling into post-acute withdrawal unexpectedly, causing a high relapse risk.
I compiled this list of warning signs as a comprehensive yet brief resource one can quickly scan as a reminder of common red flags to watch out for. Catching yourself when you fall into the “stinking thinking” will hopefully allow you to reduce the risk of relapse.
Let’s take a closer look at the meaning of each early warning sign on the list.
Isolation is one of the most commonly cited relapse risk factors. Isolation can cause addiction, and addiction leads to further isolation.
As Stephanie described in my article on what addiction feels like:
The loneliness made me have time to think and the more time I had to think the more I wanted to use because all my thoughts were about using or the horrible person I had become while using.
In recovery, isolation further instills the sense of being separate and disconnected from others. Human beings are social creatures, and isolation cuts us off from this basic need. Increasingly isolating oneself heightens the risk of relapse and can be an early warning sign.
Becoming Irritable, Reactive, and Resentful
Becoming increasingly irritable is another commonly cited warning sign of a potential relapse. Irritability generally consists of being highly reactive to situations. Instead of being able to take a step back when a problem arises, reacting consists of impulsively lashing out based on the emotion.
This reactivity carries over to one’s relationships were resentment builds leading to interpersonal conflict. Every small thing becomes perceived as a personal attack, and one begins to take on a defensive posture in one’s relationships.
As irritability, reactivity, and resentment build, one’s mind becomes rigid, and one’s sense of separateness from others is further instilled. As one progresses down this path, the risk of turning to addictive substances or behaviors increases.
Shifting Back Into Unhelpful Networks
One of the most frequently cited pieces of recovery advice is the need to change one’s network. Staying around the same unhelpful people leads to the same unhelpful behaviors. You are the product of the people you spend most of your time with.
As Stephanie shared in my article, “A Powerful Story of Addiction and Recovery“:
I dropped a lot of friends that still used. My best friend used cocaine, and I had to distance from her, too. No one ever wants to be alone, but the first bit of recovery is just that. It’s about tearing down the social network and rebuilding it with people that aren’t involved in that life.
A huge warning sign for a potential relapse is the withdrawal from social support, meetings, and reverting back to spending time with old friends who reinforce old behaviors.
Becoming Dishonest and Deceptive
Dishonesty and deception are some of the most common features of addiction. When in recovery, one is encouraged to begin telling the truth and speaking with candor.
While experiencing an addiction, persons develop habitual patterns of dishonesty, often being able to hide their addictions from those closest to them. This dishonesty becomes a normal way of life.
Beyond lying to others and lying to oneself, deception, and conning to get what one wants further separates an individual from others as they interact through persona masks.
Falling back into these deceptive patterns of behavior can be a red flag for a potential relapse.
Getting Stuck in Your Head
When living in one’s head, attention is taken away from the present moment. Anxiety about the past and future take over, and panic attacks may overcome one’s mind with thoughts of “what if?” making catastrophic scenarios seem imminent and real.
Anxiety can be a normal part of one’s life and is not a warning sign of relapse on its own. The way one responds to anxiety is the warning sign. For more on how to respond through helpful coping strategies, see my article on How to Stop Living in Your Head.
It is unhelpful when responding to anxiety with further overthinking, catastrophizing, and fusion with thoughts that take one away from the present moment. An early warning sign of relapse is stopping effective coping skills.
A regular meditation practice may be one of these effective skills. For more on this topic, see my article on The Benefits of Meditation for Addiction.
Worrying About Other People
It is important to distinguish a healthy concern for others and an unhealthy need to focus on other people. An unhealthy focus on others is based on an attempt to build one’s own sense of self by pointing out the faults in others. This can also result in blaming others for your own shortcomings and frequently thinking about how you have been wronged.
Another way this unhealthy focus on others can manifest is an attempt to save another person. Rather than focusing on one’s own recovery, constantly diverting one’s attention to another person allows an individual to not have to look at their own flaws. This attempt to fix or control another person comes from a place of low self-esteem.
This warning sign is tricky because helping behaviors outwardly appear generous and selfless. This kind of helping behavior, on the other hand, is based on a strong ego attachment and needing external validation to feel satisfied.
When in recovery, it is essential to consider whether or not your helping behaviors come from a healthy place. The twelfth step’s call to help others is a healthy version of helping. Paying attention to the way one is helping is important so that the addiction does not merely become transferred to this behavior. See my article “Can You Be Addicted to a Person?” for more on this topic.
Overconfidence in One’s Recovery
This is another deceptive warning sign since a high level of confidence does not seem like a risk factor. When someone says, “I got this” with passion and vigor, our natural inclination is to believe them.
In early recovery, overconfidence in one’s ability to control an addictive substance or behavior may serve as a rationalization for not having to engage in certain recovery activities. A healthy level of fear is actually helpful since it decreases the chance of testing oneself, leading to further rationalizations such as, “I deserve one drink.”
In later recovery, this overconfidence can also lead to relapse through rationalizations like, “why can’t I just be like normal people?” and the decision to try reverting to social drinking, when this has never worked in the past.
Overconfidence can also lead to the decision to stop healthy recovery behaviors and focusing on other areas of life, such as one’s career, instead. This diverted attention away from recovery, combined with the lack of a healthy fear of the substance, can increase the risk of relapse.
Falling Out of Healthy Habits
In early recovery, one begins incorporating several healthy habits. Each healthy habit is like a protective barrier, reducing one’s risk of relapse. This is why treatment programs include routines like meditation, exercise, journaling, peer-support meetings, and regular sleep.
Each of these habitual behaviors facilitates an upward spiral of recovery, building momentum over time. Overconfidence in one’s recovery or a temporary state of apathy can derail healthy habits, increasing the risk of relapse.
Early warning signs include putting off meetings, stopping prayers or meditation, a decrease in exercise, poor sleep patterns, and a general lack of structure in one’s life.
Feeling Increasingly Apathetic
Throughout recovery, there may be moments when one loses a sense of one’s values. If things are not going the way one expects and frustration takes over, it can be tempting to fall into the “screw it” mindset where nothing seems to matter.
Ironically, when nothing seems to matter, everything seems to matter. Every little road bump feels like a mountain. Apathy is a state of reactive meaninglessness, killing motivation to continue healthy recovery behaviors.
Having a sense of direction promotes mental resilience when facing difficult situations by allowing a person to reorient oneself toward one’s values. Having a mental relapse consisting of a state of apathy is an early warning sign, requiring one to pivot back toward one’s values.
For more on this topic and an exercise on how to clarify one’s values, see my article on The Importance of Having Direction in Life.
Increasing Boredom and Entertainment Seeking
Along with apathy comes boredom. When there’s no broader sense of purpose, entertainment seeking becomes central in one’s life.
In another article, I argue a sense of purpose is one of the most neglected aspects of recovery. Addiction is a problem characterized by an existential void. In recovery, if one does not have a guiding principle of underlying values or a sense of purpose, it is easy to slip into thoughts like “Why get up? Why leave the house? Why do anything?”
Like Victor Frankl said: “suffering without meaning is despair.” Chronic entertainment seeking becomes a way to escape the pain of despair, similar to the way addictive substances or behaviors function in active addiction.
Finding oneself in this state of complacency may be an early warning sign that entertainment is acting as a replacement for the addiction, increasing the risk of relapse.
Increasing Suicidal Thoughts
Suicidal thoughts are rooted in the painful despair of meaningless suffering, where one is plagued by thoughts of others being better without them. This state of hopelessness is all-consuming but temporary in the long-run.
A significant warning sign of relapse is this fusion with thoughts that others are better off without you, combined with a sense of profound disconnection from others. Using substances can be compared to a temporary version of suicide.
Both suicide and substances are a way to escape the intense pain of disconnection, burdensomeness, and hopelessness. Catching these types of thoughts and using effective coping strategies is crucial in preventing a relapse.
Avoiding Positive and Negative Feelings
As previously stated, an addictive substance or behavior, like suicide, is a way to escape the intense pain of despair. Recovery requires confronting difficult thoughts and painful emotions rather than reinforcing their power through avoidance. Avoiding these thoughts and emotions prevent further recovery since avoiding negativity also means avoiding positivity. As Brené Brown states:
“We cannot selectively numb emotions, when we numb the painful emotions, we also numb the positive emotions.”
Avoidance can result in self-sabotaging behaviors, preventing one from experiencing joy and progress in recovery. Examples of this might include withdrawing from a romantic relationship when things are going well or ruining one’s chance at a promotion when things are going well at work.
Finding oneself engaging in self-sabotaging behaviors to avoid positive situations might be a sign of unresolved underlying issues. Avoiding both positive and negative emotions may be an early warning sign of a potential relapse.
Each of these early warning signs are things to look out for while in recovery. By recognizing the signs, one can pivot back toward recovery, preventing a potential relapse.
In a study on relapse prevention, the author provides five simple rules to consider: 1) change your life; 2) be completely honest; 3) ask for help; 4) practice self-care; and 5) don’t bend the rules.
Another helpful tip to consider is HALT:
- H – Hungry
- A – Angry
- L – Lonely
- T – Tired
If you are beginning to feel irritable and reactive, see if you can address any of these foundational areas.
Recovery looks different for each individual and some of these early warning signs of relapse might not be relevant. It is important to consider your own unique warning signs, creating a plan for how you will respond when you notice them.
Building a relapse prevention plan based on your own red flags can be assisted by the support of a peer in recovery, such as a sponsor. It may also be helpful to consider seeking the support of a professional in the field, such as an addiction counselor or a psychologist.
Hopefully, this list of relapse warning signs is a helpful resource you can use to build your own list of signs to look out for in your own thoughts, emotions, and actions.
Feel free to add a comment down below if you have any further suggestions that don’t appear on this list.