PAWS

Again. At least I think so. Or hope so ? Because if it’s not …. .

I’d never really heard of PAWS before I became a non drinker; when after the initial difficulties and emotional roller coaster of withdrawal, I didn’t exactly enter the happy calm space I was anticipating … No, I found myself still subject to mood swings, unexpected bouts of depression, sudden onset of anxiety symptoms, insomnia, and emotional uncertainty …

Then kind members of the sober community enlightened me, and I started reading about PAWS.

After acute withdrawal, the next stage of sobriety includes symptoms known as the Post Acute Withdrawal Syndrome (PAWS). This stage has fewer physical symptoms, the manifestations are more emotional and psychological.

As I understand it,  Post-acute withdrawal occurs because your brain chemistry is gradually returning to normal. As your brain recovers from being regularly poisoned,  the levels of your brain chemicals fluctuate as they approach the new normal equilibrium, and this fluctuation causes PAWS.

Over the past decades, much has come to be known about the long-term effects of drugs of addiction, especially on the neurobiology of the brain. Most substances of addiction, like alcohol, benzodiazepines, opiates, and stimulants lead to lasting changes in the brains handling of learning, motivation, and pleasure. Primarily, these drugs hijack the brain’s “reward” circuits, a critical part of which is dopamine. In the case of alcohol (and drug) abuse and dopamine, the brain not only becomes tolerant, but it also gets used to, and “expects” an excess of dopamine, meaning the newly sober user  experiences a simultaneous lack of dopamine (which is unpleasant) AND increased brain craving for the trigger that provides dopamine. In other words, not only does an addict feel bad without the drug, his focus turns solely to it to make him feel good again. Great ! Cravings explained in one easy sentence ….

There are several other key neurotransmitters involved, as well as dopamine, including serotonin ( mentioned here https://wordpress.com/post/alcoholfree2016.com/2097 )

While different drugs of abuse seem to lead to different sub-sets of PAWS symptoms, PAWS that occur from alcohol and benzodiazepines are generally more similar because they’re pharmacologically more similar in mode of action – key things are irritability, anxiety, and sleep difficulties. I have read that how long people experience these paws symptoms is typically a reflection of how long they were using  the drugs as opposed to how much.  great . So my 30 odd years of alcohol excess is definitely going to come back and haunt me here ….

The most common post-acute withdrawal symptoms are:

Mood swings  (triple tick)
Anxiety. tick
Irritability. Tick
Tiredness. Double tick
Variable energy, double tick
Low enthusiasm. Triple tick
Variable concentration double tick
Disturbed sleep tick

Im utterly fed up right now. I’m stressed , fighting with Mr Lily over problems that are insoluble, anxious about the responsibility I’m taking on in our upcoming holiday, worried about no 1 son – and totally alone with no support in this one, I feel fat, sluggish, lazy and unmotivated. So unmotivated I even missed my favourite yoga class this evening.
This feels like a total rollercoaster of symptoms. At the beginning; the first two weeks were really tough – my symptoms would change minute to minute and hour to hour. Then I had a period of pink cloud – when I felt AWESOME …. I enjoyed that 🙂 But in the last 3 months of so, I don’t feel I’ve made any significant progress . I get these awful low moods, then they will disappear for a few days / a week , only to return again. I hoped that  the good stretches would get longer and longer, I’m not sure that’s happening and the bad periods of post-acute withdrawal are just as intense and last just as long.

Thank goodness I’m not craving alcohol right now, as I’m feeling so very vulnerable ….


23 comments

  1. Lily I could have written those words myself – you have expressed exactly how I am feeling. I don’t know how to make it better but I hope you will take some comfort from knowing you are not alone. Tori xx

    Liked by 2 people

  2. I’ve never been to 3 months. So I’m responding based on what I’ve read on other blogs. But I think somewhere around 3-6 months this is pretty common to feel that way.

    I know that likely doesn’t help. I just wanted to say it’s normal to go thru highs and lows. And I do hope you get thru it ok.

    Hugs.

    P.s. I love your writing and the things you discuss. 😉

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  3. Lily, i feel for you I really do. PAWS can cause a lot of our moods and usually passes after a few days. (Only to return at a later day unfortunately) I’m at month 4. Im not worried that im going to drink. I dont get bad cravings like the earlier months but for me now, its like learning to live my life all over again. Moods, emotions, social events, my whole life!
    I do hope you feel more positive soon. I too have heard its common to feel like this months 3 -6ish xxx

    Liked by 2 people

  4. The anxiety is at a peak right now and the desire to drink it away is strong. PAWS is very real. So many withdrawing from benzos and ssri drugs say the same.

    Liked by 1 person

  5. Hello Lily, stay strong, it will pass.
    I have just written you an email, too lengthy to put in comments, however it has been returned. Could you give me your email address, please, and I’ll send it to you? Otherwise I can add it here, it’s just it addresses some of your previous blog entries as well.
    Thanks
    Trish xx

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  6. At 4 months, I am starting to feel the energy, focus, and highs that I have been missing for ages. I thought that at about 2-3 months, I was feeling as good as it was going to get, which was not that good. It gets way better though. I am awake today at 5:00 am with energy, and am going to an 8:00 exercise class. This is totally laughable to my drinking self — the idea that I would voluntarily get up and exercise was not possible. So it does get way better, but for me, it took month 4 to make a sudden leap. Hang in there!!!

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  7. I’ve been reading your wonderful blog for some time now – you have a real gift for identifying and putting into words so many of the ups and downs of getting sober.

    I am 58, a retired health visitor, with husband and two adult children. I finally, finally, stopped drinking for the last time in May 2014. I don’t think much about alcohol at all now, but read a few blogs each day as a kind of “insurance policy”, to remind myself not to get too complacent.

    I remember very well, at about 6 months sober, going through a few weeks of raging PAWS symptoms, high anxiety, extreme irritability, completely, totally overwhelmed by life. I just wanted to curl up in bed and not come out again until I felt I could cope. I am very fortunate in no longer having employment thrown into the mix, however it was an extremely challenging time, dealing with elderly parent’s dementia-related problems and demands, and exacerbation of daughter’s mental health problems. At the time, I got through it by lowering my own expectations of what I should be doing, doing only the essentials, saying no to requests from others, and trying to unwind with a good book when possible. As you know, it will pass, it is a symptom of your improving health, so be as kind to yourself as possible.

    Just to go back to a couple of your other posts – what to tell others? I told everyone, good friends as well, that I stopped for a while and now I prefer not drinking. In the beginning I felt more of a need to explain further, but now that’s usually all I say. If necessary, I’ll say that I’m forgetful enough at the best of times and wine makes it even worse, that I sleep better without it, that I don’t like the way it makes me feel, that “fuzziness”.

    Your holiday concerns – it will be harder in some ways, easier in others. I found it useful to observe the effects alcohol had on others,the flush of their faces, the inability to see when they were dominating a conversation, the justifications for having another, and I knew that I didn’t want that any more, I would reach that point and way, way, beyond it far quicker than anyone else. Without alcohol, you can be your own self – less sloppy and emotional, but open and more responsive to what others. I actually have a lot more fun now, I am more witty, quicker to see the funny side of things, and, what really surprised me, ready to do daft things and much less self-conscious about making a fool of myself.

    You are dealing with a lot right now, I expect that once you are away and removed from all the other daily concerns that you will able to relax and enjoy yourself. You are well prepared, sober plans and tools in place, and going to be with people you love and trust, whose company you enjoy.

    Have a great time!

    Trish xx

    On Wednesday, 3 August 2016, alcoholfree2016 <comment-reply@wordpress.com > wrote:

    > Lily 🌷 posted: “Again. At least I think so. Or hope so ? Because if it’s > not …. . I’d never really heard of PAWS before I became a non drinker; > when after the initial difficulties and emotional roller coaster of > withdrawal, I didn’t exactly enter the happy calm space ” >

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  8. Oh dear, I replied to your email,(I am already following) and now all too much personal info has appeared on your blog!! Can you please remove it, – I’m not quite ready to share so much publicly.

    Thanks, Trish

    Liked by 1 person

      • Thanks, Lily – I.T. was never my strong point! I’m posting my comments below, minus some personal info, in case others may find it useful.

        I remember very well, at about 6 months sober, going through a few weeks of raging PAWS symptoms, high anxiety, extreme irritability, completely, totally overwhelmed by life. I just wanted to curl up in bed and not come out again until I felt I could cope. At the time, I got through it by lowering my own expectations of what I should be doing, doing only the essentials, saying no to requests from others, and trying to unwind with a good book when possible.
        As you know, it will pass, it is a symptom of your improving health, so be as kind to yourself as possible.

        Just to go back to a couple of your other posts – what to tell others? I told everyone, good friends as well, that I stopped for a while and now I prefer not drinking. In the beginning I felt more of a need to explain further, but now that’s usually all I say. If necessary, I’ll say that I’m forgetful enough at the best of times and wine makes it even worse, that I sleep better without it, that I don’t like the way it makes me feel, that “fuzziness”.

        Your holiday concerns – it will be harder in some ways, easier in others. I found it useful to observe the effects alcohol had on others,the flush of their faces, their inability to see when they were dominating a conversation, the justifications for having another, and I knew that I didn’t want that any more, I would reach that point and way, way, beyond it far quicker than anyone else.
        Without alcohol, you can be your own self – less sloppy and emotional, but open and more responsive to others. I actually have a lot more fun now, I am more witty, quicker to see the funny side of things, and, what really surprised me, ready to do daft things and much less self-conscious about making a fool of myself.

        Xx

        Liked by 2 people

      • Thank you Trish. I’m wondering how I can reply to your linger post as I don’t have an email for you? It does help, so much, to know that others have felt like this and survived ! Its good to hear all your positive points about staying sober. Gives me hope! Lily x

        Liked by 1 person

  9. Lily – I am at 4 months too and find I feel the same. I have more good days than bad but my eating habits are worse than ever. I have been wrestling with dieting but it just seems to soon, too much pressure. I do find if I keep busy my eating is much, much better but I feel insecure and unmotivated a lot of the time. I do what I have to do but not much else. I hope my motivation, energy and confidence come back soon. I appreciate your post because it reminds me that PAWS is a factor and I am not just lazy! It is nice to be in this with others and learn from those who have been through this.

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    • I think feeling ‘lazy’ is really common. I have virtually given up cooking (kids on holiday can fend for themselves- which is rubbish really) and I feels extremely apathetic. Even things I WANT to do seem like too much trouble … I glad I’m not alone – but sorry you have this too…Lily x

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