Residential treatment for depression, anxiety, post-traumatic stress and substance use disorders, among other issues is generally a transformative experience. Circumstances and situations that were previously overwhelming suddenly become manageable. Hope for the future returns. Life begins again.
Then reality hits. Family members haven’t changed, responsibilities remain and daily stressors have been lying in wait. Finding time to sleep, exercise and eat right may seem difficult, let alone budgeting time for recovery activities like meetings, step work and meditation. Fortunately for the millions of people who keep their self-care activities as first priority, in spite of distractions, sober reality becomes a lasting gift.
Yet questions remain regarding how much stress is too much and what circumstances result in relapse. Many studies have elucidated the adverse effects of stress on the brain and nervous system and its effect on behavior. As the incidence of mental illness and substance use disorders continues to soar in the United States, scientists are trying to find new ways to mitigate the effects of stress on behavior, particularly for those recovering from mental illness or addictions.
The link between stress and addiction
Lieutenant Jessica N. Cleck and Julie A. Blendy, Ph.D., at the University of Pennsylvania School of Medicine, Department of Pharmacology, thoroughly reviewed studies in 2008 on the effects of psychological stress on those with addictions to various psychoactive substances. The overwhelming finding was that those with current or past addictions were neurologically more susceptible to the effects of stress than those who were never addicted. The authors concluded that “treating the stress-related aspects of drug addiction is likely to be an important contributing factor to a long-lasting recovery from this disorder.” Blendy’s lab is currently examining this further, as breakthroughs in genetic research appear to show that the brain can, in fact, potentially make a full recovery from addiction.
Lifestyle habits and stress
High-stress situations are part of life, and preparing for them is the key. When stress levels are low, stress is easier to manage. When stress levels are already high, additional stress can be dangerous, especially for those in early recovery. Adequate sleep, exercise and nutrition are essential for physical and mental health. These essential habits regulate brain function. Thus, maintaining seemingly unrelated lifestyle habits prevents relapse into mental illness and substance use. Adding a strong support network, such as those with close ties to a recovery group, almost ensures success.
Most treatment centers teach clients about “recovery capital” and “relapse prevention” plans and strategies. Recovery capital generally refers to primary daily activities that promote health and mitigate stress. Relapse prevention plans generally refer to secondary measures that prevent relapse during times of high stress. Some examples of these primary and secondary strategies are reviewed below.
Many people who relapse describe feeling blindsided by it initially, but in retrospect report that they drifted away from their recovery program and routine prior. When the primary plan disintegrates, the secondary can rarely be effective. One easy idea to remember in such situations is the word HALT, which serves as a reminder to stop when hungry, angry, lonely or tired.
When high stress is expected, bringing a recovery buddy to the situation can be very helpful. Otherwise, other tools can be used to get through high-stress situations, such as a relapse prevention plan. If high stress and cravings do occur, they usually do not last very long. However, if the body is again exposed to a substance on which it had already been dependent, volitional control becomes difficult to re-establish without help.
Relapse prevention strategies
There is a way to continue on the path of success following treatment. Not everything taught in treatment will work for everyone, except for healthy lifestyle habits and supportive others. Establishing the simple elements of a healthy life immediately after treatment is essential and the rest will fall into place. Remember who you are, what you’ve learned and that your new life in recovery has only just begun.
Sovereign Health of Arizona provides help for women recovering from trauma and abuse, substance addiction and mental health disorders. Our individualized care provides each woman with support in her recovery using a multidisciplinary team of professionals and different approaches to treatment. Each program includes a continuing-care plan that utilizes each woman’s own social support network to maintain her recovery post-graduation. For more information, please call our 24/7 helpline.
Written by Dana Connolly, Ph.D., Sovereign Health Group medical writer
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