Transitioning back to life after rehab can be difficult. For a long time, your life was oriented around substances – but now this option is off the table, and your primary coping mechanism is unavailable. This profoundly impacts your new life – the places you go to, your social circle, and the ways you spend your time. Adjusting to this new way of living is full of challenges – and this means many people can struggle when leaving addiction rehab.
We’re going to take a look at the challenges you will face after rehab and what you can do to cope with the challenges of building a new life free of addiction.
Unrealistic expectations
Rehab is the first step on a journey to freedom from addiction, but this journey is long, and rehab is not a cure for all of your problems.
Some people may have unrealistic expectations of life after rehab, seeing it as a cure, the key to happiness, and an end to all cravings. When these expectations are not borne out by reality, they can become despondent. Sobriety helps you to stop creating unnecessary problems in your life – but the issues you were running away from during addiction will not disappear.
You might feel elated in early recovery and go through a honeymoon phase, but there may also be times when you feel awful. Early recovery has highs and lows, and it’s important to know that this is only the beginning of the process—a marathon, not a sprint. These highs and lows will even out, but it will take time.
Managing your expectations gives you the greatest chance of recovery. Recovery is gradual – and that’s okay.
Post-acute withdrawal syndrome
Post-acute withdrawal syndrome, or PAWS, is a cluster of symptoms that happen after the acute withdrawal stage. Withdrawal can last for 1-8 weeks, but PAWS can affect you for much longer. There aren’t any firm timelines for how long PAWS can last, and it can depend on the substance you were addicted to, how long you were addicted and how much you were using. Studies suggest it can take 6 months to 2 years for PAWS to resolve itself.
PAWS happens because neurotransmitters in your brain are recalibrating after sustained substance dependence. This can be a slow process, and it can normally take time before your brain produces neurotransmitters like dopamine and endorphins.
PAWS adds an additional challenge to addiction recovery and can have a significant effect on happiness after rehab. PAWS has many symptoms, and a lot of them feel very similar to depression. They tend to come in waves – you may feel your PAWS has alleviated, only to be hit with a recurrence of PAWS symptoms again.
While PAWS is challenging, and can potentially last a long time, knowing that it exists helps you to put your feelings into perspective, and have realistic expectations. Experiencing PAWS symptoms can be dispiriting, but by being aware that they can be overcome, you can gain the perspective needed to maintain your sobriety through the difficult phases of PAWS symptoms.
Developing new coping mechanisms after rehab
During addiction, substances became the main coping mechanism – during recovery, you will need to develop others. This doesn’t come naturally and will require soul-searching and commitment.
Dealing with stress, triggers, and emotional challenges without substances requires substituting your old coping mechanisms with new, healthy ones. These coping mechanisms will vary from person to person, and you need to find the ones that are right for you. They can be therapy, meditation, exercise or healthy routines, but they can also be new passions that substances obscure your desire to pursue. The most important thing is that they’re important to you. The search for meaning is a universal struggle. Finding purpose in your life after rehab can be challenging – but your hard work overcoming withdrawals means you have been allowed to search for it.
Unresolved trauma and mental health issues
Treatment for mental health issues and unresolved trauma is an important component of post-rehab life. Trauma and poor mental health are inextricably bound to drug addiction and alcohol addiction. Having a dual diagnosis – that’s a diagnosis of a mental health problem and a substance abuse disorder – is very common. The NHS estimates that 86% of people entering alcoholism treatment and 70% of people in treatment for drug use have mental health problems. Childhood trauma is also widespread in addiction. Unresolved emotional wounds will not heal themselves after rehab – they need to be worked on as part of the process of recovery.
Therapy can help you to contextualise your struggles, understand why you struggle with addiction and address the problems you were trying to escape. After spending so much time running from your problems and using substances to numb yourself, it might not come naturally, but this work is a critical part of creating new coping mechanisms and finding new meaning and purpose.
Social and environmental influences
Social pressure and isolation can be challenging after rehab. You may have decided to become sober – but friends and family outside of rehab may have not. This can make it difficult to spend time with the same people you did before rehab and can result in you feeling isolated.
The time after rehab is a time for rebuilding – and that means deepening connections with people who support your health and sobriety, and forging new connections with people who understand your struggle. Support groups, new activities and hobbies and maintaining contact with a therapist will help you feel less isolated, and building these new connections is important work.
Fear of failure and relapse
The fear of relapse can haunt you after rehab – and paradoxically, fear and anxiety are also drivers of relapse. This can be a vicious cycle, and the best thing you can do is work on coping skills and make a plan.
Acknowledging your fear and being prepared helps you to feel more in control. Self-care is key, as poor self-care increases the risk of relapse. Being kind to yourself, focusing on healthy habits and maintaining a routine is important.
Having a solid relapse prevention plan can give you peace of mind. This plan is the blueprint for maintaining a sober lifestyle after rehab.
You aren’t alone in your fears, so maintaining contact and reaching out to others in the same situation is helpful. Attending support groups, talking to supportive friends and keeping up with therapy will give you a space to talk through your fears and get insight into how others have coped with the challenges of post-rehab life.
Life after rehab
Your problems don’t go away after rehab – but you will face them with a fresh perspective. After rehab, you need to create the life you want to live. Having gone through the trials of withdrawals and dealt with your physical dependence, the next step is the gradual building of the coping mechanisms and connections that create a meaningful life.
Most worthwhile things take time to achieve. Creating a meaningful, sober life is one of the most important things you will ever do, and it’s within your reach.
(Click here to see works cited)
- Narconon International. (n.d.). Managing Expectations in Early Recovery. [online] Available at: https://www.narconon.org/blog/managing-expectations-in-early-recovery.html [Accessed 15 Apr. 2024].
- Alsheikh, M.Y. (2021). Post-Acute Withdrawal Syndrome: The Major Cause of Relapse among Psychoactive Substances Addicted Users. Archives Of Pharmacy Practice, [online] 12(4), pp.91–97. doi:https://doi.org/10.51847/ioicfujpnm.
- Alliance, N.A.P. (2020). The problem in dual diagnosis. [online] NHS APA. Available at: https://www.nhsapa.org/post/dual-diagnosis.
- Zarse, E.M., Neff, M.R., Yoder, R., Hulvershorn, L., Chambers, J.E. and Chambers, R.A. (2019). The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Cogent Medicine, [online] 6(1). doi:https://doi.org/10.1080/2331205x.2019.1581447.
- Melemis, S.M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, [online] 88(3), pp.325–332. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/.