As you learned in Module 1, addiction has long been viewed as a weakness or a flaw in the person. The truth, which we know from decades of careful research, is that addiction is a chronic disease and that relapse (a return to substance use or an increase of symptoms related to a mental health condition) is common. A relapse should be viewed as an opportunity to update and reinforce clinical (treatment) and non-clinical supports.
Video – HBO Relapse Video Clip (7:02 minutes)
It’s important that the client understands what leads to a relapse so s/he can take the necessary actions to avoid or minimize it. What triggers a relapse will be different depending on the individual, but there are some commonalities. In general, a trigger is any form of stimuli that sparks the desire to use alcohol or other drugs. Triggers prompt cravings, which are strong desires for the “drug of choice.”
To effectively manage recovery, the client first must identify and plan for how to handle their unique triggers.
- Environmental triggers are often easy to identify. Going to a bar, being in a certain neighborhood or one’s childhood home may bring back unpleasant memories that are highly associated with substance use.
- Social triggers are often easy to identify. For example, getting a phone call from a family member, meeting with a fellow user or seeing a former significant other may incite the desire to use a substance. Going to parties where people are drinking socially can sometimes be a problem, especially early in recovery
- Emotional triggers are often more complicated. For many people, underlying emotional and mental health conditions will trigger substance use, and so managing triggers requires managing one’s personal emotional state. Emotional triggers commonly associated with substance use are anger, loneliness, anxiety, exhaustion, frustration and depression.
- The Peer Specialist views relapse as a learning opportunity and not a failure on the part of the client, him or herself, or both.
- The Peer Specialist draws on past personal lifestyle changes to understand both the barriers and things that helped him or her make changes. These successful experiences from the past are used to offer hope and encourage peers through the process now.
- The Peer Specialist recognizes that clients may need different types of support services at different stages of their recovery journey. The Peer Specialist, therefore, exercises care in: 1) evaluating client needs; 2) delivering services within the boundaries of his or her knowledge and experience; and, 3) knowing how and when to involve other team members in the process.
Video – Drug Addiction: Triggers and Craving (3:05 minutes)
Relapse for persons with a mental health condition means an increase in unhelpful thinking and behaviors after a period of feeling improved or after experiencing better mental health. A relapse can involve difficulties coping with day-to-day activities, gradual changes in feelings, thoughts & behaviors (“early warning signs”) that signal a decline in mental health, or when previous symptoms of the mental health condition reoccur. Like relapses in substance use, it’s important to recognize that these relapses are a normal part of the recovery process. Peer specialists aid the client in identifying triggers and early warning signs, and developing appropriate response plans. Identifying early warning signs as quickly as possible means an individual can take positive action and seek help early to minimize or possibly prevent the impact of a relapse on their quality of life.
Early Warning Signs
Some of the more common early warning signs of relapse related to mental health conditions are:
- Feeling depressed or unhappy
- Feeling tense or restless
- Feeling anxious or worried
- Feeling unsafe or threatened
- Feeling paranoid – thinking that people are talking about you
- Feeling irritated, quick tempered or aggressive
- Not being able to concentrate for significant lengths of time
- Experiencing eating or appetite changes
- Overuse of alcohol or drug taking
- Problems with getting adequate sleep
- Withdrawing socially – staying home
- Feeling anxious about going out or going to work
- Hearing voices
- Experiencing racing thoughts or disordered thoughts
- Having mood swings – becoming excited and high or the opposite – feeling very low and suicidal