I just could not believe it! I was accepted into the Social Work Program. The monumental Task I was to undertake started to weigh heavily on my doubting mind. I mean this was higher Education, was I up to the task? Would I fail? Bigger classes, meant more people. I was so awkward, how would I every do this!! I could not fail the man that hand picked me to be part of this program. All potential students had to sit at before a panel of Master Social Workers and participate in an interview. That panel believed in me, but the years of my conditioning could not be so easily ignored. I just could not believe in my self. I was so anxious I had actual physical pain in my chest and throat, it was awful. How was I going to endure two years of this?!
The day came and the first day of classes began. You remember that lady that was a foster parent who hired me for two days to care for her children while she cleaned her house? She sat next to me. I was like oh my God for real? How awkward! I bailed on her just after one day of babysitting, because I could not handle the responsibility, what in the world was I thinking taking up a seat in this class!!! She didn’t even recognize me, but I felt I owed her an explanation. I explained to her who I was and why I bailed on her. She laughed and said, but you did such a good job with the children, they absolutely loved you!! I was shocked, Really? I thought I was a mess. She sat beside me for the next two years, I really appreciated that.She also encouraged me through out the two years, complimenting me and telling me how smart I was. I really needed to hear the encouraging words, that were not told to me as a child. It was still very difficult for me though. I was constantly being triggered, and had to fight every step of the way not to quit.
I was struggling with Post Acute Withdraw Symptoms. PAWS for short.
Post-Acute Withdrawal Syndrome
- Table of Contents
- What Is Post-Acute Withdrawal Syndrome?
- Symptoms of PAWS
- Common Drug Classes Associated with PAWS
- Risk Factors for PAWS
- What to Expect
- PAWS: A Normal Part of Recovery
What Is Post-Acute Withdrawal Syndrome?
Post-acute-withdrawal syndrome (PAWS) refers to a constellation of symptoms experienced by some individuals who are addicted to alcohol or certain drugs after a prolonged period of withdrawal.
PAWS is also known by several similar terms, including post-withdrawal, protracted withdrawal, prolonged withdrawal syndrome, and protracted abstinence.
PAWS is separate and distinct from the acute phase of withdrawal, which typically occurs in the first two weeks after drug cessation.
Acute withdrawal has long been studied by addiction researchers and, dependent on the type of drug from which withdrawal is occurring, is characterized primarily by physical symptoms. These symptoms may include:
- Autonomic nervous system hyperactivity (sweating, nausea, rapid heart rate).
- Intense drug craving.
In contrast to acute withdrawal, symptoms of PAWS generally occur 2 months or more after drug cessation and are primarily psychological in nature, affecting a person’s mood, sleep patterns, and response to stress. The symptoms of PAWS generally last for several months in people recovering from addiction, though they can disappear in a matter of weeks or, in rare cases, persist for a year or more.
Symptoms of PAWS
There are a myriad of symptoms associated with PAWS. Though each of these is fairly common among people withdrawing from drugs and alcohol, the exact number, combination, and timing of specific symptoms is different for each person. Physical differences between people, as well as differences in the types of drugs used and the amount and frequency of use all affect each individual’s experience of PAWS.
Mood swings: The brain of a chronic drug user, including patients taking medications under their doctor’s supervision, has become adapted to a constant supply of a mood-altering substance. When that substance is removed, periods of mania or depression can occur for no apparent reason while the brain rebalances itself.
Anhedonia: Although they work in different ways, virtually all addictive drugs, and many medications like antidepressants, have the end result—in the short term, at least—of boosting neurotransmitters and neural pathways that make the user feel good. Otherwise, why would people take them? Once these drugs and medications are stopped, however, it can take some time for the brain to produce normal levels of these feel-good chemicals on its own again. Until it does, an individual may find that nothing seems fun or interesting anymore – even activities they used to enjoy.
Anxiety: For addicts and patients alike, cessation of a drug or medication is a major life change. Therefore, it is understandable that there can be a great deal of anxiety, and even panic attacks, that accompany this shift. Additionally, drugs such as alcohol and BZDs that chronically inhibit brain activity result in a hyperexcitable, anxiety-prone state when they are stopped.
Insomnia: Many psychoactive drugs and medications affect sleep patterns, and the brain adapts to long-term use. Once these drugs are stopped, it can take time to re-establish healthy sleep patterns.
Sleep disturbances: Subconscious desires to take alcohol or drugs, or to resume some aspect of the drug-using lifestyle, can manifest themselves in vivid, realistic dreams. Though such dreams may be very disturbing to a person in recovery, they are not a warning of impending relapse, but simply a reflection of how deeply the drug-taking compulsion can be ingrained in the mind.
Cognitive impairment: Like mood changes, this is another symptom of neurotransmitter imbalance. It is important to remember that difficulties in thinking clearly and maintaining concentration are usually temporary and not a sign of permanent brain damage.
Depression and fatigue: Many people who stop chronic drug habits or long-term medications experience such intense feelings of depression and fatigue that they fit the criteria for Major Depressive Disorder or Chronic Fatigue Syndrome. Unlike these conditions, however, these symptoms are a phase of readjustment in the brain and generally diminish without treatment over time.
Drug cravings: People with PAWS often have intermittent cravings for the drug or medication that they took before. Because the most intense physical withdrawal symptoms have subsided, the individual may feel physically healthy but continue experiencing negative psychological symptoms which make the return to drug use seem appealing.
Sensitivity to stress: Many people dealing with the effects of PAWS find that their threshold for daily stress is very low. Trivial irritations or setbacks can feel like the end of the world. Considering that these individuals have given up what has been, for months or years, their primary tool for coping with life’s stresses, this difficulty is easy to understand. New life skills must be learned, and even dealing with normal emotions brought on by stress can take time.
These are some of the most common manifestations of PAWS but not an exhaustive list. One unifying theme among these symptoms is that they all impair various facets of an individual’s emotional state, or their “affect.” Another common aspect of these symptoms is that they are intermittent and may come and go over days and weeks, and they generally do not impact a person to the same extent over the entire course of their withdrawal.
You can imagine the internal war going on inside my head! I would come home on exceptionally bad days and tell Stanley I had to quit the program, he would ask my why and I would tell him because emotionally it is a nightmare for me! He would tell me not to be hasty and just give it a bit more time, he kept saying this too me every time I came home in tears wanting to quit.
I did two practicums, one was at ADAAC, and I enjoyed that very much. The other was at the Youth Assessment Center, that one I really struggled with. Especially due to the fact that they were changing over to a place were young sex offenders were placed. This was extremely difficult for me, especially due to the fact that they already had two sex offenders placed there. I really did not have trouble working with the other youth that were dealing with issues similar to mine, however I struggled greatly with working with the sex offenders. There was a child care student there who seemed to gravitate to the sex offenders, and I thought she was just creepy! She pretty much ignored all the other youth and worked solely with the sex offenders. I was the opposite I didn’t want to work with them. Especially after I heard that they had sexually molested toddlers. I was triggered beyond belief and for the first time I went home early claiming professional fatigue and stress. My Adviser, was very understanding and let me go home early. I was completely honest with him, and told him I was being triggered and I needed to go home and deal with it. How I dealt with it was to go home and read a book. Probably not the best way to deal with it, but I didn’t know what else to do. I didn’t have any friends I could talk to and Stanley was still at work. Never dawned on me to talk to my Social Work coordinator, or an instructor.
There was an outburst in class, tensions were high, I am sure I was not the only one feeling stress, just for me it was more intense. The students clashed with each other and started arguing. I had it, I could not take it any more, I ran to The social Work co coordinators office bawling my head off. I told him I could not do this, I was not ready, or capable of doing this.He told me that it was never to late to have a happy childhood. I sat there and looked at him like he lost his mind. What does childhood have to do with the fact that I could not handle school. It never dawned on me until much later that many children who have been abused probably felt the exact same way I was feeling. I was very much a child, and had very child like quality’s as well as some childish ones. I do believe, he was telling me I needed to reparent my self and grow up properly. That may sound like he was being harsh, quit the contrary. Children, who are abused, become frozen or stuck at the age they were traumatized. Emotionally, I was two years old. I spoke like an adult, looked like an adult, but my emotions were stunted. A lot of my behaviours were odd, because I was reacting to situations, like a two year old who has been wounded would. This coupled with the fact that I did not have the skills available to me, that a healthy, whole adult would have made it even more apparent I was different. To further complicate matters, I had undiagnosed, complicated mental illness’.
One of the things that most bothered me about PAWS, is that when I was stressed I would feel like I was high or drunk and would actually stagger and slur my words. It was embarrassing!! It was also very frightening, what if I stayed like that?! Well It passed, thank God! I gradually stopped having those episodes, it took about a year for the symptoms to go away for me. However, some effects still remain to this day.
I was struggling, not realizing that I was suffering from Complicated PTSD, and extreme Depression, and agoraphobia I was a mess, but on the out side it appeared that I was functioning to a degree. On the inside though I was churning with constant anxiety, fear and confusion, it was awful! My classmates, actually people in general felt uncomfortable around me. Being Hyper vigilant and hypersensitive, I could read people like a book. I could feel there discomfort, annoyance, and sadly, sometimes distain. It as a very uncomfortable situation for me. I could not help internalizing feeling of unworthiness, and inadequacy. I knew, I made them uncomfortable, and they did not like the fact we all were considered peers.
I did Graduate at the top of my Class with a 3.9 GPA. that is out of 4.0, so that was very good indeed. I worked my but off for that grade. Since I didn’t have a tv or even a radio, when I got home hitting the books was what I did until it got to dark to see. Then I would switch to the gas lamp, and study till Stan got home then we would eat and go to sleep. Sometimes I would study so much that when I close my eyes I would see the words on the back of my eye lids. The fact that I even completed this program is astonishing. Not only because of my issues, but also my education. The truth is mathematically, I was probably around grade three, and english, about grade five. I am talking about spelling, mechanics, grammar, things like that. How did I manage to do what I did?
I got to make a speech at graduation, it was fantastic. My first foster parents and my Aunt El and Uncle R all came. I was so proud that they came to help me celebrate my accomplishment! They were beaming.
Thank you so much for sharing my life with me, it means the world to me!!! LOVE