Updated: Aug 11, 2022
Whew. That is one weighty word. I consulted my ol’ friend and foe, Dr. Google, for the precise definition, to attempt to start this blog from a place of neutrality. According to Oxford Languages, “relapse” can be considered a verb or a noun.
As a verb, relapse means: (of someone suffering from a disease) suffer deterioration after a period of improvement. "two of the patients in remission relapsed after 48 months"
As a noun, relapse means: a deterioration in someone's state of health after a temporary improvement. "he responded well to treatment, but then suffered a relapse"
Basically, when used in either way (from this source, at least) it is a deterioration following improvement. Welp. So much for neutrality. As someone who has gone through a relapse, more than one, actually, I know that this experience goes by a few aliases. I heard and used the term “reoccurrence,” which I learned in treatment for addiction, because I had one 30 days in, and then the term “slip/blip” which my addictionologist/psychiatrist prefers (which does feel much friendlier), and then “relapse” which I learned later, in a program I work daily to stay sober.
Whichever term you use to describe using a potentially addictive substance after a period of deliberate abstinence, nothing softens the edges around how it feels when you are experiencing it. It levels you physically, mentally, biologically – but the emotional devastation is gutting. The anxiety, the fears, the guilt. The shame. The shame alone is so consuming you feel as if you invented the emotion all by yourself.
But relapses are not uncommon. In fact, I’ve been told by many professionals in the substance use disorder and mental health fields that relapses are almost an expected part of recovery – it is very common, as evidenced in the chart below.
Relapse rates for people treated for substance use disorders vs. people treated for high blood pressure and asthma*
So why is there such a stigma around the word “relapse”? Why are we so ashamed when it happens to us?
Maybe it’s just the word. By its definition, the fact that it’s considered a “deterioration” after improvement, the word “relapse” itself feels negative. And perhaps that’s why it’s a term that has aliases and has been repackaged by various users. My personal experiences with relapses were painful and miserable while I was in the midst of them, but with each one, I learned something important about myself and my recovery. Mindsets, feelings, attitudes, long-held thoughts and relationships that needed closer examination. More mental health work. More attention from me and from some professionals. And without those slips and reoccurrences, I wouldn’t have figured out what I needed to – and I wouldn’t have reaffirmed my commitment to sobriety with greater desire and intensity each time.
More than anything, relapses taught me that I really was doing this for myself. All of the hard work, sleepless nights, days when I wanted to kick a hole through the drywall and break plates and scream in frustration and rage. The crying. Ohhh, the crying. Relentless self-examination instead of escape and avoidance. Slow, tremulous, agonizing step-by-step, minute-to-hour-to-day-at-a-time, relearning how to be present in my own life in sobriety. And how to enjoy being there.
My relapses helped me identify triggers and understand where I needed to develop (and actually use) coping methods and tools. And probably one of the most important lessons of all for me: that I am never alone, and all I need to do is ask for help.
Here are some other things that I learned, and I share them, in the hopes they may help somebody else:
1. I did not lose anything. I relapsed, but I did not wipe the experience, knowledge and strength that I gained before my blip on the radar of recovery. I learned to consider my relapses as more information for the mental and emotional arsenal I use to fight the disease of addiction. I filed away what I learned. And I got back up and fought again. That is the most important thing.
2. There is no shame for me to carry about relapse. I learned to drop the weight of that shit and let it go. Rewiring our brains into different neural pathways and corresponding behaviors is something that takes time. I learned to let these experiences inform my decisions, and how I moved forward in my personal recovery. And I moved onward.
3. My disease is still there, just waiting for me. Addiction is a chronic disease, and it took me a while to accept that. For one of my relapses, I was truly convinced that I had whipped my addiction into submission, and I could jump back into light, social use. Not so much. I’m not saying it’s impossible, because I am not a medical professional, and I definitely do not have all the answers. However, I know from my personal experience that just because I had an extended period of happy sobriety, my addiction didn’t pack up and depart for a more comfortable climate.
4. I cannot do this alone. I need a broad community of like-minded people who get me, and a circle of kindred spirits who love me in all my feelings, fancies and freakouts. There is nothing – literally nothing – I’ve ever experienced like being known, heard and seen on these personal levels, just as who I am, no matter what that looks like on any given day. (Sometimes, I am potato-like, on Zoom most of the day, just keeping myself sane, and that's alright...)
I do not wear social masks anymore. I do not pretend. And sometimes, being myself with my people, with all my grisly, grotesque, vulnerable, soft and squishy fish-belly innards hanging out, is the only thing that keeps me sober and sane for that day.
5. Nothing ultimately feels better than honesty. Ever. Even if a little fudging here and there seems a little cozier initially, it ultimately feels icky and breeds shame and self-loathing. Especially about relapsing. Even when honesty is so brutal and DIFFICULT, the second it’s over there’s some relief. It’s worth it. And it’s not worth relapsing to keep a lie going, either. Even if you’re only lying to yourself.
6. That therapy and mental health professionals REALLY do help. I would not have been able to get and stay sober without the platoon of people who helped get me here.
7. Accountability is key. Even after treatment, I needed to continue random screenings and peeing in a cup for a longer time to ensure I wouldn’t return to previous behavioral patterns. I know many people who didn’t need that level of accountability. I sure did! And there’s no shame in that either.
8. That I always remembered HOW MUCH I HATE being under the influence nearly the second I was. And I couldn’t take it back and undo it. But almost immediately, I regretted it. And remembered why it was so awful. It changes me. I do stupid things. I say horrible things. I am literally not myself. I am unrecognizable TO myself. And I despise it.
9. That alcohol truly is a depressant, and it affects me in that way hugely and almost immediately. Theoretically, I knew that, but I somehow just thought it didn’t apply to me?! Shocking, I know, but dear reader, it does, in fact, apply to me, too. Turns out, not introducing a depressant into my bloodstream 24/7 makes me significantly less depressed. Magic, amirite?
10. That ultimately, something in my people, places and things still needed adjustment when I relapsed. It meant something was not calibrated in my life or in my environment to provide me with the level of comfort or ease that I needed. So I had to investigate each aspect thoroughly to understand the “why” and adjust accordingly so it didn’t happen again.
If you are struggling to stay clean and/or sober, or you’re having a rough day, coming back from a relapse or you know someone who is, please just remember that this can be part of the process and the journey for many of us. And there’s nothing shameful in that. We do recover – and we do it together.
* NIDA. 2022, March 22. Treatment and Recovery. Retrieved from https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery on 2022, August 9