PAWS stands for post-acute-withdrawal syndrome. PAWS is a name for symptoms that linger after the initial week or two of acute withdrawal. People typically experience PAWS as emotional numbness, the inability to feel pleasure, depression, lack of motivation, insomnia, inability to concentrate, anxiety, and irritability. Some people also experience mood swings, panic disorder, or obsessive-compulsive disorder. There is not much scientific evidence for what causes PAWS and it is not recognized by the American Psychiatric Association. However, there is a lot of anecdotal evidence from people recovering from addiction. If you’ve been in recovery for months and you persistently experience the symptoms above, you may be experiencing PAWS.
PAWS may be caused by an imbalance of neurotransmitters in the brain. Depending on what drugs you used most heavily, you may be short on dopamine, serotonin, or GABA, and you may have too much of the excitatory neurotransmitter glutamate too. Since dopamine is a key neurotransmitter in developing addiction, it may also play an important role in PAWS. Dopamine plays an important role in goal-directed and reward-seeking behavior. When you use drugs like opioids or cocaine, the levels of dopamine in the brain are many times higher than they would be for normal motivators like food or sex. As a result, the brain makes less of it over time. When you quit using drugs, you typically have low dopamine levels, which can cause lack of motivation, poor concentration, emotional numbness, and inability to feel pleasure.
It may take a while for dopamine and other neurotransmitters to get back to normal levels. Not only that, it takes the brain some time to adjust to normal feelings of pleasure and gratification, since drugs often amplify these far beyond what you would experience naturally. Whereas cocaine may cause an explosion in the reward centers of your brain, for example, normal pleasures may seem weak by comparison. It may take a while to readjust to normal levels of stimulation.
Typically, this takes 18 months at the longest PAWS will last, but most people start feeling better within six months to a year. That’s not terribly long in the scheme of things, but when you’re going through it, it can feel like forever. Many people who experience PAWS in recovery start to wonder if it’s worth the effort to stay sober if they’re just going to feel like zombies for the rest of their lives. The good news is that PAWS does eventually go away, but the bad news is that there isn’t a lot you can do for it in the meantime. Antidepressants sometimes help. If you’re in treatment or seeing a therapist, you should definitely discuss your symptoms with your therapist. Some people find that exercise and social connection help too.
Arbor Behavioral Healthcare offers an integrative and holistic approach to treat substance abuse and a wide variety of addictions, as well as underlying mental health and psychological issues. All of the addiction recovery programs offered by The Arbor are designed to heal the mind, body, and spirit leading to a lifetime of sobriety, health and wellness. If you’re ready to find healing and restoration in a peaceful, loving environment, please call us today at 844-560-7269.
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