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PAWS (Post Acute Withdrawal Syndrome)

Specific emotional or mental health problems, like anxiety, depression, insomnia, confidence etc. Along with bodily health, exercise, nutrition.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Topcat » 24 Sep 2012 07:48

I found THIS one of the best sites but there are numerous others.

Discovering PAWS for me was the turning point. Up until my Counsellor put me onto PAWS, I was stumbling around in the dark on a continual roller coaster of stop/start binge drinking. Realising that PAWS was in fact all part of the healing process (and not some evil plan to keep me hooked) made it all a lot more bearable. Sure, it was tough getting through it (the worst being just before 4 weeks), but I knew it would end in a few days and, sure enough, it did and I felt positively euphoric then - I'd done it - I'd got through my toughest challenge. After that, the PAWS bouts eased up each time until the last one was just 24 hours of feeling a bit bleugh. That was just after the year milestone.

I found the bouts came in cycles, one month, 3 months, 6 - like the challenges in fact. The toughest part was knowing that there was an instant "cure" waiting in the wings. One drink and it would all go away - that took some fighting, but it can/will be done if you really want to win the war.
Last edited by Topcat on 08 Feb 2013 16:01, edited 1 time in total.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by MissBlue » 24 Sep 2012 11:59

Franki wrote:It's very logical once you understand it and it seems to explain my own roller-coaster of binges, although not having known about PAWS before I didn't keep a note of the days/weeks AF to see if there was a pattern for my "giving in" to the instant "cure".

What I intend doing now is to keep an online AF/PAWS diary, much the same as I do for Dog. Knowing that I will have to fill it in each morning, as I do hers, will, I think, help me to understand and control my addiction better than I have been doing lately.

Many thanks to Rebecca for starting this thread. ;)?
Discovering PAWS has been a major break through for me too. However I have noticed I used to relapse and have greater cravings around the build up and night of the full moon ( no laughing at the back please). Has anyone else noticed this? I could add lots more jokes about this but it somehow it is a real trigger for me.

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by MissBlue » 24 Sep 2012 12:21

Thanks Franki <:)> I also suffer from migraine headaches too ( nay luck ()o ) The next full moon is 30th Sept so I am staying in that weekend and going to pamper myself as hoping these feelings will lessen.

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by CJ » 24 Sep 2012 14:13

Miss Blue I am one of the ones at the back definitely NOT sniggering. I often feel really down around start of the full moon- very much like PMS- and as soon as the full moon is here I feel great. I'm sure it's significant.

Thanks mods for setting up this thread. So often on this site we see people saying why don't they feel better yet, they've given up drinking but they feel so low and depressed and moody. I know I did. To the extent that I wondered if it was all worth it. When I read about PAWS it all made sense and gave me hope that the horrid feelings would pass. Eventually they did, and it WAS worth it!
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by smudge » 24 Sep 2012 16:01

I felt a waffle coming on, and Lo! Here it is! :shock: :D

Considering how much I drank and how long I drank for I was amazingly ignorant about going through alcohol withdrawal both in the detox/acute withdrawal phase and the post acute phase.

My expectations of recovery were that after the first couple of weeks of sobriety :

1) I would feel physically fabulous
2) I would feel mentally fabulous
3) I would be able to start drinking like normal people
4) It would turn out that Santa Claus was real after all.

The main reason I was so woefully ignorant is because, deep down, I still believed all the stereotypes about people who drank too much. People with serious problems sat on benches out on the street drinking their bottles of booze which were hidden from view in brown paper bags, they often staggered around shouting incoherently at people, exposed themselves when they pissed on the street, and slept in doorways. I did none of those things so therefore my problem couldn't be serious. It took me a long, long time to lose this belief and realise the truth about how bad my drinking really was.

I now realise, like everyone else who has been a member here for more than a few weeks, that life isn't that neat or that simple, and withdrawing from alcohol and staying sober for the long haul is more complicated than I thought.

There came a point over two years ago that I finally got up a head of steam, detoxed from alcohol and have stayed sober ever since. A question I have never successfully answered for myself is "If I had heard of PAWS and known what giving up drink would be like while I was still drinking would it have put me off trying to get sober?". I really, really don't know. But one thing I am absolutely certain of :

Learning about PAWS once I got sober was absolutely vital to me staying sober.

So, I think this thread has huge value for anyone coming to the forum with a serious intent to recover. I made my own first reference to PAWS in a post here after more than nine months of sobriety. I wish I had understood more about it (believed it more?) much earlier. If anyone is interested in what I said at that time then the post can be found here. It would be worth reading the follow-up posts on the rest of that page and the start of the following page too.

My own experience of PAWS consisted of the following problems - not all at the same time I hasten to add! - and the problems ebbed and flowed. These are written in no particular order - I've written them as they occur to me, not in order of severity.

1) Memory problems
2) Rigid thinking
3) Inability to multi-task
4) "Jumpy" thinking and a total inability to concentrate
5) Fatigue, insomnia and sleeping problems
6) Aggression, inappropriate rage and anger, extremely bad moods, hair-trigger temper
7) Depression
8) Anxiety & Paranoia
9) Tearfulness
10) I staggered and wobbled, making me appear drunk
11) Extreme sugar cravings
12) It took me a long, long time to work out when I was thirsty, how to avoid being thirsty and how much liquid I needed.
13) I got stressed at the smallest little bit of responsibility e.g. having to wash dishes could send me into headless chicken mode.
14) Oh yes, that reminds me - dropping stuff - I got very clumsy and smashed loads of things.
15) Inappropriate emotional reactions and over-reactions.

[Edited on 31st January 2013 : The bits I have struck through are probably, but not definitely, unrelated to PAWS. They are more likely to be related to a mild case of Wernicke-Korsakoff Syndrome - a condition I have been diagnosed with quite recently.]

The problem with the list above is that some of those issues were "built-in" and existed before my drinking got totally out of control, and in a few cases they were the cause of some of my drinking excessively. So, how much is me and how much is PAWS is difficult to say. I had mental health problems (depression, anxiety, paranoia and PTSD), and I drank because I couldn't deal with them. When I gave up drinking it felt like those issues hit me like a sledgehammer - I was facing them without a crutch or a shield or a cushion for the first time in years. So, how many of the problems I had were caused by PAWS, how many were caused by brain damage from my alcohol use and how many were "built-in" is impossible to say.

What I can say with certainty is that the problems I have listed have either gone or are much, much, much easier to cope with now. If I started drinking again I imagine them coming roaring back like a tsunami. I'll stay sober today, thanks very much! I just love the peace and calm too much to want to go back to the life I had as a drunk.

As I've said elsewhere, the wikipedia article about PAWS is one I found impossible to relate to, and it slowed down my acceptance of it as an issue with real ramifications for me and my recovery.

My favourite PAWS article is :

Why we don't get better immediately

The wiki article for anyone who really wants to read it is :

Post-acute-withdrawal syndrome

A thread I found on an AA site has some interesting posts which are well worth reading :

PAWS Experiences
Last edited by smudge on 31 Jan 2013 14:59, edited 2 times in total.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Finley » 24 Sep 2012 16:43

No sniggering here either Miss Blue. I think, like Franki and CJ, that the moon's cycle affecting our moods/withdrawl/PMS is entirely plausible too. It's a great idea for you to be aware when the next is due (30 September, you say?) so that you can plan accordingly. Even if it doesn't help to know per se, it must surely help to have planned strategies to get you over that time. I'll be really interested to hear how it goes :)

I think in any case, knowing about what is happening to us and why is always helpful. It might not make the feelings go away, but does give us some perspective on it and also the feelings/symptoms won't take us by surprise, so may be less distressing just because we're expecting/prepared for them ?
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Jake. » 24 Sep 2012 19:10

2 YEARS!!!

I haven't got that long!

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by MissBlue » 24 Sep 2012 20:13

Smudge (::) <:)> ;)? Thank you for posting the links. Good essential reading for anyone who is going through the challenges. Lots of it making sense to me.

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by smudge » 24 Sep 2012 21:14

MissBlue wrote:Smudge (::) <:)> ;)? Thank you for posting the links. Good essential reading for anyone who is going through the challenges. Lots of it making sense to me.
Glad you found the links useful MissBlue. I found that learning about PAWS made a lot of things make sense for me, and was a positive thing for me. <:)>
Xenon wrote:2 YEARS!!!

I haven't got that long!
Why? What is going to happen? :shock:

PAWS doesn't affect everyone Xenon, and even the people who do get symptoms of it will get it to different degrees and for different lengths of time. It could be over pretty quickly for some people. I would guess that the important factors determining how long PAWS affects people would be :

[Edit : I want to stress that this list is my best guess and is not based on anything scientific. I hope people think it is reasonable.]

1) Age - obviously the younger the better
2) Diet - if people ate a sensible diet despite the drink that must help massively
3) Exercise - getting plenty of exercise despite the drink would help
4) Length of time that alcoholic levels of drinking took place for
5) Overall length of time that excessive drinking took place for
6) Genetics
7) General self care after giving up drink

Only you know how you might score on all those things. The important thing to remember is that it is worth it! So, don't panic. And anyway, the worst time is apparently between 3 and 6 months after sobriety for most people, so it doesn't last for ever. <:)>
Last edited by smudge on 25 Sep 2012 12:09, edited 1 time in total.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Topcat » 25 Sep 2012 07:01

Xenon wrote:2 YEARS!!!

I haven't got that long!
Xenon/Jake, it is not two years of solid PAWS. It came and went with me every two or three months and just for 2 or 3 days at a time. It gradually eases as time goes on too. I would much rather have PAWS than go through withdrawal again or go through the horror of the embarrassment of being so drunk I don't know what I'm doing/saying. Smudge is right, it is nothing to panic about - just be aware of what it is and why it is happening - it is the body/mind healing itself.

I found the hardest PAWS symptom was disorientation. I stumbled (and actually fell) a couple of times. Rather embarrassing to fall whilst sober. Also very tense and knowing that a drink would make it all go away was extremely tempting. I had to remind myself that the drink would also mean that I would have to start again from scratch - not something I was prepared to do.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Jake. » 25 Sep 2012 07:41

thanks guys

that's good to know, will be a really strong incentive to stay sober at 2 years I guess. I do feel sluggish/lethargic ans depressed sometimes. I also get those phantom hangovers. I did just think sober life was like this so thanks for making this thread.

I feel like a fool drinking for all those years because I felt depressed, when I felt depressed cas of the drink! Doh!

I guess it will all get better in time

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Topcat » 25 Sep 2012 09:11

Same here re: your final paragraph Franki. Sure if I'd known about PAWS years ago, I would have managed to stop earlier. I very much doubt though that I could have stopped when I first became aware of my dependence. I really didn't want to. My whole social life revolved around drink/drinking. I realise now that it was a pathetic waste, but no-one could tell me that at the time. We live and learn. I'm grateful that I did manage to stop in the end.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by MissBlue » 25 Sep 2012 10:33

Posting this in the hope it helps someone else. I was having horrible headaches but another member ( Biggles <:)> ) told me about these; methylcobalamin ( vitamin B ) 1000 pg. They are small " nuggets" about this size O and dissolve under the tongue and you take one a day. Vitamin B aids nerve ending healing and is good whilst our brains re- hydrate, I have also noticed I am calmer taking this supplement. This is the only supplement I am taking and although I baulked at the price £9.80 for 30 nuggets, I now consider that money well spent.

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by MissCheese » 25 Sep 2012 11:59

Great posts Smudge, really does make you pause for thought.

Not sure how many of my current ailments can be attributed to PAWS directly but it helps to know that this may not go on forever. I know the depression will as that came before the alcoholic period of my life, even though I was a 'heavy' drinker then.
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by smudge » 25 Sep 2012 12:33

Franki <:)>

About my list of what I thought might affect PAWS severity and duration...

I only had the exercise one working in my favour (I'm a regular dog walker and I don't dawdle), all the others were against me.

I can't deny that PAWS was a problem for me. But knowing why things were happening the way they were was incredibly important to me. Knowing that the good things about being sober were going to keep getting better and better, and the PAWS symptoms would get less and less was just incredible. It made sense of things for me, and it made it all worth it.

MissCheese <:)>

I'm glad you found the thread useful. Comparing my mental health now, to my mental health while I was drinking is like comparing a goldfish to a chicken - it just can't be done. I am so much better now, although I am unlikely to ever be completely well (I've been depressed since childhood). Usually I have bad times now when I let my self-care slip. (I've never been good at sleeping and eating regularly. And using my light box often feels like a boring chore.) The main thing for me is that my mental health is so much more under my control now rather than being something that was happening to me that I could do nothing about.
\:)/
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by koalaBear » 25 Sep 2012 19:29

PAWS for me has meant 2 things above all else, fatigue and anxiety.

The fatigue was at it’s worse during the first month but has only just started to lift completely. The anxiety (generalised) just crops up every now and again and has been lasting for 2 or 3 days at a time. If I hadn’t known about PAWS, I may have relapsed during these periods.

For some reason I’ve never had a problem with insomnia throughout the AF process, sleep like a log. Lucky me.

I didn’t look after myself at all when I drank, most nights I didn’t even bother with dinner :(
smudge wrote:The main thing for me is that my mental health is so much more under my control now rather than being something that was happening to me that I could do nothing about
;)? I feel that too and it’s great
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by powellct » 26 Sep 2012 14:14

I'm back to stick me two penn'orth in....

Great to see a thread about PAWS - like Smudge I didn't know about it in the early days and thought that what I was going through was my body telling me I'd completely f*cked it up and I'd never get better (in reality, some people don't :( ) - but that passed. From memory it was 6-9 months dry I started to get wobbly, but people in my group have reported as quickly a 4 weeks - others have nothing.

Word of warning - it was mentioned in an earlier post: There is absolutely NO valid or rational reason for drinking because of PAWS. If you've made it through this far, then you won't die, its just bloody uncomfortable. Go back to drinking and your dopamine receptors kick off again, and it gets harder to stop again (Google "kindling" on wiki) - if you're following the SMART programme redo a CBA, and focus on the LT cons - drink and there's every possibility they'll happen (as has happened to a friend of mine who used PAWS as an excuse to go back to 3 bottles of wine a night. His divorce is imminent, as is the sale of his nice big 5-bed detached).

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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by powellct » 27 Sep 2012 07:55

Sounds like a pretty good explanation to me...!!!
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Topcat » 30 Sep 2012 13:44

Think of it for what it is Franki. It is in fact the brain healing itself so you are now officially well on the mend ;)?
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Re: PAWS (Post Acute Withdrawal Syndrome)

Post by Jake. » 30 Sep 2012 14:23

I dont really get phantom hangovers now, so should clear in a few months

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