Stress and Recovery by Karis Bjerke

Why is stress so dangerous in recovery? Would you be surprised to learn that stress is second to change in recovery on the relapse progression syndrome by Terence Gorski? Just waking up and navigating through your day has its own stressors, add to that the stress in recovery from substance use and returning to use seems like a viable option to cope.

Terence Gorski and Merlene Miller (2013) provide valuable information in their Staying Sober book focusing on relapse prevention. They list Post-Acute Withdrawal Syndrome symptoms as:

Inability to think clearly: concentration and abstract reasoning are commonly experienced.

Memory Problems: Short term memory loss and long term memory loss of events that occurred moments to years ago.

Emotional Overreaction or Numbness: Mood swings are on overdrive and are increased in intensity or completely absent. It can feel like a person is on an emotional roller coaster throughout the day. When stress is added to the nervous system it can shut down and a person can become emotionally numb.

Sleep Problems/Disturbances: Dreams can become quite disturbing and vivid. Other sleeping issues can be trouble sleeping, staying asleep or sleeping too much.

Physical Coordination Problems: This can be a dangerous symptom in that when physical coordination is off, accidents are more common to occur. Common symptoms are balance issues, dizziness, hand-eye coordination problems. This symptom is most commonly viewed as a spike or increase in clumsiness and is easier to mistake as actually being a PAWS symptom.

Stress Sensitivity: Here is a big one! Difficulty in managing stress and stressful situations becomes harder and elicits reactions we could often regret later. Reactions to low level stress are overreactions and reactions to high level stress are even more intense. Add all the other PAWS symptoms or even just one of them and the stress of life feels unmanageable.

So how would a person cope with all this new stress in recovery? There are many approaches and coping skills to implement. First and most importantly is nutrition and a healthy lifestyle. Schedules and routines help to manage and make time for things that need to be accomplished through the day. Talking about your stress, healthy communication skills and stress prevention techniques are just as important.

It is important to recognize that stress puts individuals at a higher risk for returning to use. Learning how to cope with stress in recovery is challenging especially with PAWS and when learning to not use as a coping skill for life challenges which can feel pretty intense and at times overwhelming.

Please ask and let’s work together learning how to navigate recovery and stress during this transition period of your life and the healthy changes you are making.


Gorski, T. T., & Miller, M. (2013). Staying sober: a guide for relapse prevention. Independence, MO: Herald House/Independence Press.