Perspective Piece: Relapse, Mental Health, and the State of the World
As I sat down to write this article, I thought to myself, what should my first sentence say, “During these uncertain times” or, “during this challenging time,” and that reminded me of the opening line of every speech and television commercial I have heard over the past several months. I say to myself, thanks for stating the obvious. But, in all honesty, the commercials I have heard and the conversations I have had frequently prompt me to think more about the people I know who are in recovery from drugs and alcohol abuse. I also think of people who struggle with mental health issues such as anxiety and depression. How are they managing their recovery during the pandemic?
The first emotion that comes to mind is grief. We all lament the loss of that life before COVID-19. The simple routine of waking up every morning, having your morning coffee, showering, and heading out the door for a day’s work or social gathering with sober supports no longer exists for most of us. Of course, there are virtual Zoom meetings that one can attend in an effort to get some sort of support, but it is not the same. Many people in recovery have had their daily routines wiped away. In recovery, attending 12-step fellowship meetings or even meeting other people who are in recovery for a cup of coffee or a meal, outside of the home, plays an integral role in one’s recovery journey. This type of support and human contact has become a cornerstone of psychosocial support for people who are trying to attain sobriety. And it’s gone.
Boredom, a significant trigger for relapse is the second emotion that pops up. Because many people in recovery work hard to maintain a routine that supports and nurtures an alcohol and drug-free lifestyle, attending in-person meetings, working and even participating in mental health treatment such as individual and group therapy is essential to their recovery. When these options are no longer available as they once were, routines are derailed. Instead of being able to go out and actively participate in recovery activities, people have been isolated in their own homes. Being shut away in your home and feeling bored, “blah” or “blue” can place almost anyone’s thoughts on a dangerous trajectory. Imagine having a little devil on your left shoulder and a little angel on your right shoulder. The person in recovery is in the middle and very susceptible to listening to the temptation of the little devil saying, “What’s one drink, one line of coke or one bag of dope gonna do? There is nothing else to do, you are on edge, and things are tough, treat yourself to not feeling any worry or pain.” While across the way the little angel is saying, “I know you are bored, but you have come so far. You have been clean and sober for 6-months. You know how to live a sober life. I know it is hard, but everyone is going through a hard time right now.” Here you are, the person in recovery, stuck on the couch feeling “blah” trying to fight off the little devil on your shoulder and feeling as though you are going at it alone because the level of support you once had is different, it’s gone. There’s a lot of temptation hiding in that boredom.
Fear, caused by an exposure to danger, is the third emotion commonly felt. The COVID-19 world of today has resulted in trauma for many, many people. Experiencing substantial fluctuations in mood throughout the day is the norm. For example, when I first wake-up, I tend to feel the most energized and positive. I might say to myself, “You got this; today is going to be a good day.” But, hours later, my internal dialogue changes to this high-strung, Negative Nancy who snaps at anyone in her line of sight. Feeling irritable, afraid about what’s going to happen next (a zombie apocalypse-LOL!) which is out of our control. Understand, feeling sad, fearful of contracting this illness, or angry about the state of the world are normal, though very unpleasant, emotions to experience. For people in recovery, learning how to cope with negative feelings without using drugs or alcohol to “numb” them out is a significant part of the work that is done in recovery. Definitely, the danger today is not having access to those lessons in how to cope with the unpleasant feelings. And that can be the trigger for relapse for folks in recovery.
There’s yet one more emotion in this recital of hazards. Hope. Hope is the feeling that what’s desired is possible. In working with people who have struggled with drug and alcohol abuse, in conjunction with other mental illness such as severe anxiety and depression, I can honestly say that bearing witness to their resilience has been nothing short of astounding. Yes, for many relapse almost seemed inevitable during this time. But, picking themselves up and dusting themselves off by demonstrating self-compassion has overpowered the unsolicited temptations of the little devil on their shoulders. I have watched people re-invent what their recovery looks like.
A friend of mine has been clean and sober from alcohol and opioids for over two-years. She also struggles with overwhelming feelings of anxiety. In talking with her during this time she stated, “My recovery has become even more self-fueled. I have had to find different ways to hold myself accountable by using different applications like bluejeans.com to attend 12-step meetings and participating in tele-therapy sessions with my therapist.” The advent of digital-therapeutics that offer psychological intervention is technology that we all can afford to benefit from with the current state of the world. Digital-therapeutics (DTx) deliver evidence-based therapeutic interventions to individuals that are driven by high quality software programs to prevent, manage, or treat a medical/mental disorder. They can be used in concert with medications or therapies to optimize care and health outcomes (Digital Therapeutics Alliance, 2018). Having the option to talk with a mental health professional or sponsor, in-person, is no longer the standard. Sadly, for many, the task of seeking mental health treatment is not easy. Therefore, using a digital-therapeutic (DTx) affords individuals who need help during this time immediate access to quality therapeutic interventions around the clock. Like my friend, people in recovery have had to adapt their recovery approach in an effort to maintain their sobriety. Yes, the world does look different than it once did. But the human race is resilient, and markedly so for those in recovery who are fighting an internal battle every day to maintain their sobriety.
Sources: Digital Therapeutics Alliance. 2018. Retrieved from: https://dtxalliance.org/wp-content/uploads/2018/09/DTA-Report_DTx-Industry-Foundations.pdf