Often, we think substance abuse relapse happens in an instant. In reality, it’s a gradual process that can happen over a series of events. The series of events are our warning signs that we are stepping off our recovery path. They let us know that something isn’t work and needs to be changed. By the end of this post, you will learn more about the warning signs and start to personalize a plan to overcome a relapse or prevent one so that course correct your recovery path.

Why is this Important?

Understanding how relapse happens is key in preventing it and creating a life of recovery. In early stages of recovery, it’s not as easy as just not using alcohol and/or drugs. Some of my clients say being sober is the easy part, recovery is the hard part. I hear so many times from others and sometimes clients that relapse is just part of recovery. Yes, it can be for some but it also doesn’t have to be. These stages of relapse will help you to identify triggers and warning signs to help prevent a relapse.

Stage One-Spiritual Relapse

Spiritual relapse is the first to happen. We lose ourselves in our addiction. Our addiction consumes us and who we are, it becomes our identity. We start self-sabotaging or just giving up on ourselves. We hear messages that we won’t get sober this time or that relapse is inevitable. These begin to be a self-fulfilling prophecy.

Here are some other spiritual relapse examples:

Negative self-talk
Not going to support groups (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery, Celebrate Recovery, Cocaine Anonymous, etc.)
Not communicating with our Higher Power or participating in spiritual activities.
Not giving back to your community (i.e., volunteering, being wrapped up in your issues, not engaging in a community)

No Particular Order

It’s important to know that the next 3 stages are put in numbers but they can typically happen together, while you are going through a spiritual relapse, solo, or not at all. This isn’t like check boxes. You don’t have to have any or all of these to be starting on a path to relapse. Just experiencing lapses in one of these stages is enough to put you in danger of using your drug of choice.

Stage Two-Behavioral Relapse

Behavioral relapse occurs when you stop doing the tasks you were doing to keep you sober. I once had a friend say that she knew she was in a relapse when she stopped making her bed. This was because making her bed became a routine for her in recovery so when she stopped, she knew she was relapsing.

Here are some other behavioral relapse examples:

Stopped attending therapy or maybe showing up late or rescheduling a lot
Stopping routine behaviors such as making bed, not eating breakfast, or not reading at night.
Not reaching out to supportive people. This could be sponsors, mentors, spiritual leaders, family, friends, etc.
Missing support group meetings or pro-recovery events

Stage Three-Emotional Relapse

For some, emotional relapses can be dangerous for our recovery. Emotions are hard for a lot of us, both in our addiction and our recovery. When we first get sober a lot of things come up and dealing with our emotions without our drug of choice becomes difficult. But then we start coping or using techniques that we learned therapy to help us understand and accept our emotions.

Here are some ways we experience emotional relapses:

Giving into our emotions. This could be over feeling emotions, acting out, or not using coping skills.
Missing medication doses if we are on meds.
Having a defeatist or failure beliefs
Escaping into coping skills. This might look like binging your feel-good show on Netflix, sleeping, or avoiding people.

Stage Four-Mental Relapse

Our brains can be our own worst enemy. It can trick us into thinking nothing is wrong and that we can go back to old behaviors. It even beats us up more than others.

Here are examples of mental relapses:

Negative Thinking or ”Stinkin’ Thinkin’”
Criminal or Loophole Thinking
Replaying old use or memories that gets us in our feels

Stage Five-Physical Relapse

Physical Relapse is the final stage of relapse. When we have gotten to this stage we are either on our way to addictive behaviors or actively engaging in them. This could be actively using/drinking or doing old addictive behaviors like binging on food or hiding food. For those struggling with mental health only or maybe co-occurring disorders, this would be going completely off mental health medications without consulting a medical professionals.

At Which Stage Can You Prevent a Relapse?

The great thing is you can always prevent yourself from getting to stage 5. The best way to prevent a relapse is to use your coping skills in stages 1-4. In stages 1-4, there are supportive people in your recovery that you have built that can help pull you out of a relapse. They can also be the coping skills you need to combat these stages. Getting to stage 5 doesn’t mean you are going to relapse, there is still time to bounce back. It is going to take you pulling yourself out of it though. There is time to pivot as long as you don’t drink, use, or go back to addictive behaviors (food, sex, gambling, games, etc.).

What Do I Do if I am in One or More of these Stages?

The way to pull yourself from these stages is just the exact opposite of what put you in these stages. If you stopped going to meetings or therapy, get your butt in a seat at that meeting or call up your therapist. If you are deep in your feels, acknowledge that, accept the feels, and cope with the feels. It will be the hardest thing you will do in the moment but overcoming it will be very rewarding. I will do a more in-depth article about how these stages of relapse can be transferred into being our stages of recovery. I will link it here.

Creating a Relapse Prevention Plan

The key is making sure you have identified what each of these phases look like for you. Having a relapse prevention plan or writing down your warning signs are the best ways to overcome a relapse. Remember you are not planning a relapse you are preventing it. Play that tape through. If you have had relapses previously, I suggest sitting down and look at what happened leading up to your relapse based on each of these stages. For those who haven’t had a relapse, you can start by looking at what your recovery efforts that you have developed in each of these phases. If you need some help, I have created a worksheet to help you out. You can submit the form here to request a copy of my relapse prevention plan.

Final Thoughts

Being able to understand how relapse happens can help to prevent it. If you are someone who thinks they are heading down a relapse path, I hope this article helped. Sometimes being able to work through this with a therapist can give you insights you might not think about or provides skills to overcome your relapse. If you experiencing a relapse as you are reading this, know that you can still pull yourself out. It’s not too late to get back on your recovery path. I can help. You can schedule a free consultation with me here.

Photo by James Wheeler on Pexels.

Disclaimer: This is in no way a replacement for a therapeutic relationship or substance abuse/mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. Reading this blog or responding to it does not constitute a provider-patient relationship. If you are looking for a local mental health professional feel free to use the contact tab to request an appointment or search Mental Health Match, Therapy Den, or Psychology Today for local therapists in your area. If this is a mental health or substance abuse emergency and you need immediate assistance, please call 911, call 988, go to your local ER, visit TRC for withdrawals or your local detox center, or call 211 if you are in Oklahoma.

5 Stages of Substance Abuse Relapse