Post acute withdrawal symptoms (PAWS) is an acronym for the range of symptoms alcohol addicts can experience after a prolonged period of withdrawal. Otherwise known as Post Acute Withdrawal Syndrome, you may also see it referred to as post-withdrawal, protracted withdrawal, prolonged withdrawal syndrome, or protracted abstinence.
When you have been severely dependent on alcohol and you stop drinking you will typically experience acute withdrawal symptoms during the first few weeks. PAWS is separate from this and usually occurs up to two months after the acute withdrawal phase. The symptoms of PAWS differ from those experienced in the initial withdrawal period in that they are more emotional and psychological rather than physical symptoms.
Why are Post Acute Withdrawal Symptoms (PAWS) so delayed?
As your body becomes accustomed to working again without the presence of alcohol it is gradually taking over the functions that the alcohol was performing. During post-acute withdrawal your brain chemistry is improving but it may fluctuate until it reaches equilibrium.
Most people experience some post-acute withdrawal symptoms. Unlike the initial withdrawal phase, in post-acute withdrawal, most people experience the same symptoms.
What are the symptoms of PAWS?
Mood swings: Drinking alcohol increases the levels of dopamine in your brain, which results in heightened levels of pleasant feelings. When you drink regularly, your brain stops bothering to produce the same amount of dopamine, expecting the presence of alcohol to do the job instead. By removing the alcohol your brain has to readjust and rebalance, resulting in mood swings or depression.
Anhedonia (the inability to feel pleasure in usually pleasurable activities): Alcohol has the effect of enhancing the feeling of pleasure that you would normally feel by increasing neurotransmitter activity. When the alcohol is removed it may seem for a while that you no longer feel any pleasure until the brain readjusts.
Anxiety: Drinking alcohol has a tranquilising effect on your nervous system making you feel relaxed and calm. During the withdrawal period it may feel as though your nerves are in a heightened state of sensitivity, causing anxiety and even panic attacks.
Insomnia and sleep disturbances: Post alcohol withdrawal can take some time to establish regular sleep patterns. This can also lead to feeling tired all the time.
Sensitivity to Stress: many addicts use alcohol as a way to numb their emotions and escape from difficult situations. It can feel as though these emotions are out of control when they are left to experience them without the use of alcohol.
Alcohol Cravings: All these symptoms can leave the addict feeling as though they are unable to cope without the use of alcohol and they will often find themselves craving it. This can be the biggest cause of relapse.
The Importance of Being Aware of PAWS
As the symptoms of PAWS can sometimes not appear until up to several months after the acute withdrawal period, and do come and go, it can be tempting for a recovering addict to return to drinking in the belief that they are unable to cope without it.
If you are aware that this is a normal part of the recovery process it will be easier to accept it and deal with it. You will find it easier to work through this period if you focus on how far you have come, stay active, and keep fit and healthy to stay strong.