For many people battling addiction, transitioning from rehab back to their lives can be an emotional and complicated process.
Rehab gives people a chance to detoxify their bodies and gain some perspective on what's fueling their addiction behaviors. When they return to their lives and come face to face with all the triggers and stressors that were contributing to their disease, it can feel overwhelming. For some people, the transition can exacerbate feelings of anxiety and depression.
Shirley Hickman, MSW, a social worker at Mirmont Outpatient Center in Broomall, part of Main Line Health, who specializes in addiction treatment, says the hard work begins when you leave rehab. There is no single solution to combating depression after rehab. Rather, a mix of techniques — such as eating and sleeping well, exercising, and forming meaningful connections with yourself and the world around you — are needed to effectively manage addiction, and the behaviors the disease causes, after rehab.
Here's what causes depression after rehab and what you can do to cope:
Why do some people feel depression and anxiety after addiction recovery?
Addiction is a psychological disorder in which people experience patterns of distorted thinking, and substance use is a common symptom of the disease itself. People struggling with addiction typically go to rehab because their lives, in some shape or form, have become painfully difficult to manage.
During rehab, the body can detoxify and have some space away from the substances, triggers, and stressors that are contributing to the disease. Rehab also gives people the opportunity to gain insights about what's fueling their behaviors and distorted thinking. "You go into rehab, you stop your substance, and then you have to learn what you're up against," says Hickman.
After rehab, people have the challenge of leaving the "rehab bubble" and re-introducing themselves into the world with the goal of sobriety. They no longer have the full-time job of keeping up their substance use as their day-to-day agenda. Recovery doesn't end after rehab. In actuality, once a person leaves rehab, the real work has to begin, says Hickman. Where some people will feel motivated to conquer those issues after rehab, others will feel as though the transition, and the work it requires, is monumental.
In general, the causes of depression after rehab vary from person to person. People with addiction often have co-occurring mental health disorders that were already there before rehab. Others develop depression after traumatic life events that cause grief or loss.
Feelings of depression after rehab for drug addiction or alcohol detox could also be connected to chemical changes in the brain that are caused by months or years of substance use. After all, alcohol is a depressant and can bring on feelings of depression.
People recovering from substance misuse may experience post-acute withdrawal symptoms for up to a year, sometimes longer. These symptoms include brain fog, lack of mental clarity, racing thoughts, and problems with attention and focus. "It takes time for the body to adjust to the removal of toxic chemicals," says Hickman.
How can you cope with feelings of depression after rehab?
People recovering from addiction will need to make multiple changes in their lives when they leave rehab. "If you don't introduce any changes, you will revert back to old behaviors," Hickman said.
To cope with depression after rehab, it's crucial to continue treatment and find a support group. The disease doesn't disappear once a person has completed rehab and stopped using substances. The distorted thinking will still be there, and people must work at managing the symptoms and behaviors it causes.
Addiction feeds off of isolation, so socialization and connection are necessary for recovery. Hickman says people need to connect in three ways: with yourself, with the world around you, and with something that's bigger than you.
Connection with yourself involves practicing self-care and prioritizing your hunger, mental health, sleep, physical activity, and social life. Be patient with yourself and give your body what it needs.
Having support from others is another way to help prevent depression after addiction recovery and/or alcohol detox. There are many different support groups in which people who are recovering can form connections and hold each other accountable. Through these relationships, people can learn to ask for help, find value and self-worth, and not minimize what they are going through. "You need a list of people who you can call and talk to so that you're not doing it alone," Hickman said.
Finally, Hickman recommends connecting with something that's bigger than you. For some people, this means finding spirituality or religion; for others, it means connecting to the earth, nature, and energy. "Connecting to something bigger than you gives you a macro perspective of how you see your life," Hickman said. It lets you pull away from stressors in your life and see things from a bigger perspective.
While recovering, it's also important to regularly check-in with a psychiatrist or physician. They can help you take your medications as prescribed once you're out of rehab. "Medication management is so key," Hickman said.
There is no single solution that will make your life better after rehab. You have to eat right, exercise and sleep well, take your medications properly, connect with others, and find ways to release stress.
"You need a plethora of things," Hickman said. "If [you] are no longer present for [yourself], then the disease steps in."