(PAWS) is it a real thing?

I’ve been feeling very ‘Pawsy’ lately. Been reading my blogging friends that are on a roughly the same day count as I am (91 days today). They all seem to be experiencing similar symptoms. Feeling generally down and anxious (not all the time) but sort of starting to wonder what the point is of being sober if you are going to feel shitty.

This got me thinking about PAWS. Is it a real thing? According to Wikipedia there have been few scientific studies supporting its existence. Because of this, the disorder is not recognized by the Diagnostic and Statistical Manual of Mental Disorders or major medical associations.

This isn’t enough to persuade me that it doesn’t exist. Alcohol research that is truly impartial and will expose the true extent of harm the drug does and how addictive it is is sparse to say the least. Remember, research needs to be funded by someone and alcohol companies do fund research that will publish studies that are skewed or that tell half truths.

A recent survey by a US website called postacutewithdrawal.org found that ninety per cent of respondents to their online survey reported post-acute withdrawal symptoms (PAWS). These results come as a bit of a surprise because it was assumed that only a minority of people who break away from addiction experience symptoms beyond the first few weeks.

Doctors and medical professionals that specialise and deal with drug addiction and withdrawal all know about and have direct experience with patients going through PAWS.

The length of time and severity of PAWS is linked to the amount of years and the volume you drank.

Post-acute withdrawal occurs because your brain chemistry is gradually returning to normal. As your brain improves the levels of your brain chemicals fluctuate as they approach the new equilibrium causing post-acute withdrawal symptoms.

The Symptoms of Post-Acute Withdrawal

The most common post-acute withdrawal symptoms are:

  • Mood swings
  • Anxiety
  • Irritability
  • Tiredness
  • Variable energy
  • Low enthusiasm
  • Variable concentration
  • Disturbed sleep

“The brain has tremendous capacity to heal, but it doesn’t heal quickly,” says Dr. David Sack, CEO of Promises Treatment Centers and Elements Behavioral Health.
As the body moves toward homeostasis, says Dr. Joseph Lee, Medical Director of the Hazelden Youth Continuum, it has to reach a “new kind of normal” in the process. Some people experience a more prolonged withdrawal, he says, “and it takes a long time to recalibrate.” In fact, instead of feeling better, many addicts in recovery feel worse.

The biggest thing Sack’s seen in his patients is increased anxiety. People are “more nervous, more anxious, less resilient; and that anxiety is experienced as fear, as uncertainty, a greater sensitivity to rejection.” Some of this excessive reactivity is linked to the glutamate neurotransmitter system, as many drugs of abuse block glutamate. In response, the body ups its production of this chemical, even after the drug is taken away. 

“The advice I would give is to be patient with the time it takes to heal and feel better,” Parrish says. “These tough issues weren’t created overnight, and they won’t disappear overnight. I have learned that when I feel particularly “PAWS-y,” that means I’m subconsciously working something out—this makes dealing with the symptoms of feeling a little crazy and not sleeping less exhausting. It won’t last forever.” 

extract from https://www.thefix.com/content/paws

I found this video from Annie Grace and Doctor Dr. Jaffe Ph.D from the Alternatives Addiction Treatment in Los Angeles that explains why it takes a while to feel better.


46 thoughts on “(PAWS) is it a real thing?

  1. Hi, hope you are OK? One thing we will never know is whether these things are alcohol related or not when each downer hits. I’m guessing people who have never touched a drop of alcohol or a drug in their life still go through phases like this and experience all if the above. The difference is with ex-drinkers, we automatically assume it’s down to the fact that we’ re not drinking and what is the point in not drinking if this is how we’re going to feel. I bet if you weren’t sober you’d probably be feeling shit with a whole heap of self-loathing on top. I’m still in the ‘grateful to have escaped the hell’ stage at the moment xx

    Liked by 4 people

  2. This video was really interesting – that guy sure knows his shit doesn’t he! What he was explaining really helps me understand how I was using alcohol to ‘shut my brain up’. My brain has obviously adapted over the years to being externally dampened by alcohol. So when I don’t have it, it doesn’t know how to be stable and calm – which explains the constant insomnia, anxiety, over-thinking, giddiness etc. Very interesting. Also, the lady said it was about 6 months until she felt much much better, which sounds sooooo long, but I bet it feels good when you get there (I wouldn’t know, I’ve never managed it, but I will keep trying) xxx

    Liked by 3 people

    • Yes this is a massive eye opener for me. Seriously my last couple of sober stretches were so weird and difficult I couldn’t get it together and I didnt see massive progress fast enough and that is why I started drinking again. Now that I have the knowledge I am more likely to muscle through. xxx

      Liked by 2 people

  3. I am still on the fence on PAWS. I think that certainly there is a change in our brain chemistry and in our bodies in general. Especially if you’ve been a very heavy drinker for a very long time. Now, I had hardcore withdrawals near the end. When in detox I had DT’s. For the first 3-6 months I was a zombie in some ways. But definitely the first two months were hard – always tired, emotional, etc. But is it all PAWS? I don’t know. Again, I agree that our bodies and brains are adapting. Absolutely. On the other hands, as someone mentioned, we all have bad days, sober or not. I get some of those “symptoms” now – who doesn’t get irritable? Or low enthusiasm for things? Do I attribute that to PAWS, or just being human?

    In the end, I am not entirely sure still. I may have to dive back into this – it’s been a few years since I’ve thought about PAWS, but it is interesting. Thanks for sharing this!

    Liked by 7 people

    • Hey Paul. Yes I agree its very broad and these symptoms can just be attributed to life or underlying mental health issues. I just find it interesting that the last couple of times I tried to get sober I only lasted 3-6-9 months due to everything not magically being amazing when I got sober. Like the guy in the video says, the problem didn’t happen over night so it makes sense that your body and brain needs time. I drank for many many years, large volumes. Don’t think three weeks is enough to fix and recalibrate the damage alcohol did especially to my brain. It would be great if someone would actually fund a propper study on this.

      Liked by 3 people

      • I agree. I think that the idea of life being unicorns and rainbows (and bunnies. Don’t forget the bunnies) after we get sober is mislaid. We are going to have bad days. Bad periods. I know because I get them now, even 5+ years sober. That’s life.

        But it would be interesting to see what the studies on this would be. But I wonder if because of what we just said – that life is life – how many people would erroneously attribute a bad day to PAWS? It’s a tough thing to measure, I imagine. And who would fund it? no idea. It would have to be a very impartial entity.

        Liked by 2 people

  4. Thanks for posing. I agree with everything you wrote. I love to hear the science behind it and the experience of those who have been through it. I cut myself a lot of slack when I was healing and it helped me to roll my eyes and say “oh it is PAWS I just need to muscle through. How about some more candy for you?” I do believe it is different for everyone and deeper and longer for some than others. My biggest symptoms were lack of confidence, unable to make a decision about much of anything and just a general lack of focus.

    I still have those days, but certainly less frequently and the feeling doesn’t linger for days. Hang in there!

    Liked by 2 people

  5. I think the general ups and downs are body healing AND normal changes that as drinkers we never experienced.

    For me, I fell into a severe depression. I became almost incapacitated with anxiety. I could not cope with life.

    I decided to try an antidepressant at that time and it changed my life. I had been self medicating for so long. After 3 years I still take it and probably will indefinitely.

    For me it brings me to a baseline where yoga, meditation, relaxation and treats help.

    That’s not the answer for everyone. Some anxiety and depression is completely normal. Suicidal thoughts are not. That’s why having help and support in early sobriety is do important.


    Liked by 4 people

    • Its difficult to differentiate the symptoms of PAWS from what could be an underlying mental health condition. I’ve always been prone to depression, was actually diagnosed as bipolar as a teenager. Getting anti depressants on the National Health Service is quite difficult in the UK. Will keep this in the back of my mind, thank you for the heads up Anne. xxx


      • Crikey Hurrah, come to Cornwall they give antidepressants out like candy here and seem to convince everyone they need them. I work in mental health and more than half of people could get better with simple CBT, mindfulness, yoga, diet etc.
        Bipolar has the highest incidence of addiction along with schizophrenia as they try to normalise. Do you know if you are bipolar 1 or 2?


      • Bipolar 2. I was diagnosed as a teenager and was on Lithium for years. When I moved to the UK I went off my meds and started drinking again. I want to see if I can sort this out without medication first. I’m so scared of being dependant on something and then not being able to get it if I need it. This is a tough time but hey I’m still getting up in the morning and brushing my teeth. That’s a big win in my book. xxx

        Liked by 1 person

  6. I believe it is a real thing. But for me I have had a turnaround with my thoughts about it. I am choosing to push ahead. Not to use it as an excuse for my poor behaviour. Fingers crossed.

    Liked by 5 people

  7. I really think it took me way over a year for me to heal and begin to learn how to deal with life.
    (I did have my cochlear implant operation at the same time, which made my body really confused.)
    I also slipped into a deep depression, but I think that was due more to my implant and the results.
    However, it wasn’t until my second year that I felt my energy increase.
    I am also dealing with sleep issues, that have plagued me.
    I don’t know if I had PAWS, but I sure had a bunch of other stuff!!

    Liked by 4 people

    • Hey Wendy! Yes it seesm that they say around a year. I know its diffrent for everyone. Wow thats amazing that you had to deal with recovery from surgery and from quiting drinking at the same time. Sleep is so important. It must be tough not being able to sleep enough. I really struggle if I dont. xxxx

      Liked by 1 person

  8. Great video and defo a few aha moments for me. PAWS is a real thing whether you cannot see it under a microscope or test it etc. It’s just a way of capturing all the things that the majority of people experience when quitting alcohol and suggesting that you will move through it out to the other side. Certainly for me in the first 3-6 months I would get all kinds of mood swings and weird feelings and after blogging about it people would invariably comment on it being PAWS and then I woul think ‘oh yes, of course it is’. This is how I know I am getting back to “normal”, today if I experienced a variety of symptoms I would assume it’s just “life” or my period coming. PAWS doesn’t make sense for me now which I think means I am pretty much through that. I think that it’s a guaranteed thing in the beginning PAWS is the go to answer but a check in with yourself periodically as you approach a year is a good way to see if it’s PAWS or just life.
    Keep going, I love the journey you are on and we are following.

    Liked by 2 people

    • Thank you Ginger! I’m just trying to find out as much as I can so that I don’t fall back into drinking again. I’ve learned so much and think if I knew about PAWS the last 4 years of relapses wouldn’t have had to happen. Anyway some people just have to learn the hard way, I’m obviously one of them. Thank you for your support and input I really appreciate it, more than you could know. xxx

      Liked by 1 person

  9. Being only in the first bit of sobriety, maybe I have not experienced PAWS yet, but I am inclined to agree with Paul and those who suggest that the symptoms of PAWS are those that have always existed under the booze. I had some trouble quitting drinking before and the anxiety and out of control feelings are (nearly) completely absent this time. I stunted my emotional growth by squashing the feelings and now they are ever-present. This time, I have yoga and meditation to get me through it and the yucky stuff hasn’t surfaced. I daresay – YET – but it is so valuable to hear your experiences as you forge ahead on your journey. The take-away – don’t get complacent – never know when there’ll be a rough spot! 🙂

    Liked by 3 people

  10. First of all WELL DONE! The good news is it really does get better. All those “antsy” feelings are so noticeable at the start but honestly when you see yourself getting through them with your own hard work and if it’s the case the support and love of others you’ll be so happy. Wishing you the very best …it was the best decision I ever made. So much out there and no hangover to get in the way of it🙂

    Liked by 3 people

  11. At somewhere near 75 days (trying not to “count” and get caught up in that…I can get number kooky)…I’ve been wondering why I’ve been a bit in a funk. This was a great post and discussion. (Hope everyone isn’t annoyed with all my “like” clicks) It’s been a good week to read…rather than write. This is new info for me to ponder! Thanks —to you and all who type!

    Liked by 2 people

  12. Wait a second, I think my life was just described as one big bout of PAWS. Ha. But seriously, congrats on 90+ days. Fantastic. And as for the PAWS, if you are having them, they are real for you. One thing Im coming to terms with is that everyone’s path is different and while we may have general similarities, as long as you embrace the feelings it will pass. Love the clip. So helpful and pretty much anything Annie Grace makes me happy.

    Liked by 2 people

  13. It’s so interesting reading all of the comments on here! I quit drinking at the end of October (end of September initially), and I had several events coming up (Christmas, a conference in February, and a trip in April) that I was so excited about being sober for and showing off the “new me”. I couldn’t wait for people to say “WOW! You look great! Have you lost weight? You’re glowing! Look how shiny your hair is!” (not that I’m super vain, but because I had read about those being the benefits to quitting drinking and was using that as a way to push through the initial few weeks of hell).
    Well… Christmas was a write-off because my skin was so freaking awful that I wanted to crawl under a rock and hide and I hadn’t lost any weight. I looked terrible.
    January it took every ounce of energy I had to drag myself to work, and once there I didn’t get anything done because I just couldn’t get my brain to even work! It was terrible! I was in a constant fog.
    Conference in February just happened and same thing – bad skin and no weight lost, still in a fog, and looking like CRAP.
    I have been exercising and eating more fruits and vegetables, I have been drinking lots of water, taking vitamins… I rarely drink pop and I don’t eat junk food. I HAVE been eating more chocolate (but not gorging on it for gods sake). Doing all that AND staying sober (and not smoking) and feeling like absolute crap for months has been honestly so frustrating and disheartening until I read about PAWS and thought “Ok, I can do this… I can make it through this… this is something that not everyone experiences and that’s why I don’t read about it too often…”
    So THANK YOU for posting about it and talking about it and opening up discussions about it. I think it’s so important for people to be aware that this is a possibility!


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