Relapse Warning Signs

Read the following lists of relapse warning signs. Place a check mark next to any that have happened to you. Place a question mark next to any that you do not understand. Underline any words that cause you to have strong thoughts or feelings, make you want to do something.

Phase I: Internal Warning Signs

  • ___ Trouble thinking clearly: Sometimes I cannot understand what is going on. At times, it is hard to think, or I can only think about the same thing over and over. At times I cannot think at all, or when I do, I make mistakes that I usually would not make.
  • ___ Trouble managing feelings and emotions: Sometimes I have mood swings. I go from feeling excited to feeling depressed within a matter of minutes. Sometimes I do not feel anything when I know I should. At times the way I feel does not match up with anything that is happening. At times I feel or act crazy and feel bad later. When these things happen, I try to forget about them.
  • ___ Trouble remembering things: At times, I forget things I have just learned. Sometimes I can remember things from the past and other times I can’t, no matter how hard I try. Sometimes when I can’t remember, I make mistakes that I feel bad about later.
  • ___ Trouble managing stress: Sometimes I do not know when I am tense until I become really uptight. When I try to relax, it gets worse. Sometimes it gets so bad that I am afraid I might collapse or go crazy.
  • ___ Trouble sleeping: At times, I cannot sleep at night. When I do, I still feel tired the next day. Sometimes I have strange dreams and nightmares, including dreams about using that seem real. Sometimes I get very tired and sleep much longer than usual.
  • ___ Trouble with physical coordination: Sometimes I stagger, have dizzy spells, stumble, or have accidents. At times reading and writing become more difficult.
  • ___ Feelings of shame, guilt, and hopelessness: At times I feel guilty and ashamed. I think something is wrong with me and I am afraid I won’t get better. When these things happen, I try to take care of them on my own. I do not tell anyone. No matter how hard I try, things seem to get worse and I begin to think it is hopeless to try.

Phase II Return of Denial

  • ___ Concern about well-being: Sometimes I worry about my recovery. This worry comes and goes and doesn’t seem to last very long.
  • ___ Denial of the concern: In order to deal with these worries, I try not to think about them. Soon I forget what I was worried about. Sometimes even when I try to remember, I can’t.

Phase III: Avoidance and Defensive Behavior

  • ___ Believing “I’ll never use again”: Sometimes I believe I will never use alcohol or drugs again. Sometimes I tell others, but most of the time I keep this to myself. When I start believing this, I do not feel I have to work as hard to stay clean and sober.
  • ___ Thinking about others instead of myself: When I stop working as hard to stay sober and clean, I find myself blaming other people for my problems. Sometimes I think others should be acting differently, and I criticize them to others or to myself.
  • ___ Defensiveness: when I start thinking this way, I feel as if others do not like what I am doing. I get angry when people try to talk to me and I avoid them. I do not let other people talk, or I do not talk so they won’t find out how I feel.
  • ___ Compulsive behaviors: I overdo things and get wrapped up in things so I do not have time to think. I may get over-involved with work, sex, food, exercise, or AA, just so I do not have to think about or feel my problems. This doesn’t make my problems go away.
  • ___ Impulsive behavior: I become so stressed out that I do things on the spur of the moment that I feel bad about later.
  • ___ Tendencies toward loneliness: Even though I want to be around people, I make excuses so that I do not have to. I spend more time alone, and do things to avoid thinking and feeling.

Phase IV: Crisis Building

  • ___ Tunnel vision: I look only at a small part of my life, and ignore everything else. When little things go wrong, I blow up and feel like life is unfair.
  • ___ Minor depression: I start to feel down and depressed. I have less and less energy, and I oversleep. I try not to feel these things by getting busy and not talking about it, but the feelings do not go away.
  • ___ Loss of constructive planning: I stop making plans for my day and react to whatever comes up.
  • ___ Plans begin to fail: My plans are not well thought out or realistic. I begin to have more and more problems. I feel bad about them, but do not know how to solve them.

Phase V: Immobilization

  • ___ Daydreaming and wishful thinking: I daydream about something that might solve all my problems like winning the lottery or running away to another place.
  • ___ Feeling that nothing can be solved: I begin to feel as if I have failed at recovery. Nothing I do appears to make things better.
  • ___ Unfulfilled wish to be happy: I want things to work out and I want to be happy, but I don’t know how to make them better or I’m afraid to try.

Phase VI: Confusion and Overreaction

  • ___ Periods of confusion: I can’t figure anything out. This makes me angry with myself and I become more confused.
  • ___ Easily angered: I become angry with people over little things. I feel angry most of the time and am afraid I might hurt someone. Sometimes I want to hurt others.
  • ___ Irritation with friends: When other people try to talk to me about what is going on, I think they are criticizing me and we have arguments.

Phase VII: Depression

  • ___ Irregular eating habits: I stop eating regular meals, and eat junk food instead. I either overeat or eat little or nothing.
  • ___ Lack of desire to take action: I feel scared and trapped. It seems impossible to start, let alone finish anything.
  • ___ Irregular sleeping habits: I find it impossible to sleep until I am completely exhausted. When I finally get to sleep, I have bad dreams and may sleep for 12 to 20 hours at a time.
  • ___ Loss of daily structure: I get so stressed and miserable that I cannot make decisions. I miss appointments and meetings. Sometimes I plan on going, but I am running so late that I decide not to go at all.
  • ___ Periods of deep depression: I feel hungry, angry, lonely, and tired. I feel angry with others. They try to help, but I think that nobody really cares.

Phase VIII Behavioral Loss of Control

  • ___ Irregular attendance at recovery and treatment meetings: I stop going to my regular recovery meetings. I miss counseling appointments. I begin to feel that there are more important things to do and that the sessions aren’t helping anyway.
  • ___ Development of an “I don’t care” attitude: I feel like everything is hopeless. I don’t want other people to know this, so I act as if I don’t care.
  • ___ Open rejection of help: When people try to help me, I blow up and drive them away. I tell others that I do not need their help and avoid anyone who might see how I really feel.
  • ___ Feelings of powerlessness and helplessness: Things appear to be so bad that it seems useless to try to do anything to make them better.

Phase IX: Recognition of Loss of Control

  • ___ Self-pity: I feel sorry for myself and try to get sympathy and attention from friends or recovery and family members.
  • ___ Thoughts of social drinking: I start thinking that maybe I could drink or use drugs and stay in control. I think about how good it would feel to drink or use drugs for just a little while.
  • ___ Conscious lying: I start to lie to others even when I do not need to.
  • ___ Complete loss of self-confidence: I think I am a total failure at recovery and in life. I do not believe that I can change things for the better, no matter what I do.

Phase X: Option Reduction

  • ___ Deep resentments: I feel angry with the world and feel as if everyone is against me.
  • ___ Discontinue all treatment and recovery offerings: I do not attend recovery meetings, avoid my sponsor, and have stopped going to counseling or aftercare.
  • ___ Overwhelming loneliness, frustration, anger, and tension: I begin to feel like I am insane and think my only choices are drinking or using drugs, suicide, or insanity.
  • ___ Loss of behavioral control: I have problems in all areas of my life. I cannot control how I act think, or feel.

Phase XI Return to Use, or Physical/Emotional Collapse

  • ___ Return to “controlled” use: I try to use with control and sometimes I am able to do this for a short period.
  • ___ Shame and guilt: I feel ashamed and guilty for using and believe that if I had done things the right way, this wouldn’t have happened to me. I believe I am a bad person because I’ve started to use again.
  • ___ Loss of control: I begin to use just as much or more than I did before.
  • ___ Life problems: I begin to have severe problems with my spouse/partner, job, friends, health, or the law. I need professional help in order to get better.

From: Relapse Prevention Workbook for Chemically Dependent Criminal Offenders