What is the link between addiction recovery and exercise? 

Not long ago, on their first day of treatment for alcohol use disorder (AUD), one of our clients told us a story.

They’d quit drinking once before – on their own – but relapsed. They committed to our residential program because this time they wanted help. They wanted their sobriety to last, and they realized the best way to achieve sustained sobriety was with the kind of support you can only find in a professional treatment program.

But we digress.

Here’s the story they told us about the first time they tried to quit.

At the first AA meeting they went to, 15 years ago, an old-timer was the guest speaker. He had an interesting life and an eventful recovery journey, so he was asked to talk to the group and tell his story. Our patient says never forget the first words that man said, standing up in front of the group of about 50 people at that meeting:

“Yeah, even though I’m glad I’m sober, I’m glad to be at a meeting, and I’m honored I was asked to speak here tonight, it makes me sad looking out at this group, because one thing I know is that there’s a good chance a lot of you aren’t going to stay sober.”

He went on to cite statistics about relapse rates and other scary stuff, then told his story. He was 72 years old. He’d first entered AA in his early 30’s. He stayed sober for 30 years. Then, just before he was about to retire, he relapsed. Not for one day, or one week, or one month.

For five years.

His behavior during relapse led to serious consequences. He lost his job. His wife left him. He lost the respect of his kids and burned through almost all his retirement savings. How? He took unnecessary trips. He spent money resolving a DUI. And of course, he spent way too much money on bar tabs.

Then he hit bottom and found his way back to AA. He’d just gotten his five year chip the week before he spoke at that meeting.

That’s the very definition of a cautionary tale.

Trigger Management: How to Handle the Bad Days

If you’re in recovery, these stories are important to hear.

Anyone with an alcohol use disorder (AUD) needs to remember that relapse can happen. It can happen after a week, a month, or a year. It happened to this man after 30 years. That’s why you should know ahead of time that if you’re in recovery, you’ll have bad days, just like anyone else has bad days. However, when you have bad days, you’ll want to drink. Or if you have a substance use disorder (SUD), you’ll want to use your drug of choice. And if you go back to drinking or doing drugs, the consequences may be severe.

We’re not saying you’ll spend your retirement money or end up divorced and estranged from your kids – but it can happen.

That’s why you have to plan for the bad days.

On your bad days, it will seem like triggers are everywhere.

Triggers – meaning external stimuli that elicit thought processes that can lead to relapse – are different for everyone. Trigger can be people, like family members, friends, or peers you used to drink or do drugs with. They can also be places, like bars you used to frequent, or places you used to get drugs. Triggers can also be sensory, like specific odors, or songs that evoke certain memories.

The one thing all triggers have in common is what they do to your thoughts and emotions. They can elicit patterns of thought and emotion that lead to relapse. That’s why a big part of treatment is trigger management.

Trigger management is learning how to process triggers so they don’t lead to relapse – and it’s one of the most important skills you’ll learn during recovery.

For some people, the very best trigger management skill they learn is very simple: exercise.

The Gift of Exercise

Exercise can be an important piece of the recovery puzzle. Some say it’s the most important piece of their aftercare plan and the only thing that really makes them feel better. Especially in the beginning, and especially on bad days. Since we don’t encourage people to put all their eggs in one basket, recovery-wise, we remind them that it’s one part of the entire recovery picture.

But we get it.

Exercise works.

The people for whom it works for tell us that no matter how much they want to drink or use drugs, their workout routine saves them. Without fail, they get started doing their thing – whether it’s yoga or running or lifting weights – and start to feel better in about ten minutes. The longer they work out, the better it gets. They feel the tension slipping away. They feel alive. Vital. And when it’s done, they feel better.

It works every time.

But why?

The Neurochemical Effects of Exercise for Addiction Recovery

What’s going on in my brain when you exercise? Research shows that exercise alters brain chemistry for the better.

Among other things, exercise:

Increases levels of norepinephrine, a hormone that regulates stress.

• Exercise creates a short-term stress on the body, but in response, the mind generates chemicals like norepinephrine, which help the body process stress hormones. In this way, one thing exercise does is allows the body to practice regulating stress.

Lowers levels of cortisol, a hormone that causes stress.

• Evidence shows that exercise intensity determines how much exercise decreases circulating levels of cortisol:
  • Low intensity exercise has a modest but noticeable effect on cortisol reduction. Low intensity exercise is any activity performed at about 30-40% of your maximum possible level of effort.
  • Moderate intensity exercise has a significant effect on cortisol reduction. Moderate intensity exercise is any activity performed at about 50-60% of your maximum possible level of effort.
  • High intensity exercise has the most significant effect on cortisol reduction. High intensity exercise is any activity performed at about 60-80% of your maximum possible level of effort.

Increases levels of serotonin, a neurotransmitter which combats depression.

• Studies show that during exercise, activity increases the amount of amino acids muscles require to function. When levels of these amino acids decrease, the chemical precursor to serotonin, called tryptophan, has a better chance of crossing the blood-brain barrier, where it becomes serotonin. High levels of serotonin in the brain correlate with both a reduction in stress and a reduction in depressive mood.

Increases levels of dopamine, a neurotransmitter related to both reward seeking and pleasure.

• Dopamine plays a complex role in human behavior. It’s involved in coordination, movement, and motivation.  It’s also known as the body’s feel good chemical because it contributes to feelings like bliss and euphoria. Decades of research show that exercise can increase levels of circulating dopamine in the brain. In addition, regular exercise over time leads to more efficient dopamine production, which contributes to higher default levels of circulation dopamine in the blood and brain.

Improves executive function in the brain.

• Research shows:
  • Aerobic exercise can lead to modest improvements in executive function, i.e. how well the mind processes information and makes decisions.
  • High intensity exercise like weightlifting can lead to significant improvement in executive function.
  • Exercise with a mix of low intensity activity, high intensity activity, and activity that requires heightened coordination – traditional martial arts, yoga, and chi kung, for instance – leads to more significant improvements in executive function than aerobic exercise or anaerobic exercise (e.g. weightlifting) alone.

Exercise and Recovery

Everyone in recovery deals with trigger-rich days.

That’s because just about everything involved with being a living, breathing adult – family, work, friends, bills – has potential to cause stress and anxiety. When stress and anxiety reach a critical threshold they can become triggers and lead to relapse.

And that’s where exercise comes in. On those challenging, trigger-rich days, exercise is an efficient and powerful coping mechanism.

People in recovery who rely on exercise as a primary coping mechanism say that exercise:

• Chills them out and gets them steady. They describe exercise like a brain reset: it helps them let go of the stress of the day and move forward with a clean slate.
• Gives them time to get away from it all. Exercise is their time to think things over, get perspective, and solve problems on their own terms. It’s the one time of day that’s theirs and theirs alone.
• Gives them something to look forward to. People who exercise in the morning may go to sleep early just so they can get up early and have a good workout. People who exercise in the evening look forward to it all day, and often use it as a transition between work and home life.
• Helps them feel connected. Many people go to group exercise classes like spinning, aerobics, yoga, or high-intensity interval training (HIIT). They form relationships with instructors and peers based on a shared activity that’s not drinking or doing drugs. This has many positive ramifications: more sober friends increases their chances of staying sober, as does learning to have fun and spend free time in a sober-friendly, healthy environment.
• Helps them feel better. Always. We say this above, and repeat it here because that’s the one thing everyone comes back to. Exercise makes them feel better in the moment. It may be hard to get started on some days, but before long, the resistance fades and the benefits appear: improved mood, improved self-esteem, and reduced stress. Again, the people that love to exercise report that it’s hard to find anything that works as well, as quickly, and as consistently as their daily workout.

Don’t just take it from them, though.

The research we cite above shows that exercise has a quantifiable neurochemical effect on the brain. It reduces stress and improves overall brain function. That’s what makes it an ideal sober-friendly activity, and a tool which everyone in recovery should have in their toolbox.

That brings us back to the anecdote we shared at the beginning of this article – the one shared by a new patient of ours about his first encounter and an AA meeting. We wonder: if the old-timer who spoke at that meeting had exercise in his life, perhaps he wouldn’t have had his devastating five-year slip. Maybe he could have avoided all that pain and difficulty, simply by adding exercise to his daily routine. And maybe, just maybe, if everyone in recovery adds exercise – a little bit every day – to their recovery/sobriety/aftercare plan, they may be able to reduce their chance of relapse and increase their chance at achieving long-term sobriety.

If you’re in recovery, we think you should give exercise a shot: at best, you’ll find a rock-solid, top-line activity. And at worst, you’ll get in shape.

Either way, that’s a win-win.

If you need help in the recovery process, The Ridge offers a comprehensive detox program that includes an inpatient rehab facility in Cincinnati, along with other treatments and therapies. You can contact today to learn more about it.

The misuse of alcohol or substances leads to functional changes in the brain, transforming addiction into a disease rather than a choice. Contrary to popular belief, addiction is not about strength, willpower, or moral character. Many individuals grappling with addiction often face questions from their loved ones, such as “Why can’t you just stop?” However, this question overlooks the true nature of addiction, as it is a medical condition rather than a simple decision like choosing between iced tea and soda.

Addiction is classified as a disease, just like many other medical conditions. To be considered a disease, the scientific community requires a disorder to meet three specific criteria: causing harm to the individual, presenting a consistent and identifiable set of signs and symptoms, and yielding abnormal test results when compared to a person without the disease. Addiction fulfills all three criteria, further emphasizing its status as a disease rather than a matter of personal choice.

Brain Scans Show Altered Function

That’s why scientists call it a disease of the brain.

The relevant test – the one that must yield an abnormal result when compared to an individual without the disease – is a brain scan. In this context, a brain scans is a sophisticated image of the brain that looks at the function, rather than the structure, of the brain. Neuroscientists have performed these brain scans on people with and without addiction. They know what a typical brain looks like, compared to the brain of someone with a diagnosed alcohol or substance use disorder.

When a brain is scanned, different colors in the scan reveal different levels of overall activity. As a rule of thumb, the darker the color, the more the activity. The waking human brain typically displays the highest level of activity toward the front, in an area called the prefrontal cortex. That pattern changes consistently in people diagnosed with AUD or SUD. In their brains, the prefrontal cortex shows less activity, while an area in the central part of the brain – the reward center –  shows more activity than in a typical brain. The abnormal brain scan is the key to understanding why people can’t make the choice to just stop using.

When we understand that the disordered use of alcohol or substances – a.k.a. addiction – has a physiological base, we know we can remove things like willpower, ethics, morals, strength, and choice from the equation.

Form and Function in the Typical Human Brain

Different brain areas have different functions, and there are connections between these different areas. One of these parts is the nucleus accumbens (NA). Neuroscientists call the NA the pleasure center or the reward and reinforcement center of the brain. The NA is a group of brain cells that have only one function: it causes an individual to repeat any behavior that stimulates those brain cells.

That’s interesting: it only exists to reinforce itself.

Why would we have a part of the brain like that?

The answer: survival.

Scientists theorize that it’s beneficial to repeat any behaviors that increase the likelihood of survival of the individual and/or the species. In that regard, there are certain behaviors that have always been very important to our survival. These include but are not limited to eating food/drinking water, having sex, and sleeping. These behaviors are salient. They matter a lot. They stimulate the NA, and therefore, we repeat them, and we repeat them frequently.

Another part of the brain that’s relevant to our discussion is the frontal lobe. The frontal lobe, or lobes, are located in the front of the brain. Neuroscientists call this the socialization center. It’s the part of the brain responsible for keeping track of everything our society or culture teaches us is good or bad, acceptable or unacceptable, right or wrong, and safe or unsafe. The frontal lobes are the part of the brain where we store information about ethics and morals are learned. When you tell someone to make a choice, the frontal lobes spring into action, no matter what the choice is about – good vs. bad, acceptable vs. unacceptable, etc.

Brain Form and Function During the Disordered Use of Alcohol or Substances

Now let’s talk about how the brain behaves when someone has an alcohol or substance use disorder.

We already know, by definition, that disease means altered function. In a typical brain, the frontal lobes are very active and dominate most conscious behavior. This means that when you have a choice to make, our frontal lobes – the place where we store everything we know and have learned – kick in. In a brain with the disease of addiction, however, the frontal lobes do not kick in the way they should. They do not dominate behavior. A different part of the brain takes over. Which one?

The pleasure/reinforcement center.

It becomes more active, and dominates.

Why?

Because it has been repeatedly overstimulated.

That’s the key.

Scientists know of thirty million mood-altering substances that affect the brain. Out of those 30 million, less than one hundred of them can lead to the disease of addiction. It’s rare. Think about it: only a tiny fraction of the total number have that result. The one thing that all mood-altering substances have in common is that they overstimulate the reinforcement center of the brain – and they do it to a far greater degree, to a higher intensity, and for a longer duration than any of the naturally salient stimulators of the reinforcement center.

It’s important to understand the reinforcement center does not recognize that mood-altering substances are abnormal. It’s there to get us to repeat whatever behavior stimulates it, not judge the stimuli. That’s what neuroscientists mean when they say that mood altering substances hijack the human brain. They affect the part of the brain that’s supposed to drive us to repeat whatever stimulates it. They stimulate it more than water, one of the few things on earth that’s absolutely necessary for our survival.

Stimulate and Repeat: The Cycle of Addiction

When a part of the brain is repeatedly stimulated, it becomes more active. In some cases, it becomes more dominant.

This impairs our decision-making process and creates a battle between our conscious frontal lobes and our subconscious pleasure center.

Which part of the brain will win the battle?

The part that’s more active. The part that’s dominant.

People with an alcohol or substance use disorder definitely know drinking and doing drugs is not good for them. Most of them want to stop. But because the thought “I want to stop” comes from the under-stimulated, conscious part of the brain – the frontal lobes – it gets overwhelmed by the subconscious reward center, which is stimulated over and over again by the addictive substance.

That’s why people with an alcohol or substance use disorder find it almost impossible to simply decide to quit, and that’s also why it often takes external factors – such as evidence-based treatment – to send the disease of addiction into remission. We advise anyone who thinks they have an addiction disorder to get a full evaluation from an addiction expert. When they learn their brain may have been hijacked by addiction – when they learn you have a disease of the brain – it increases their chances of agreeing to professional treatment and support.

Back to Balance: Rebuild Your Brain

One last thing: it’s critical to understand that it’s possible to restore your the brain to it’s typical form and function. Evidence shows that with abstinence, a brain that shows an abnormal scan can repair itself. It may take between one and five years, but it can return a typical scan, with no sign of the dysfunction associated with addiction.

That’s important.

That’s what real remission means, according to the medical model of disease: the absence of an abnormal test. A disease is not in remission until the relevant test – in the case of addiction, the brain scan – returns a typical result. When an individual with addiction seeks professional treatment and support for addiction, they can learn the skills necessary to maintain abstinence.

With abstinence, they stop overstimulating the reward center of their brain, which prevents it from dominating the decision-making center of their brain. Over time, their brain returns to balance. The part of their brain that evolved to make important decisions – the frontal lobes – once again dominates. When the frontal lobes dominate, the individual is no longer controlled by the reward center of their brain – and that’s the goal.

The Ridge Can Help

If you or a loved one is suffering with disordered use of alcohol or substances, The Ridge is here to help in the detoxification process. Contact us to learn more about the top drug and alcohol treatment Cincinnati has to offer.

Mindfulness for Addiction Recovery

In the 20th century, most people working in health sciences lumped mindfulness in with new-age practices that had no real evidentiary foundation that made them appropriate for clinical application in mental health or addiction treatment.

However, in the 21st century, the practice of mindfulness is no longer considered experimental. Once a novelty without much data or evidence to verify its benefits, research into the mechanisms and efficacy of mindfulness practices on health and wellness began in the 1970s. It gained momentum in the 1980s and 1990s. Then interest surged in the 2000s. Between 2000 and 2010, the volume of mindfulness studies published in peer-reviewed scientific journals exploded. This piqued the attention of the traditional medical establishment. It forced a shift in the way doctors, therapists, and health scientists view techniques once considered interesting but unverified fluff.

Since 2010, wide-ranging surveys and meta-analyses have addressed and verified the scientific basis for mindfulness. The current consensus is that practices such as meditation, yoga, tai chi, and basic breathing exercises are practical and effective components in the treatment of mental health disorders of all sorts. People in recovery from substance use disorders find mindfulness particularly effective.

This article offers a brief history of mindfulness in the U.S. We’ll discuss the neural mechanisms mindfulness training targets, and describe general theory to explain why mindfulness plays an important role in any treatment and recovery plan for people in treatment for substance use and addiction disorders.

Mindfulness in the U.S.

While a majority of the population may view mindfulness as a relatively new phenomenon, history tells a different story. Mindfulness arrived in the U.S. over a century ago. The renowned Indian guru Swami Vivekananda addressed the Parliament of World Religions in Chicago in 1893 tht’s now legendary. Vivekananda represented India, Hinduism, and yoga. But his speech triggered national interest in spiritual and physical practices from Tibet, China, and Japan.

In the decades that followed, the secular aspects of Hinduism, Taoism, and Buddhism – yoga, taiji/qigong, and meditation, respectively – slowly worked their way into American culture. The 1960s saw an explosion of interest in yoga. The publication of a popular series of books by Richard Hittleman helped. Then, in 1970, yoga made it to television. The show Yoga for Health proved yoga, and by extension, mindfulness practices in general, were here to stay.

Dr. Jon Kabat-Zinn, a researcher at the University of Massachusetts, conducted the first scientific studies on the mental health benefits of mindfulness. He began by examining the effect of mindfulness on chronic pain management. Next, he widened the scope of his research to include stress, anxiety, and depression. He synthesized his work into a system known as Mindfulness Based Stress Reduction (MBSR). MBSR is now a default therapeutic technique in use by therapists, treatment centers, and addiction experts worldwide.

It’s been combined successfully with a variety of traditional psychotherapeutic modes. These include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Relapse Prevention (RP). Evidence for the complete integration of MBSR with these techniques – and its acceptance by the scientific community – is reflected in a new family of acronyms. We now have MBCBT (Mindfulness-Based Cognitive Behavioral Therapy), MBDBT (Mindfulness-Based Dialectical Behavioral Therapy), MBACT (Mindfulness-Based Acceptance and Commitment Therapy), and MBRP (Mindfulness-Based Relapse Prevention).

Mindfulness Training: Neurochemical Mechanisms

For generations, neuroscientists believed that after a certain point early in life, the formation of new brain cells stopped. This misconception was debunked in the late 1990s, when scientists identified the formation of new brain cells in songbirds. They then documented the formation of new brain cells in adult humans in the early 2000s. A growing body of research proves definitively that mature humans can not only produce new brain cells, but the new brain cells can be produced in a relatively short amount of time. It only takes eight weeks – and the process can be facilitated by the practice of mindfulness techniques.

Mindfulness training results in an increase in brain matter density (neurogenesis) in the following brain regions:

Hippocampus

The hippocampus is an essential structure in the limbic network, the part of the brain primarily responsible for emotional regulation. The hippocampus also contributes to the formation of memory and cognitive functions like self-awareness, compassion, and reflection.

Amygdala

Part of the limbic network, the amygdala is known to be associated with sensations of stress and anxiety.

Posterior Cingulate Cortex (PCC)

The PCC is involved in the process of assessing the relevance of external stimuli to oneself. In addition, it contributes to placing these self-referential stimuli in an individual’s emotional and autobiographical context.

Cerebellum

The cerebellum is primarily known for its function with regard to sensory perception and motor control. However, it also contributes significantly to the regulation of cognitive and emotional processes.

Temp-parietal Junction (TPJ)

The TPJ facilitates the integration of internal and external sensory information, social cognition, and the ability to interpret the desires, intentions, and goals of others. Activation of the TPJ is linked to feelings of empathy and compassion.

The brain structures stimulated and strengthened by mindfulness training combine to form a functional group uniquely relevant to the treatment of substance abuse and addiction. Substance use disorders compromise and lead to deficits in emotional regulation, stress response, anxiety, self-awareness, social intelligence, and empathy.

While these deficits manifest in different ways for different people, their cumulative effect leads to dysfunctional behavior. This can manifest in the form of counter-productive coping skills. Self-medication – a common reason people use illicit substances – suppresses powerful emotions. Disproportionate stress-response and exaggerated anxiety increase the desire for self-medication. Distorted perception normalizes the self-destructive consequences of substance abuse. Diminished social intelligence and reduced empathy contribute to the tendency of people with substance use disorder to lose sight of the consequences of their actions.

Mindfulness training reinforces the neural mechanisms necessary to bolster the perceptive skills required to bring these deficits back into balance. It enables individuals to see and understand their behavior. This, in turn, allows them to build healthy and life-affirming coping skills that lead to sustainable recovery.

A Mindful Model of Addiction

A deep dive into the scientific literature available on the effects of mindfulness training on mental health disorders, including addiction treatment and recovery, leads the diligent reader to mountains of data describing the positive benefits of mindfulness. Most of these are related to well-being, mood, self-efficacy, stress tolerance, and the ability to gain a non-judgmental perspective on behavior. However, only one study elucidates the connection between Buddhist philosophy – the theoretical basis of most practical mindfulness techniques – and contemporary theories of addiction. In “Craving to Quit: psychological models and neurobiological mechanisms of mindfulness as treatment for addictions”, a 2012 paper published in Psychology of Addictive Behaviors, researchers apply the Buddhist theory of human suffering to substance abuse disorders.

They call it “an early model of addiction.”

The Buddhist Model

The Buddhist theory of suffering is relatively simple. It states that desire causes all human suffering. Therefore, the path to enlightenment – or in the case of regular people living 21^st century lives, the path to health and wellness – lies in releasing attachment to objects of desire.

Buddhist philosophy also asserts that personal identity is formed, in part, by associations created by habitual behavior. An individual desires an object or subjective sensation and connects fulfillment of that desire to a concept of identity. This reinforces both the habitual fulfillment-seeking behavior and concept of self to the sensations and emotional states achieved by fulfilling the desire.

In the case of an individual with a substance use disorder, pleasurable sensations that follow substance use are the objects of desire. Those sensations become an aspect of identity. When those sensations fade, so fades the habituated sense of identity. The fulfillment of desire, therefore, becomes the search to maintain identity. Identity becomes inextricably intertwined with substance use.

Mindfulness Training: Interrupting the Craving Cycle

The way to break this cycle is to separate the habituated sense of identity from the cycle of desire. Substitute the idea of craving for the phrase cycle of desire, and addictive behavior becomes logical. A person with an addiction craves reinforcement of their sense of identity. More simply put, they crave being themselves. In the case of an individual with an addiction, the created self is counter-productive. It damages long-term health, function, and survival. When the cycle continues in unchecked, iterative repetition, it undermines the true self by distorting emotion, perception, memory, and cognitive function. It supplants and ultimately destroys the original self and becomes the default state of identity.

Buddhist scholars call this cycle “the chain of dependent origination.” Craving is what connects identity to the chain. Therefore, breaking the cycle of craving enables an individual to escape the cycles of addiction. Mindfulness training teaches the skills required to see the cycle as it is – a self-destructive one – and replace it with constructive patterns of behavior. Dr. Lawrence Peltz, author of “The Mindful Path to Addiction Recovery: A Practical Guide to Regaining Control over Your Life” describes mindfulness training as

“… In essence, mindfulness is the quality of awareness that sees without judgment, shining a light on each moment just as it is. This includes physical sensations, feelings, thoughts, and the nature of our experience continually shifting and changing. With practice, it is a skill that can be developed by anyone.”

The first step in developing this important recovery skill is learning to slow the mind down, relax, focus, and “shine a light on each moment just as it is.” There are many paths to this mind-state.  Seated meditation, walking meditation, breathing exercises, and the practice of yoga postures all work. What all these techniques have in common is that they help an individual see what drives their actions. It helps them gain the perspective they need to decide whether those actions help them or hurt them.

Benefits Of Mindfulness In Recovery

Mindfulness allows an individual to observe, for instance, that stress triggers a cascade of emotions that leads to a particular behavior, like substance use. Mindfulness allows the individual to understand that though substance use temporarily alleviates the symptoms of stress, that same stress, anxiety, and tangle of uncomfortable emotions returns when the substance clears their system. The clarity of mindful perception can lead to the insight that substance use, in the end, does not work. This insight may lead new levels of understanding. The authors of “Craving to Quit” summarize the benefits of mindful perception in this way:

“By decoupling pleasant and unpleasant experience from habitual reactions of craving and aversion, careful attention to the present moment can function to bring a broadening or spaciousness of awareness that allows new appraisals of life situation. A possible result of this…is the ability of mindfulness to facilitate positive reappraisal.”

Using Mindfulness To Overcome Cravings

When a craving hits, habituated patterns drive behavior toward the self and identity created by addiction. Traditional therapies based on talking and thinking often fail to interrupt these patterns.  Mindfulness training – through breathing exercises, somatic practices, and the cultivation of non-judgmental detachment – teaches skills to stop the cycle of craving in its tracks. It allows the moment of craving to pass without acting upon it. It creates the internal space to replace the negative patterns of addiction with the positive patterns of recovery.

In the context of treatment and recovery, the power of mindfulness lies in its ability to support, complement, and functionalize more traditional modes of therapy. While methods such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Relapse Prevention (RP) help individuals identify patterns of behavior that undermine health and well-being, they do not offer specific techniques with the strength to arrest craving cycles during the critical moments in which cravings occur.

Final Thoughts On Mindfulness Based Addiction Treatment

For decades, mindfulness training has helped individuals with substance use and addiction disorders achieve balance and harmony in their lives. In the early days of the mindfulness movement, the scientific establishment often ignored these techniques. Those days, thankfully, are over. Advances in neuroimaging have allowed researchers to identify discrete changes in brain structure following mindfulness training. This research offers clear data on the mechanisms by which mindfulness supports recovery.

Coupled with a compelling, logical theory to elucidate the role of mindfulness vis a vis identity, choice, action, and behavior, mindfulness is now part of a 21st century approach to addiction treatment. It’s no longer a novelty. The mental health community now accepts mindfulness as an effective, practical, and evidence-based model of treatment for substance use and addiction disorders – and that’s a sign of real progress.

Keep Acute Stress from Becoming Chronic

Everyone gets stressed.

It’s part of the human experience.

And anyone who’s lived through the past two years in the U.S. knows all about stress.

2020 gave us the pandemic and the election season. 2021 gave us more pandemic, more politics, and a dose of complicated world affairs. Two months into 2022, and guess what? More pandemic and more politics. And now we’re on the verge of another election season, which means even more politics.

Unfortunately, we can’t put our heads in the sand like an ostrich and ignore everything around us until it goes away. Because even if it does go away, more stress will come.

That’s why we say it’s part of being human.

And that’s why each of us needs to learn practical stress management skills. If we didn’t, we’d all walk around all day stressed, worried, and probably irritable or outright angry. At our families, at our coworkers, at our friends, or at the world in general.

That’s no way to live.

Stress and Addiction Recovery

If you’re in recovery from an alcohol or substance use disorder (AUD/SUD) or undergoing a detox program, you know how important it is to manage stress. From the small stressors to the major life stressors, you have to learn how to deal with them all. Because for you, too much stress can lead to the one thing you most want to avoid: relapse.

You understand that when you don’t address your stress head on, it builds up. What starts small – if ignored – gets large. It can happen quickly. Like a snowball rolling downhill. Let it gain momentum and it gets hard to stop. The more momentum it gains, the harder it is to stop.

Therefore, you go to meetings. You follow your sobriety plan. You stick to your aftercare program. Your meetings give you a place to talk things out in a supportive environment designed for you to share anything and everything that threatens your sobriety or might lead to relapse. Your aftercare program includes daily activities that support your sobriety and, by design, reduce your overall daily stress levels. You spent time during treatment learning what works for you and what doesn’t, so you should have the tools you need to manage your days and nights.

Sometimes, though, all that gets tough.

Your program may seem like too much. It might feel overwhelming. You may find yourself in the tricky position of feeling like the thing designed to keep you from being stressed and preventing you from relapse is actually causing stress, which you know can lead to relapse. When that happens, it’s important to take a step back, get perspective, and recalibrate.

It’s time to get back to basics.

How to Recalibrate

The most basic thing to remember is that you need to stick to your recovery plan. But here’s an important point: if you’re not doing basic stress reduction as part of your daily routine, it can undermine your recovery plan and disrupt your sobriety.

That’s how this post will help you. We’re going to remind you of the essential basics of stress management, so you can review them, check them against your daily routine, and make sure you’re setting yourself up for both success in recovery and success in life.

We’ll start by giving you a quick refresher on exactly what stress is and how it functions in our lives.

Stress: What You Need to Know

It’s important to understand that stress itself is not a bad thing.

It’s actually a productive force in our lives.

But not all stress is good.

There are two different kinds of stress: acute and chronic.

Acute Stress

In most cases, acute stress is positive, although it doesn’t always feel positive when it happens. Acute stress is what happens in your brain and body in response to immediately threatening external stimuli. When you have a near miss driving your car and your adrenaline spikes – that’s acute stress. It’s our natural fight-or-flight response kicking in. When the threatening stimulus disappears, so does the stress. It may take a few minutes, but it happens.

We feel the rush, then we calm down. That’s totally normal. And that’s the course acute stress is supposed to take when we experience it. There’s a spike, a denouement, then a reset back to normal. It’s as if the commanding officer in your brain shouts “High Alert! Battle Stations!” then five minutes later says, “Threat passed! At ease, soldiers, as you were.”

Chronic Stress

Chronic stress is stress that persists for a longer period of time. It lingers after the immediately threatening stimulus disappears. And, more importantly, it can also appear in response to stimuli that are not an immediate physical danger, but instead, cause psychological discomfort. Think of spending months or years in a job you don’t like, a marriage you’re not happy in, or in circumstances you don’t like: that’s what chronic stress feels like.

The problem is, your body doesn’t know the difference between acute and chronic stress, and that’s when problems can happen.

If we extend the military metaphor, chronic stress is like when the commanding officer in your brain shouts “High Alert! Battle Stations!” and then never tells you to stand down or to be at ease. Your brain and body stay on high alert. Sometimes for days. Sometimes for weeks. And for some people, this state of high alert may last for months or years.

If you’re in addiction recovery, you know chronic stress is one reason many people turn to alcohol or drugs in the first place, and why many people relapse: it’s painful and overwhelming. That’s why anything you do to keep acute stress from becoming chronic stress is important: it can keep you from feeling overwhelmed, keep you grounded, and keep you on your sober path.

The Consequences of Chronic Stress

If you’re in recovery, you should understand that stress management is not just for you.

Everyone needs to know how to keep acute stress from becoming chronic stress.

Why?

We need to learn productive ways to cope with stress because, according to the Mayo Clinic, long-term exposure to stress hormones – a.k.a. chronic stress – has a significant negative impact on your emotions, on your body, and on your behavior.

The behavioral consequences of chronic stress include:

• Withdrawal from friends, family, and social activities
• Overeating or undereating
• Misuse of alcohol and/or drugs
• Tobacco use
• Exercising less

The emotional consequences of chronic stress include:

• Sadness/depression
• Anxiety
• Anger/irritability
• Decreased focus

The physical consequences of chronic stress include:

• Fatigue
• Insomnia
• Stomach problems
• Headaches
• Muscle/joint pain and stiffness

And as we mention, if you’re in recovery, you know about another negative consequence of stress. It increases the likelihood of relapse. That’s why it’s important for all people in recovery to know the signs of stress, and to have a robust array of stress management strategies and techniques at the ready.

How to Manage Stress: First, Identify It

Practical stress management can be tricky, but the most effective stress management techniques are simple and straightforward. The tricky part lies in recognizing when to apply them and applying them consistently. We’ll repeat the main point of this article: if you make stress management a habit, you’re ahead of the game.

Before we offer our five tips for creating the foundation for effective stress management in your life, we want to address what we mean by the trick lies in recognizing them. Here’s what we mean: it’s critical for you to understand that the behavioral, emotional, and physical consequences of chronic stress are also the symptoms of chronic stress.

And to tie this together for people in recovery, what we mean is that when you feel overwhelmed by recovery and by your program, it’s time for you to take inventory – a phrase you should recognize from your time in treatment and from participating in community support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).

You take your stress inventory by asking yourself the following questions, which are derived from the list above.

Personal Stress Inventory: Twelve Questions to Ask Yourself

1. Am I withdrawing from my friends, family, and my recovery community?
2. Have I been eating too much or too little?
3. Have I been thinking about drinking or using drugs?
4. Has my tobacco use increased?
5. Am I exercising less, or not at all?
6. Have I been unusually sad lately, and don’t know why?
7. Have I been unusually anxious lately, and don’t know why?
8. Am I more angry or irritable than usual?
9. Am I having problems concentrating at work, or following through on projects?
10. Have I felt tired all the time over the past few weeks?
11. Am I getting good sleep, and enough of it?
12. Have I been having unexplained stomachaches, headaches, or muscle/joint pain lately?

We don’t have an official scoring system for these questions. However, if you answer yes to at least half of them, we think you need to be honest with yourself: you’re probably stressed – and your stress management techniques aren’t keeping up with your stress levels.

We don’t have to remind you – again – what happens when your stress overmatches your capacity to manage it.

Thankfully, we know how to help.

How to Manage Stress: Our Five Top Tips

When you realize you let your stress levels get unmanageable, or let them approach unmanageable, it’s time to do what we say in the beginning of this article. It’s time to recalibrate and make sure you set yourself up for stress management success. If you’re in addiction recovery, stress management success is almost synonymous with effective relapse prevention: that’s why managing stress should be a top priority.

Here are our top five tips for beating the stress in your life:

1. Hobbies and Sober-Friendly Activities

Spend time doing things you love, like practicing hobbies such as reading, playing/listening to music, or anything you enjoy that’s sober friendly and feels good.

2. Exercise and Activity

Get out of the house and move every day. Stay active and exercise in any way that works for you. Start with simple, fun activities like walking, running, or taking group exercise classes. Find something you love doing, and do it as often as your schedule allows.

3. Mindfulness Practices

Learning mindfulness techniques such as meditation, deep relaxation, mindful walking, tai chi, or yoga can make a big difference in your life. If you learned these techniques during treatment but dropped them when you returned home, we get it. Sometimes responsibilities force us to put mindfulness practices – and self-care – on the back burner. Now is the time to get back to that yoga, tai chi, or meditation practice that helped you find balance during treatment. It can bring you back into balance, now.

4. Social Contact

This one is simple: connect with friends and family as often as possible. If you’re isolated, or in a place without many family or friends around, we recommend recommitting to your recovery community. Go to more meetings, find a sponsor if you haven’t yet, and say yes to any sober-friendly get-togethers or events organized by people in your community support groups.

5. Good Food Every Day, Three Times a Day

Eat a healthy, balanced diet high in whole grains, fruits, vegetables, and lean protein. This is truly the foundation of good health. That means mental health, emotional health, and physical health. To achieve recovery success you need all three, and food is a great place to start. You don’t have to go gourmet, you just have to get the basics right: three healthy meals a day.

If you’ve been so busy you find yourself justifying drive-through fast food more than you can care to admit, we sincerely urge you to keep driving until you get home to your fridge or to a grocery store with healthy options. We promise your body will thank you. And making a good, healthy choice will boost your self-esteem and increase your chances of avoiding temptation the next time all you want is that happy meal or triple-decker.

The trick, as we mentioned above, lies in making these stress busting techniques habits that you practice daily, rather than exceptions that you implement when stress overwhelms you. The core philosophy behind successful stress management is creating a strong foundation of positive routines for your mind and body. That way, when things in your life do get stressful, your mind and body can handle them without getting out of balance.