Author: Kayla Gill

With 9 years in the rehab space, Kayla has overseen the creation of comprehensive addiction treatment content for online audiences worldwide. Her experience managing content for a luxury destination rehab, and her personal path to healing via residential rehab and various therapeutic modalities, inform her first-hand understanding of recovery. She takes inclusion seriously and is especially interested in how trauma and minority experiences shape readers’ journeys.
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Anorexia vs. Bulimia: Knowing These 4 Key Differences Can Improve Your Recovery

You might think anorexia and bulimia are pretty much the same thing, but actually, they work in very different ways. Learning about these differences isn’t just about knowing medical facts—it can help you spot warning signs in yourself or someone you care about. 

Let’s look at how anorexia and bulimia compare and what physical signs, behaviors, thinking patterns, and health risks are unique to each condition. We’ll also explain treatment options and where to find help, whether you’re trying to understand your own experiences or are concerned about a loved one. 

Before getting into the specific differences between anorexia and bulimia, what exactly is an eating disorder, and what makes them so serious?

What Are Eating Disorders?

Eating disorders are serious mental health conditions that involve harmful eating habits and troubling thoughts about food and eating, as well as distorted body image. About 9% of people in the U.S. will have an eating disorder in their lifetime.1 Women and girls are diagnosed more often, but anyone can develop these conditions.

Anorexia nervosa and bulimia nervosa are 2 of the most well-known eating disorders. They share some features but work differently in terms of eating behaviors, symptoms, and health effects. Other types include binge eating disorder and avoidant/restrictive food intake disorder (ARFID).

Eating disorders aren’t choices or phases—they’re complex conditions influenced by genes, biology, psychology, and social factors. They can seriously harm people’s physical health, emotional well-being, and everyday life. But with quality treatment and support, people can and do recover—though that journey looks different for each person.

Infographic showing the top underlying causes of both anorexia and bulimia, including distorted body image, fear of weight gain, perfectionism, low self-worth, personal shame, anxiety or depression, and unresolved trauma, illustrated with symbolic icons and rooted fork and knife.

Anorexia Nervosa: Key Characteristics

Anorexia involves severely limiting food and having an intense fear of gaining weight, even when you’re already underweight. People with anorexia usually see their bodies differently than others do. For example, they may think they look fat even when they’re actually very thin.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), to be diagnosed with anorexia,2 someone must eat so little that they’re at an unusually low weight, be terrified of gaining weight, and have a distorted view of their body. There are 2 main types: The restricting type (mostly limiting food) and the binge-eating/purging type (restricting but sometimes also bingeing and purging).

Physical signs of anorexia3 include:

  • Extreme weight loss
  • Always feeling tired or dizzy
  • Complaining about being cold all the time
  • Development of fine hair all over your body
  • Constipation
  • Brittle nails
  • Dry skin
  • Stopped menstruation

Many people who struggle with anorexia create strict food rules, like cutting food into tiny pieces, only eating at certain times, or avoiding meals with others.

The mental side often includes:

  • Constantly thinking about food, calories, and weight
  • Feeling a sense of control or achievement when restricting food
  • Difficulty recognizing how serious your condition is
  • Reluctance to ask for help

How can clinicians better identify bulimia given its “hidden” nature compared to the more visible signs of anorexia?

Being direct and sensitive when asking about binging or purging is important. It can be easy to dance around the topic, but it’s important to bring light to it in sessions so clients can be challenged. There is a delicate line to balance here, and it can be managed with tone, building trust, and appropriate timing. Clinicians can also ask about their recent diet history and exercise patterns. This may not directly or completely uncover behaviors, but it can be a leading indicator of areas where there may be some concerns.

Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C

Bulimia Nervosa: Key Characteristics

Bulimia involves cycles of eating huge amounts of food (binging) and then trying to prevent weight gain through behaviors like throwing up. During binges, someone eats an excessive amount of food in a short window and feels like they can’t stop or control their eating.

After binging, people with bulimia try to “undo” the calories they ate by making themselves throw up, taking laxatives or diuretics, fasting, or exercising too much. Unlike people with anorexia, those with bulimia usually stay at a normal weight or slightly above, which makes the condition a lot harder for others to notice.

Physical signs of bulimia4 might include:

  • Puffy cheeks
  • Dental problems from stomach acid
  • Calluses on knuckles from self-induced vomiting
  • Weight that fluctuates up and down
  • Stomach problems
  • Imbalanced electrolytes
  • Acid reflux
  • Chronic sore throats
  • Heartburn

The binge-purge cycle often happens in secret and makes people feel disgusted, guilty, or ashamed. Despite these negative feelings, the cycle is hard to break because both binging and purging can temporarily make emotional pain feel better. Like anorexia, bulimia involves intense worry about body shape and weight, but the approach to food is very different.

Infographic comparing anorexia and bulimia, showing anorexia involves severe food restriction and symptoms like always feeling cold, strict food rituals, and negative body talk; while bulimia involves overeating with compensatory behaviors and symptoms like frequent bathroom trips after meals, puffy cheeks, and hiding food.

Major Differences Between Anorexia and Bulimia

Physical Appearance

The most obvious difference is how people with these disorders typically look. Those with anorexia are usually very underweight, while people with bulimia may maintain their normal weight or be slightly overweight. This means you can often see anorexia, while bulimia can stay hidden for years.

Eating Patterns

The eating patterns are also quite different. People with anorexia mainly restrict their food intake,5 eating very little or avoiding certain foods completely. People with bulimia swing between episodes of binge eating (eating large amounts of food at a time) and compensatory behaviors to try to get rid of those calories.

Relationship to Food

These conditions cause different feelings about food, too. People with anorexia tend to create strict rules about food and may feel anxious about eating. Those with bulimia typically feel out of control during binges, often eating foods they normally avoid, then desperately trying to counteract what they’ve eaten.

Emotional Experience

The emotional experience is different as well. Anorexia often brings a sense of accomplishment from restricting food and losing weight, while bulimia usually involves intense shame around binging and purging. 

Binge eating disorder (BED) and orthorexia survivor Elisa Aas describes how shame fueled the cycles of her disordered eating:6 

You feel you abused food and your body so much you don’t deserve to enjoy food again.

Both of these conditions make people feel unhappy with their bodies, but how that shows up in behaviors is quite different.

Finding and diagnosing these disorders also follows different paths. Anorexia tends to be diagnosed earlier on7 because of visible weight loss, while bulimia’s secretive nature and normal-looking weight make it harder to notice from the outside. This difference can affect how quickly someone gets help, and what kind of help they need.

Infographic illustrating the top health risks of anorexia and bulimia; anorexia risks include heart problems, weakened bones, organ failure, hormone disruption, and muscle breakdown, while bulimia risks include digestive damage, tooth erosion, swollen glands, kidney strain, and electrolyte imbalance.

Key Similarities Between Anorexia and Bulimia

Though they may look different, anorexia and bulimia have important similarities. Both involve judging your self-worth largely based on your weight and body type. People with either condition often measure their value as a person by how they look8 or how well they can control their eating.

Risk Factors

Both anorexia and bulimia can come from similar risk factors,9 including genetics, personality traits like perfectionism, history of dieting, and cultural pressures around thinness. Traumatic experiences, family dynamics, and other mental health issues like anxiety or depression can contribute to both disorders.

What are the most promising developments in eating disorder treatment that address both the physical and psychological aspects of these conditions?

The most promising development I have seen in eating disorder treatment for Anorexia and Bulimia is the increase in adoption of the Health at Every Size Approach.  So often, patients living in larger bodies have fallen by the wayside due to the stereotypes of what an eating disorder ‘should look like,’ when eating disorders are, first and foremost, mental illnesses that have a physical impact. 

By treating the physical impacts of the disorder but not using them to determine the severity of one patient’s condition over another, and incorporating a variety of therapies (such as DBT, ACT, CBT, and family therapy), eating disorders are being treated at all angles.  As a person in recovery who has lived in a larger body for most of my life, paired with my professional experience, I have witnessed how the Health at Every Size Approach leads to creating more inclusive treatment plans and lasting positive outcomes.

Sage Nestler, MSW | Releasing the Phoenix

Coping Mechanisms

There’s significant overlap between eating disorders,10 especially among people with anorexia. One study found that of the participants with anorexia, over half switched between the restricting and binge-eating/purging, and one-third developed bulimia. But interestingly, people initially diagnosed with bulimia nervosa rarely developed anorexia. So while diagnostic crossover is common in eating disorders, it tends to follow specific patterns. 

Both of these sets of behaviors serve as strategies for coping with difficult emotions and life stress. Behaviors like restricting food or binge-purge cycles temporarily relieve anxiety, distress, or emptiness. That emotional relief and sense of control11 make both conditions very hard to overcome without addressing the underlying psychological needs they’re meeting.

Impacts on People’s Lives

Finally, both of these common eating disorders seriously impact people’s quality of life, causing distress and making it hard to function at work or in social settings. They isolate people from their support networks at a time when they need connection the most.

Health Risks and Complications

Anorexia and bulimia both cause serious health problems, but in different ways. 

Health Risks of Anorexia

Anorexia has the highest death rate12 of any mental illness, with risks coming mainly from malnutrition that affects every system in the body. Severe malnutrition can cause: 

  • Heart problems
  • Bone loss
  • Muscle wasting
  • Hormone imbalances
  • In the worst cases, organ failure

Health Risks of Bulimia

Bulimia’s health risks13 come mainly from purging behaviors. Frequent vomiting can cause:

  • Irregular heartbeat from electrolyte imbalance
  • Cardiac arrest in severe cases
  • Damage to the digestive system
  • Tooth erosion
  • Swollen salivary glands

Overusing laxatives or diet pills can lead to:

  • Laxative dependence
  • Chronic digestive problems

Hormonal Imbalance

Both disorders can affect fertility and hormones. In anorexia, periods often stop14 due to low body weight and fat percentage. While people with bulimia may continue having periods, hormone disruptions can still happen, which can affect their fertility and bone health.

Long-Term Problems

Long-term problems differ somewhat between these 2 conditions. With anorexia, long-term malnutrition15 can lead to: 

  • Permanent bone density loss and an increased risk of fractures
  • Heart complications (bradycardia, arrhythmias, hypotension)
  • Brain changes and cognitive impairment
  • Reproductive issues 
  • Pregnancy complications 
  • Gastrointestinal problems
  • Weakened immune function
  • Electrolyte imbalances that affect multiple organ systems
  • Increased overall mortality risk if left untreated

Bulimia’s long-term effects16 include: 

  • Chronic digestive problems
  • Dental complications (tooth decay, gum disease)
  • Higher risk of esophageal cancer from repeated exposure to stomach acid
  • Osteoporosis due to nutritional deficiencies
  • Menstrual irregularities and reproductive problems
  • High cholesterol 
  • Increased risk of diabetes
  • Heart irregularities and arrhythmias
  • Severe dehydration and electrolyte imbalances
  • Anemia

While some health issues like amenorrhea, acute dehydration, and certain heart problems may go away after recovery, others like osteoporosis, reproductive issues, diabetes risk, and cholesterol problems may need ongoing medical monitoring.

Medical Emergencies

If you experience fainting, chest pain, difficulty breathing, seizures, or blood in vomit, please seek emergency medical care immediately—these are not symptoms to ignore or push through. These signs indicate your body is in serious distress and requires urgent professional attention. We know reaching out to someone about an eating disorder can feel overwhelming, but regular medical supervision is absolutely essential to monitor and address these potentially life-threatening complications.

What approaches are most effective for families supporting a loved one in the early stages of eating disorder recovery?

It is important for families of loved ones in eating disorder recovery to be gentle and firm simultaneously. Be gentle in a way that validates one’s feelings, but be firm in not accommodating anxiety around eating. What would that look like? One may say to their loved one, ‘I can understand how you feel, and it is important to follow your therapist’s recommendations and eat to nourish your body.’ Using the word ‘and’ instead of ‘but’ validates both aspects of one’s experience and their long-term goal.

Jennifer Chicoine, MA, LCPC, CCTP | Peaceful Healing Counseling Services

Treatment Approaches

There’s real hope for recovery from eating disorders—both anorexia and bulimia respond well to proper treatment,17 and many people go on to live healthy, fulfilling lives free from these struggles. While the journey has its challenges, effective treatments exist and are continually improving.

Treatment approaches for anorexia and bulimia share some similarities, but also have important differences tailored to each condition. For someone with anorexia, especially when their weight has become dangerously low, the first priority is ensuring medical stability and safety. This compassionate healthcare might include time in a hospital or inpatient treatment center where a team of medical professionals can help restore weight in a gentle, supportive way.

With bulimia, treatment typically focuses on breaking the cycles of binging and purging and rebuilding a healthier relationship with food. Outpatient therapy is often the starting point, but some people might need additional medical support to address health complications. 

People can and do recover, and build lifelong healthy relationships with food.6 As Aas says,

You deserve to eat, you deserve to recover from an eating disorder, you are worthy of love, you are worthy of acceptance—mainly from yourself.

Learn more about evidence-based approaches that can transform your journey to recovery in our guide to finding treatment for eating disorders.

Therapy

Both conditions benefit from psychotherapy, but the approaches might differ. For people with anorexia, family-based treatment (FBT)18 shows strong results, especially for adolescents. This approach empowers their family members to take an active role in their recovery.

For bulimia, cognitive behavioral therapy (CBT) is often the go-to treatment. It helps people identify unhelpful thought patterns, develop regular eating habits, and learn healthier ways to cope with their feelings. 

Both conditions can also benefit from dialectical behavior therapy (DBT),19 which teaches skills for managing emotions and relationships.

Nutritional Counseling

Nutritional counseling plays a major role in treating both disorders, though the goals differ. For anorexia, the focus is on gradually increasing food intake and expanding variety. For bulimia, establishing regular eating patterns and challenging food rules is key to breaking the binge-purge cycle.

Medication

Medication has a more established role in bulimia treatment, with certain antidepressants showing effectiveness in reducing binge-purge behaviors.20 For anorexia, medication is less commonly the primary treatment but may help with co-occurring conditions like anxiety or depression.

Compassionate, Comprehensive Recovery and Support for Eating Disorders

Healing from an eating disorder takes both professional guidance and loving support. The journey looks different for everyone—people with anorexia may start with rebuilding their physical health, while people with bulimia may focus on establishing gentle routines.

When friends and family create spaces free of food judgment, recovery flourishes. And with compassionate professionals by your side, even setbacks become stepping stones.

Many people with these conditions find their way to complete recovery. Your struggle isn’t a personal failure—it’s a health condition that responds to care. If you’re suffering, find an eating disorder treatment program that meets your needs and reach out to a specialist today. 

You deserve support, and healing is within reach.

FAQs

Q: What causes anorexia and bulimia? 

A: These eating disorders develop from a mix of genetics, personality traits, family dynamics, and social pressures. Things like perfectionism, stress, and cultural beauty standards also play a huge role. They’re not choices or personality flaws—they’re serious health conditions that need supportive care.

Q: How do you know if someone has bulimia? 

A: Signs of bulimia include sneaking off to the bathroom after meals, swollen cheeks, calluses on knuckles, excessive exercise, dental issues, and missing food. People with bulimia often succeed in keeping it hidden because their weight might not change much, but they struggle in secret.

Q: Will I ever accept being at a normal body mass index (BMI)? 

A: Healing takes time, but yes, many people learn to feel comfortable in their bodies with the right support. Therapy helps challenge negative thoughts, and focusing on what your body can do instead of just how it looks can make a big difference.

Q: What are the first steps in getting help? 

A: Start by talking to your therapist, doctor, or someone you trust. You can also use an independent, non-biased treatment finder or call the National Eating Disorders Association helpline (1-800-931-2237). A specialist can help figure out the best plan for you. 

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Kratom Withdrawal: 7+ Steps for Easing Symptoms and Promoting Healing

Kratom seems like a mild, harmless drug, but it affects the brain in similar ways to opioids, and withdrawals can be very uncomfortable. Many people feel sick or have intense cravings when they try to cut back or stop using kratom similar to symptoms of opioid use disorder.

Everyone’s experience with kratom withdrawal is different. Some people have mild symptoms while others struggle more. Here’s what to expect to help you mentally prepare, make the process easier, and set yourself up for success.

We’ll take a deeper look at what kratom withdrawal feels like, how long it lasts, and what you can do to help yourself feel better and improve your chances of staying sober. We’ll also talk about when it might be time to get professional support.

Infographic titled '7 Common Symptoms of Kratom Withdrawal' featuring illustrated icons for each symptom: anxiety and restlessness, muscle aches and body pain, nausea and digestive issues, sleep problems, kratom cravings, fatigue and low energy, and mood swings and depression. A silhouette of a distressed person stands inside a large kratom leaf on the right.

What Is Kratom?

Kratom (Mitragyna speciosa) is a tropical tree1 related to coffee that grows naturally in Thailand, Malaysia, Indonesia, and other parts of Southeast Asia. For centuries, local workers chewed the leaves or brewed them into tea to fight fatigue and increase productivity during long workdays. It’s gained popularity in recent years as a recreational drug.

Today, people use Kratom for pain relief or to help with opioid withdrawal. While it might seem helpful at first, regular use can cause you to become physically dependent, making it hard to stop.

How Kratom Works in Your Body

When you take kratom, chemicals in the plant called alkaloids2 (mainly mitragynine and 7-hydroxymitragynine) interact with receptors in your brain. At low doses, these chemicals create mild stimulant effects, making you feel more energetic. At higher doses, the create opioid-like effects,3 producing pain relief and feelings of pleasure or relaxation.

Kratom use is complex because it affects multiple brain systems at once. It activates opioid receptors (like morphine or oxycodone would), but also impacts other systems that regulate your energy and mood. This complex pharmacology explains why kratom can be both stimulating and sedating.

Kratom is not as high-risk as some other substances, but it can have serious side effects that should be taken seriously. Per the National Institute on Drug Abuse (NIDA).

Rare but serious effects have been reported in people who use kratom,4 including psychiatric, cardiovascular, gastrointestinal and respiratory problems.

Infographic titled 'Common Reasons People Turn to Kratom Use… Despite the Harmful Risks' showing three categories of motivation: Relief & Coping (chronic pain, opioid withdrawal, anxiety and stress, emotional strain), Boost & Performance (increased focus, energy boost, mood lift), and Social Influence & Curiosity (peer influence, curiosity about effects, perceived natural high). Each reason is represented with an icon inside a leaf shape.

How People Use Kratom

In the U.S. and other Western countries, people use kratom for various reasons:5

  • Managing chronic pain
  • Easing opioid withdrawal symptoms
  • Self-medicating anxiety or depression
  • Boosting energy or focus
  • Recreational purposes

Kratom comes in different forms: Powder, capsules, extracts, and teas. Some people chew the leaves directly, while others mix the powder into drinks or food.

See our article on self-medicating with substances to understand if you might be using kratom to cope with underlying issues.

Kratom’s Legal Status

Kratom’s legal status is unclear in many places. The U.S. Food and Drug Administration (FDA) has issued warnings about the safety of kratom6 and has not approved it for any medical use. While kratom remains legal federally in the U.S., several states and cities have banned it.

The Drug Enforcement Administration (DEA) classifies kratom as a “Drug and Chemical of Concern.” Internationally, some countries where kratom grows naturally have made it illegal, and regulations vary widely elsewhere.

This uncertain legal status makes it hard for manufacturers to ensure kratom’s purity and safety7 for those who use it.

Kratom Dependency and Addiction

Like many substances that affect your brain, regular kratom use can cause you to become physically dependent.8 This means your body adapts to having kratom in your system and starts relying on it to function normally.

Infographic titled 'Helpful Detox Tips for Kratom Withdrawal' displaying 10 illustrated tips: stay hydrated, eat light nutritious meals, move your body gently, take warm baths or showers, use ibuprofen or melatonin, create a comfy recovery space, sleep whenever you can, lean on your support network, and remind yourself the discomfort is temporary. A trash can filled with kratom leaves and capsules is shown at the bottom.

How Dependency Develops

When you use kratom regularly, your brain adjusts to the chemicals it provides. Over time, your brain may produce fewer of its own, natural feel-good chemicals because it’s getting them from kratom instead. When this happens, you might need higher doses to feel the same effects of kratom (tolerance), and your body might react negatively when you don’t have it (withdrawal).

Kratom dependency9 can ramp up in as little as a few weeks of daily use, though it varies from person to person. How quickly you become physically reliant on kratom depends on:

Dependency vs. Addiction

While dependency is mainly about your body’s physical reliance on kratom,10 addiction involves both physical dependency and behavioral changes. If you find yourself doing any of the following, it could be a sign that you’re developing a kratom addiction:

  • Continuing to use kratom despite its negative effects on your life
  • Spending a lot of time getting, taking, or recovering from kratom
  • Neglecting responsibilities or missing out on important activities because of your kratom use
  • Being unable to reduce or control your use of kratom
  • Having strong cravings for kratom

Risk Factors for Kratom Dependency

Some factors that might make you more likely to develop dependency include:

  • A history of substance abuse problems
  • Using kratom to self-medicate mental health issues
  • Starting to take larger doses of kratom or graduating to more highly concentrated extracts
  • Taking kratom daily or throughout the day 
  • Using it for extended periods
  • Combining it with other substances

Understanding the difference between casual use, dependency, and addiction helps you identify where you might be on this spectrum. If you notice signs of dependency or addiction, it may be time to reevaluate your relationship with kratom and start making some changes.

Kratom Withdrawal Symptoms

When you stop taking kratom after regular use, your body needs time to adjust to functioning without it. This adjustment period can bring on a range of uncomfortable symptoms that affect both your body and mind.

Physical Symptoms You Might Experience

Your body can react in several ways when you stop taking kratom:11

  • Muscle aches and pains: Many people say they feel like they have the flu, with sore, achy muscles and joints. Moving around feels harder than usual.
  • Nausea and stomach problems: Your digestive system often reacts strongly during withdrawal. You might feel queasy or sick to your stomach. Some people have vomiting, diarrhea, or loss of appetite.
  • Sweating and chills: Your body’s temperature regulation can go a bit haywire. You might find yourself sweating heavily one moment and feeling cold the next. Night sweats are especially common.
  • Runny nose and watery eyes: Just like with a cold, you might have a runny nose and eyes that tear up for no reason.
  • Tremors or shaking: Some people notice their hands trembling or have full-body shakes during withdrawal.
  • Headaches: These can be accompanied by sensitivity to light or sound.
  • Fatigue and weakness: You might feel completely drained of energy, making even simple tasks feel exhausting.

Psychological Symptoms

There are also mental symptoms of kratom withdrawal:12

  • Anxiety and restlessness: You may feel on edge, unable to relax, have racing thoughts, or feel a sense of worry that’s hard to shake.
  • Mood swings: You might be on an emotional roller coaster, feeling irritable, angry, or sad for no clear reason.
  • Depression: Some people have a persistent low mood, lack of motivation, or feelings of hopelessness during withdrawal.
  • Cravings: You might find yourself thinking about kratom often and having strong urges to take it again.
  • Brain fog: Many people report having difficulty focusing or thinking clearly during withdrawal.

A Closer Look at Kratom Withdrawal Insomnia

Sleep problems deserve special attention because they can make everything else feel worse. During kratom withdrawal, you might:

  • Have trouble falling asleep, even though you’re exhausted
  • Wake up throughout the night
  • Have vivid, disturbing dreams
  • Feel like you haven’t truly rested even after sleeping

Kratom withdrawal insomnia generally peaks during the first week but can linger for several weeks. Getting even small amounts of quality sleep can make a big difference in how you feel.

Sleep struggles during withdrawal? Learn more about managing withdrawal insomnia and get tips for better rest during recovery.

What Makes Withdrawal Better or Worse?

Several factors affect how intense your withdrawal symptoms will be:

  • How much kratom you used: Generally, higher doses lead to more intense withdrawal.
  • How long you’ve been using it: Longer-term use typically means more pronounced withdrawal.
  • Your overall well-being: Being in good health otherwise can make withdrawal more manageable.
  • Support system: Having people who understand what you’re going through can make a huge difference.
  • Previous withdrawal experiences: If you’ve gone through withdrawal before, your body might react more strongly the next time (this is called the kindling effect).13

As you go through this process, it’s good to keep in mind that withdrawal symptoms are temporary. They’re your body’s way of healing and finding a new balance without kratom. While they are uncomfortable, they’re not dangerous for most people and will improve with time.

Kratom Withdrawal Timeline

If you’re planning to stop using kratom, having a roadmap of what to expect can help you prepare mentally. While everyone’s experience differs, most kratom users follow a somewhat predictable timeline of symptoms.

When Do Withdrawal Symptoms Start?

For most people, kratom withdrawal begins within 12-24 hours14 after your last dose. If you’ve been using very high doses or potent extracts, you might notice symptoms starting even sooner—sometimes within just 6 to 12 hours.

The onset often feels like a growing sense of discomfort, restlessness, or anxiety. You might notice minor physical symptoms like yawning, watery eyes, or a runny nose before more intense symptoms kick in.

Early Acute Phase (Days 1-3)

The first few days are typically the most challenging:

  • Day 1: You’ll have anxiety, restlessness, and physical discomfort. Sleep might be difficult, and you may have strong cravings for kratom.
  • Days 2-3: Physical symptoms usually intensify during this period. Muscle aches, sweating, nausea, and digestive issues peak. A lot of people describe this stage as feeling like a bad flu.

During this phase, remind yourself that what you’re experiencing is normal and temporary. The discomfort means your body is beginning to adjust to functioning without kratom.

Peak Symptoms (Days 2-5)

For most people, withdrawal symptoms reach their worst point somewhere between days 2 and 5. This is when the combination of physical discomfort and psychological symptoms can feel overwhelming.

The good news is that once you get through this peak period, your body starts to heal, and symptoms gradually become less intense. Many people find that reaching this turning point gives them the motivation to continue.

Subacute Phase (Days 6-14)

After the peak, you’ll enter the subacute phase:

  • Most severe physical symptoms (like nausea, vomiting, and body aches) start to fade
  • Sleep gradually improves, though it may still be disrupted
  • Mood symptoms like anxiety and depression may linger
  • Energy levels slowly begin to return

By the end of the second week, most people find that they’re functioning reasonably well, though not entirely back to normal.

Post-Acute Withdrawal Syndrome (PAWS)

Some people have lingering symptoms for weeks or even months after quitting substances. This is known as post-acute withdrawal syndrome,15 or PAWS. These symptoms are usually milder than acute withdrawal but can still affect your quality of life:

  • Periodic mood swings
  • Anxiety or depression that comes and goes
  • Trouble with motivation or concentration
  • Sleep disturbances
  • Occasional cravings for kratom

PAWS symptoms typically come in waves: You might feel fine for several days, then have a few hard days before improving again. Each wave tends to be less intense than the one before.

Remember that healing isn’t a linear process. Having good and bad days during recovery is completely normal. With time, these waves become less frequent and less intense as your brain chemistry rebalances.

Are you having lingering symptoms after the initial withdrawal phase? Learn about post-acute withdrawal syndrome (PAWS) and how to manage these longer-term recovery challenges.

Managing Kratom Withdrawal at Home

Many people successfully navigate kratom withdrawal from the comfort of their own homes. With the right approach and preparation, you can make this challenging process more manageable.

1. Is Home Detox Right for You?

Home detox might be appropriate if:

  • You’ve been using moderate amounts of kratom
  • You don’t have other serious health conditions
  • You have a support person who can check on you
  • You don’t have a history of severe withdrawal
  • You’re not using other substances like alcohol or opiates

However, home detox isn’t right for everyone. Your safety comes first. Here’s how to know when it’s time to seek professional help:

2. When to Seek Professional Help

Watch for these warning signs that indicate you may need medical support:

  • Severe depression or thoughts of harming yourself
  • Extreme dehydration from vomiting or diarrhea
  • Racing heartbeat, chest pain, or difficulty breathing
  • Seizures or hallucinations
  • Inability to keep any food or water down for more than 24 hours
  • Withdrawing from multiple substances at once

If you experience any of these, do not hesitate to reach out to a healthcare provider.

3. Tapering: A Gentler Approach

Instead of stopping kratom cold turkey, some people find that gradually reducing their dose helps minimize withdrawal symptoms. Here’s a simple tapering approach:

  1. Start by measuring your current daily amount accurately
  2. Reduce your total daily amount by about 10-15% every 2-3 days
  3. Space out your doses evenly throughout the day
  4. Go slower with reductions if withdrawal symptoms become too uncomfortable
  5. Keep a log to track your progress

Tapering off of kratom takes longer than quitting cold turkey, but it’s often much more comfortable. Be patient with yourself—a gradual taper over several weeks is typically easier on your body than a rapid one.

4. Self-Care Strategies That Help

These simple kratom withdrawal remedies16 can make a big difference in how you feel:

  • Stay hydrated: Drink plenty of water and fluids to replace hydration lost through sweating or digestive issues.
  • Nourish your body: Even if you don’t feel hungry, try to eat small, nutritious meals. Foods rich in magnesium (like nuts) and potassium (like bananas) may help with muscle cramps.
  • Move your body (gently): Light exercise like walking or stretching can release natural endorphins that improve your mood and help with sleep.
  • Warm showers or baths: The warmth can temporarily relieve muscle aches and help you relax.
  • Create a comfortable recovery space: Clean sheets, comfortable clothes, and a quiet environment can help ease your mind.

5. Helpful Over-the-Counter Options

While these aren’t cures for withdrawal, they may help manage specific symptoms:

  • For aches and pains: Non-prescription pain relievers like acetaminophen or ibuprofen (always follow package directions)
  • For diarrhea: Over-the-counter anti-diarrheal products
  • For nausea: Ginger tea, ginger candies, or motion sickness remedies
  • For sleep: Melatonin, valerian root tea, or magnesium supplements before bedtime

*Note that these are general suggestions, not medical advice. Check with your doctor first if you’re unsure about taking any medication or supplement, especially if you have other health conditions or take prescription medications.

Professional Treatment Options

Sometimes, getting expert help makes the difference between struggling through withdrawal and finding a smoother path to recovery. Professional drug addiction treatment provides structure, medical supervision, and tools to address not just your kratom use, but also what led you to addiction in the first place.

6. Medical Detox Programs

Medical detox programs are safe settings where healthcare professionals monitor your withdrawal symptoms and provide relief. These programs typically last 3-7 days and focus on helping you get through the acute withdrawal phase comfortably. Because the discomfort of withdrawal causes many people to start using again, supervised detoxification can improve your chances of recovery success. 

Other benefits of professional kratom detox include:

  • 24/7 medical supervision
  • Medications to ease specific symptoms
  • Prevention of complications
  • Emotional support during a challenging time

Many insurance plans cover detox services, especially if your provider determines it’s medically necessary.

7. Helpful Approaches in Treatment

Effective treatment programs typically include:

Medications: While there’s no FDA-approved medication specifically for kratom withdrawal, providers may prescribe medications to target specific symptoms, like clonidine for anxiety or trazodone for sleep problems.

Talk therapy: Interventions like cognitive behavioral therapy (CBT) help you identify and change patterns that led to kratom use, plus develop healthier coping skills.

Group support: Connecting with others who understand what you’re going through can be incredibly healing. Many programs include group therapy or facilitate attendance at support groups.

Addressing co-occurring issues: If you’ve been using kratom to self-medicate anxiety, depression, pain, or trauma, treatment will include addressing these underlying concerns.

Discover effective ways to reclaim your life from pain through specialized rehab programs in our article on managing chronic pain.

Choosing Between Inpatient and Outpatient Care

After detox (or sometimes instead of it), you might consider:

Inpatient or residential rehab: You live at the facility for a set period, usually 28-90 days. This option provides the most structure and removes you from environments that might trigger kratom use.

Intensive outpatient programs (IOPs): You attend treatment several days a week for a few hours each day while living at home. This allows you to maintain work or family responsibilities while getting substantial support.

The right level of care depends on your specific situation, including the severity of your kratom use, your support system at home, and any other challenges you’re facing.

8. Building Long-Term Recovery Support

Recovery continues long after formal treatment ends. Many programs help you develop a continuing care plan that might include:

  • Ongoing therapy sessions
  • Support group meetings
  • Wellness practices like meditation or exercise
  • Regular check-ins with a recovery coach 
  • Medication management if needed

Remember that seeking professional help isn’t a sign of weakness—it’s a proactive commitment to your health. Many people who go through formal treatment of some kind find that the structure and support give them a helpful foundation to create lasting change.

Preventing Relapse

After you’ve gone through the challenge of kratom withdrawal, the next order of business is to stay kratom-free. Relapse prevention isn’t just about willpower —it’s about understanding your triggers and building healthy strategies to navigate life’s ups and downs.

Recognizing Your Personal Triggers

Most people have specific situations, feelings, or environments that make them want to use kratom again. Common triggers include:

  • Stress and difficult emotions: Feeling overwhelmed, anxious, angry, or sad
  • Physical discomfort or pain, especially if you used kratom for pain management
  • Social situations: Being around others who use kratom or in places where you used it
  • Boredom or lack of structure: Having too much unoccupied time
  • Celebrating or rewarding yourself: Thinking “just this once” won’t hurt

Learning to identify your personal triggers is the first step in reducing your risk of relapse. When you notice a trigger, pause and remind yourself that the urge to use will pass, even if it feels intense in the moment.

Building Your Support Network

Recovery thrives in connection. Consider building support through these avenues:

  • Friends and family: Let trusted loved ones know what you’re going through and how they can help
  • Support groups: Consider SMART Recovery, Narcotics Anonymous (NA), or online forums focused on kratom recovery
  • Behavioral health professionals: A therapist or counselor who understands substance use disorders
  • Recovery apps: Many free apps offer tools for tracking your progress and connecting with others

Having people you can reach out to when cravings hit can make all the difference in preventing a momentary urge from becoming a relapse.

Practicing Healthy Coping Strategies

Life is hard at times and we need healthy ways of managing it! A large part of recovery is learning and practicing more helpful ways of dealing with challenges:

  • Physical activity: Exercise naturally boosts your mood and energy levels
  • Mindfulness practices: Meditation, deep breathing, or yoga can help manage stress
  • Creative outlets: Music, art, writing, or other creative pursuits
  • New hobbies: Activities that engage your mind and bring satisfaction
  • Helping others: Volunteering or supporting someone else’s recovery

The more tools you have in your toolkit, the better equipped you’ll be to handle difficult times. The key is to get those resources in place before those moments arrive.

Building a Recovery-Friendly Lifestyle

Small daily habits can strengthen your recovery:

  • Regular sleep schedule: Aim for 7-9 hours of quality sleep each night.
  • Balanced nutrition: Eat regular meals that support brain and body health.
  • Limit caffeine and sugar: These can mimic anxiety symptoms and trigger cravings.
  • Practice self-compassion: Recovery isn’t perfect—learn from setbacks rather than beating yourself up.
  • Celebrate milestones: Acknowledge your progress, whether it’s days, weeks, or months kratom-free.

Recovery is a process, not an event. Each day you make choices that support your health is a success, and even if you experience a setback, you haven’t lost the progress you’ve made.

Learn how proper nutrition can fuel your recovery journey in our article on nutrition for addiction and mental health healing.

Moving on From Kratom

Recovery from kratom dependency is a journey that takes time, patience, and sometimes a helping hand. While the withdrawal process has its challenges, remember that thousands of people have successfully navigated this path before you!

If you’re struggling with kratom addiction or withdrawal, you don’t have to go through it alone. Professional care can mean the difference between a difficult, uncertain recovery and one with proper guidance and support.

Treatment specialists understand what you’re going through and can help you with tools, medication, and strategies that significantly improve your chances of success.

Ready to take the next step? Search for a treatment provider today. Many treatment centers offer free, confidential assessments to help determine what level of care might be right for you. You’ll thank yourself for having the courage to ask for help when you needed it.

FAQs

Q: What is kratom addiction?


A: Kratom addiction occurs when regular use leads to dependence, causing physical or psychological cravings and withdrawal symptoms when not taken.

Q: How long do kratom withdrawals last?


A: Withdrawal symptoms typically begin within 6–12 hours after the last dose and can last from 3 to 10 days, depending on frequency and amount used.

Q: How long does kratom withdrawal insomnia last?


A: Insomnia during kratom withdrawal can last from a few days up to a week. Sleep patterns may gradually improve as the body adjusts.

Q: What are the withdrawal symptoms of Ketum?


A: Ketum (another name for kratom) withdrawal symptoms may include anxiety, irritability, muscle aches, insomnia, sweating, nausea, and cravings.

Q: What drug has the worst withdrawal symptoms?


A: Opioids, alcohol, and benzodiazepines are often considered to have the most severe withdrawal symptoms, sometimes requiring medical detox. Kratom withdrawal is usually milder but still uncomfortable.

Q: What are kratom withdrawal symptoms?


A: Common symptoms include anxiety, restlessness, muscle aches, insomnia, nausea, diarrhea, and emotional distress.

Q: Should I detox from kratom at home?
A: Detoxing at home may be possible for mild cases, but medical supervision is recommended if symptoms are severe or if there are co-occurring mental health conditions.

Q: Does kratom affect blood pressure?


A: Yes, kratom can affect blood pressure. It may cause either elevated or lowered blood pressure depending on dosage and individual response.

Q: What is kratom used for?


A: Kratom is often used for pain relief, mood enhancement, increased energy, and in some cases, self-management of opioid withdrawal—though it is not FDA-approved for medical use.

Q: Are you covered for addiction treatment?


A: Coverage depends on your health insurance provider and plan. Many policies include behavioral health services. Contact your insurer to confirm benefits for substance use treatment.

Q: How is kratom addiction treated?


A: Treatment may involve tapering off use, behavioral therapy, support groups, and in some cases, medications to manage symptoms or co-occurring conditions.

Q: What are effective ways to manage kratom withdrawal symptoms?


A: Staying hydrated, using over-the-counter medications for symptom relief, maintaining a sleep routine, and seeking counseling or medical support can help manage withdrawal.

Q: How can I manage kratom withdrawal symptoms effectively?


A: Similar to above—gradual tapering, professional support, proper nutrition, and self-care strategies can reduce discomfort during withdrawal.

Q: What are the stages of kratom withdrawal?


A: Withdrawal typically progresses through early symptoms (6–12 hours), peak discomfort (2–4 days), and gradual resolution (5–10 days), though timelines vary by individual.

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Ketamine Withdrawal Explained: What to Expect in Detox and Recovery

Ketamine started as a medication used for anesthesia, but today it’s also used in therapeutic settings and recreationally. But like many substances that alter brain chemistry, regular ketamine use can lead your body to adapt and depend on it, meaning you might have withdrawal symptoms when you decide to stop. 

Whether you’re personally navigating ketamine use, exploring treatment possibilities, or supporting a loved one through their journey to quit, understanding withdrawal can make the path forward clearer. Let’s explore what happens when ketamine leaves your system, how to manage the process safely, and what support options can help ease the transition back to life without it.

What Is Ketamine?

Ketamine is a medication1 that first appeared in the ’60s as an anesthetic for surgeries. It works by blocking certain chemical receptors in your brain, which makes you feel disconnected from pain, negative emotions, and your surroundings. Doctors and medical teams still use ketamine today in hospitals for procedures requiring sedation.

In recent years, doctors started using ketamine to treat certain mental health conditions.2 In controlled medical settings, it can promote healing for people struggling with treatment-resistant depression, severe anxiety, or PTSD.

Some people also use ketamine recreationally for its dissociative effects—a feeling of detachment from reality, visual distortions, and euphoria. On the street, you might hear it called “special K,” “ket,” “kit kat,” or simply “K.”

Infographic showing common reasons for ketamine use, divided into therapeutic uses—depression relief, anxiety and PTSD, chronic pain relief, and suicidal crisis support—and recreational uses—dissociation and escape, euphoria or high, party enhancement, and emotional self-medication.

Ketamine affects your brain3 by blocking NMDA receptors, which help with memory, learning, and pain perception. It also boosts levels of a brain chemical called glutamate and may affect other neurotransmitters like dopamine—one of your brain’s most important “feel-good” chemicals.

When ketamine becomes a regular part of your life, your body adjusts. You’ll likely need more to feel the same effects (tolerance), which can cause you to develop physical and psychological dependence, leaving you with withdrawal symptoms when you stop.

Signs of Ketamine Addiction

Not everyone who uses ketamine will develop a drug addiction, but regular use can make you dependent. Spotting the signs of ketamine addiction early can help you recognize when casual use has crossed into problematic territory.

Physical Signs

When ketamine use has become an addiction, your body might signal problems through:

  • Stomach pain or other digestive troubles
  • Changes in your appetite
  • Coordination problems that weren’t there before
  • Speech that sounds slurred or different
  • Breathing difficulties

You might notice bladder problems like needing to pee frequently or having pain when you do—a condition sometimes called “K-bladder“4 that can become serious if you continue using. 

One report from ITV News highlights the growing crisis of ketamine-related bladder damage among young people5 in the UK. Dan Parker, a 23-year-old former electrician who nearly lost the use of his bladder after just months of daily ketamine use, recalls his experience of ketamine dependence:

I had it all to lose—everything to lose. Family, friends, relationships, my son. Everything else was gone.

Infographic titled

Unlike substances that take decades to cause significant organ damage, ketamine can irreversibly harm the bladder6 in a much shorter timeframe.

What is ketamine detox?

Ketamine is a drug that can mess with both the body and the brain. When a person stops using ketamine, they will start to go through intense withdrawal, causing symptoms of extreme cravings for ketamine, anxiety, fatigue, and confusion. Some may experience psychosis, loss of motor skills, rage, nausea, ‘the shakes’, a decrease in cardiac or respiratory functions, insomnia, hearing loss, and cognitive impairment. It takes time for the body to get back to normal while going through ketamine detox. Medical support is highly recommended for a safer, more controlled withdrawal process.

Janelle Salo, RN | Healthy Earth Living

Behavioral Changes

Just like with other types of substance abuse, ketamine can reshape your daily habits and priorities. You might catch yourself:

  • Spending more time and money getting ketamine
  • Pulling away from family and friends who care about you
  • Letting responsibilities slide as ketamine takes priority
  • Dropping activities you used to love because ketamine seems more important
  • Performing worse at school or at work 

Psychological Symptoms

Ketamine can significantly change how your brain functions,7 affecting your thoughts and emotions. You might struggle with:

  • Memory gaps or problems
  • Feeling confused or foggy
  • Trouble focusing on tasks or conversations
  • Mood swings that seem to come out of nowhere
  • Intense cravings that are hard to ignore

Many people also experience waves of depression and anxiety, especially after a dose of ketamine when the effects start to wear off.

Impact on Daily Life

When ketamine starts taking center stage, things can start to unravel around you. Maybe you continue using even though it’s causing problems with your health, your relationships, or your job. If you’ve tried to cut back or stop but found it surprisingly difficult, that’s actually a common experience—and a sign that recreational drug use may have developed into something more serious. 

Illustration comparing medical and recreational ketamine use. On the left, a patient receives supervised ketamine treatment from a doctor in a clinical setting. On the right, a man misuses ketamine in a party-like environment. The text reads: “In the right setting, ketamine can heal. In the wrong one, it can hurt.” A large ketamine bottle divides the contrasting scenes.

Ketamine Withdrawal Explained

When ketamine becomes a regular part of your routine, your brain gets used to having it around. Your brain chemistry actually adapts to function with ketamine in your system. When you decide to stop or cut back, your body needs time to reset—which causes withdrawals.

Why Withdrawal Happens

Your brain has a delicate chemical balance. Ketamine affects special receptors8 that control how you think, feel, and how your body works. With ongoing use, these receptors become less responsive, and your brain produces different levels of natural chemicals to maintain equilibrium. When you suddenly remove ketamine from this equation, things get out of balance until your brain can rebuild its natural systems. This adjustment period is what we call withdrawal.

Can ketamine become addictive?

Ketamine, a sedative generally used for the sedation of animals, has been used widely over the years by humans for recreational purposes. Many people use drugs like ketamine to self-medicate for mental health issues, trauma, grief, abandonment, and other human experiences. As with any substance that a person takes consistently over time, it can become a source of addiction. If someone is struggling with ceasing ketamine use on their own, self-help groups, individual therapy, intensive outpatient treatment, and residential treatment can be considered.

Tanya Kraege LCSW, CSAC, CCAR RC, WI CPS | Ventus Rex

Common Symptoms

While ketamine withdrawal symptoms aren’t typically dangerous,1 it can certainly be uncomfortable. You might experience:

  • Strong urges to use ketamine again
  • Feeling anxious, restless, or easily irritated
  • Waves of depression or mood swings that come and go
  • Trouble sleeping or unusual dreams
  • Feeling drained of energy
  • Foggy thinking and memory blips
  • Increased heart rate or higher blood pressure
  • Unexpected sweating or chills
  • Loss of appetite
  • Confusion or feeling disconnected from reality

Some people find that the mental and emotional aspects of ketamine withdrawal9 hit harder than the physical symptoms. Feeling down and fighting those persistent cravings can be especially challenging.

Acute Cases

While ketamine withdrawal isn’t typically life-threatening like alcohol or benzodiazepine withdrawal, some people do experience more severe reactions. Research in the American Journal of Psychiatry highlights cases where people felt extreme agitation and intense mood swings when they stopped taking ketamine10 cold turkey. In one case, a person who had been taking large amounts of ketamine regularly became highly distressed—hitting walls, yelling, and behaving erratically until he received proper medical help.

Medical professionals are still working to understand these more intense withdrawal experiences, and there’s no clear definition of what “typical” ketamine withdrawal looks like. For those who use heavily and frequently, symptoms can become acute enough to seriously disrupt daily life. This is why it’s safest to quit ketamine with professional guidance, especially if you’ve been using ketamine regularly for a long time.

Ketamine Withdrawal Timeline

Everyone’s body responds differently to withdrawal, but research shows that ketamine withdrawals can kick in just 24 hours after the last dose.11 Physical withdrawals are usually short-term, but some psychological symptoms—like cravings, mood fluctuations, and sleep troubles—might stick around for longer.

For some people, withdrawal symptoms last longer than expected. Learn more about this extended recovery process and how to navigate it in our guide to post-acute withdrawal syndrome (PAWS).

How long does ketamine withdrawal typically last?

Ketamine withdrawal symptoms can vary widely from person to person, depending on various factors, including the frequency and amount of ketamine use, as well as individual physiology. Typically, acute withdrawal symptoms may begin within a few days (72 hours) after cessation and can last for about one to two weeks, though sometimes longer. Physiological symptoms to note may include delusions, double vision, fatigue, hallucinations, hearing loss, shakes, insomnia, nausea, rage, and rapid breathing, among others. Individuals may also experience lingering psychological symptoms (e.g., anxiety, depression), which could persist for several weeks or even months and oftentimes require additional attention through counseling, group support, and otherwise.

Matthew Glowiak, PhD, LCPC, CAADC, ACS, NCC | Hazelden Betty Ford Graduate School

Factors That Affect Severity

How intense your withdrawal experience feels depends on several personal factors:

  • How long you used ketamine 
  • Your typical dose and how often you’ve been using
  • Whether you use other substances alongside ketamine
  • Your overall physical and mental well-being
  • The support system and environment around you

Withdrawals can test your resolve, both physically and mentally—they’re actually one of the main reasons people return to using. But it’s good to keep in mind that withdrawal is temporary, and with the right support in your corner, you absolutely can make it through this challenging phase of recovery.

Ketamine Detox

While ketamine addiction is certainly treated in professional settings, the concept of “detoxification” for ketamine differs from substances like alcohol, opioids, or benzodiazepines. Unlike those substances, ketamine doesn’t typically cause severe physical withdrawal symptoms12 that require medical management. Most ketamine users don’t need the same kind of monitored detox process that’s necessary for substances that cause more dangerous withdrawals.

When you get treatment for ketamine addiction, the process usually focuses more on:

  • Psychological support to manage cravings and mood changes
  • Therapy to address underlying causes of your addiction 
  • Developing coping skills and relapse prevention strategies
  • Treatment for any co-occurring mental health conditions

For people who have been using ketamine heavily or in combination with other substances, a more structured environment during the early days of abstinence can still be very beneficial for monitoring mood, providing support, and ensuring a successful transition to your treatment program.

Is Medical Supervision Necessary?

While ketamine withdrawal isn’t typically severe or physically dangerous, professional support during this time can still be invaluable. Treatment providers can help manage psychological issues like depression and cravings, address any co-occurring mental health concerns, and provide structure and accountability to prevent relapse. 

For many people, having this support significantly increases their chances of staying on track toward long-term recovery, especially if they’ve used ketamine heavily or for an extended time.

Ketamine’s Therapeutic Benefits vs. The Realities of Addiction

While ketamine shows promising therapeutic benefits for depression and PTSD in clinical settings, we shouldn’t overlook its potential for addiction. Saturn, who has used ketamine extensively13 over the years, shares an honest perspective:

We all have tendencies to get addicted to things pretty easily, especially if you have a lot of traumas and stuff you’ve been through… Basically, if you use illegal drugs and have self-discipline and you do use them as a tool instead of partying, it could help some people. But some drugs some people shouldn’t be taking. We’re all different… I’ve learned that if you do too much of anything, it’s really bad for you.

His view reminds us that what works as medicine for one person might become problematic for another. Many people who initially try ketamine for its mood-lifting side effects don’t anticipate developing a substance use disorder. He recalls what a close friend went through:

One of my best friends was stuck on [ketamine] and he was about to have a kid and he had to get off of it before he had a kid and he was struggling really hard. Him and his wife… they had to get help, they couldn’t do it on their own. So yeah, it can be heavily addictive.

These experiences remind us that while medical ketamine treatments are carefully controlled, recreational use of ketamine carries real risks of developing dependence that often requires professional help to overcome.

Treatment Options for Ketamine Addiction 

The support you choose for your recovery journey can make all the difference in your long-term success.

Residential Rehab

Many people benefit from inpatient rehab programs where you live at a treatment facility for 30-90 days. These programs offer structure, daily therapy, and a recovery-focused environment away from triggers and temptations.

Outpatient Therapeutic Approaches

In rehab, your care team will create a treatment plan for you that includes a combination of therapies such as:

  • Cognitive behavioral therapy (CBT) helps you identify and change thought patterns that lead to ketamine abuse
  • Group therapy connects you with others facing similar challenges
  • Motivational enhancement therapy (MET) strengthens your internal drive to maintain your recovery

Support Groups

Joining groups like Narcotics Anonymous or SMART Recovery provides ongoing encouragement and accountability when formal treatment ends.

Harm Reduction Strategies

If total abstinence doesn’t feel achievable right now, harm reduction strategies can help you use more safely:

  • Using less frequently or in smaller amounts
  • Avoiding mixing ketamine with other substances
  • Having a trusted friend around when using
  • Learning about safer administration methods
  • Staying hydrated and keeping an eye on your physical health

The Importance of Strong Social Support

In addiction recovery, healthy social support makes all the difference. Supportive friends, family members, or professionals can encourage you when cravings hit hard or when you’re feeling low. Remember that asking for help isn’t a burden—it’s actually a sign of strength and commitment to your recovery.

The Next Step: Connect With a Ketamine Addiction Treatment Specialist

Taking steps toward recovery from ketamine use shows incredible courage! Whether you’re just starting to question your relationship with ketamine or you’re ready to start treatment, support is available every step of the way.

Ready to explore your options? Our treatment finder can connect you with ketamine addiction treatment centers that match your specific needs. These centers offer specialized support to help you navigate withdrawal, develop coping skills, and build a fulfilling life beyond ketamine use—because you deserve the chance to reclaim your health and well-being.

FAQs

Q: What is ketamine detox? 

A: Ketamine detox is the process of clearing the drug from your system while managing withdrawal symptoms, either through medical supervision or self-management with support. In medically supervised detox, healthcare professionals monitor your vital signs, may provide medications to manage symptoms like anxiety or insomnia, and offer emotional support throughout the withdrawal process.

Q: Do I need medical supervision for ketamine withdrawal and detox?

A: While not always medically necessary, medical supervision makes ketamine withdrawal safer and more comfortable. Consider seeking medical detox if:

  • You’ve been using ketamine heavily or for a long time
  • You use multiple substances alongside ketamine
  • You have co-occurring disorders like anxiety or depression
  • You’ve tried to quit before and experienced severe withdrawal or relapse
  • You don’t have a stable, supportive environment at home
  • You have health conditions that might complicate withdrawal

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How Long Does Psychosis Last? Navigating the 3 Stages From Onset to Recovery

When someone experiences psychosis, it changes how they understand the world around them. This can be scary and confusing, both for the person going through it and the people around them. Fortunately, psychosis can be treated, and many people regain stability and heal successfully with the right support.

We’ll explain what affects the duration of psychosis, how long related mental health issues typically last, and what recovery looks like. Whether you’re experiencing psychosis symptoms yourself, supporting someone who is, or just wanting to learn more, we’ll walk through what to expect in simple terms. Everyone’s experience with psychosis is different, but knowing the typical patterns can help you navigate this challenging time.

Let’s look at what psychosis is, how long it usually lasts, and what helps people heal.

Infographic titled Psychosis Timelines: 4 Common Patterns. It illustrates the duration and frequency of symptoms for four types of psychosis: single-episode, recurrent, chronic or continuous, and partial or attenuated symptoms. Each type is represented by a visual timeline using varying shades of red. A graphic of a distressed person with warning signs surrounds the head.

What Is Psychosis? 

Researchers define psychosis as “an amalgamation of psychological symptoms resulting in a loss of contact with reality.” About .5 to 3.5% of people are affected by psychotic disorders,1 and many more people experience a psychotic symptom of some kind at some point in their lives. 

Psychosis usually develops in 3 stages. 

The 3 Stages of Psychosis

Understanding these stages of psychosis2 helps you recognize what’s happening and know what to expect:

1. Prodromal Phase

The first stage is called the prodromal phase,3 also known as “psychosis syndrome.” You can think of it as the early warning period before full psychosis develops. During this time, you might notice subtle changes in thoughts and feelings. A person might start pulling away from friends and family, have trouble sleeping, feel suspicious of people around them, or suddenly struggle at work or school.

This early phase can last anywhere from a few days to several years. The tricky part is that many people don’t recognize these changes as warning signs of psychosis. They might just feel “off” or “not like themselves.” Family and friends are often the first to notice that something isn’t quite right.

2. Acute Phase

The acute phase is when psychosis becomes more obvious. This is when hallucinations (like hearing voices or seeing things that aren’t there) and delusions (strong, false beliefs) clearly appear. Someone might become convinced they’re being watched or persecuted, or they might talk about hearing voices that no one else can hear.

This phase typically lasts between a few days and several months. It’s usually the point when people finally get professional help because the symptoms are hard to ignore. Without treatment, this phase can last longer and symptoms may get worse.

3. Recovery Phase

The final stage—recovery—happens when people get adequate care. With appropriate treatment, symptoms gradually decrease. People begin to make sense of what happened and learn ways to manage their condition. They slowly get back to their regular activities and rebuild their relationships.

Recovery time varies a lot from person to person. Some people bounce back within weeks or months, while others might take a year or longer. As with any type of mental illness recovery, this process isn’t always linear—there are good days and tougher days along the way. But with the right treatment and support, most people see real improvement over time.

Infographic titled Early Warning Signs of Possible Psychosis, listing symptoms such as social withdrawal, sleep problems, paranoia, unusual thoughts, trouble focusing, drop in performance, mood swings, and loss of motivation. Each symptom is paired with a circular icon and a silhouette of a person appears on the right side.

From your perspective, what are the most important factors that influence how long psychosis lasts—and why?

In deciphering the most important factors that influence how long psychosis lasts, we would first want to consider individual physiology (e.g., medical or neurological conditions), whether there is a diagnosable psychiatric condition (e.g., schizophrenia, bipolar disorder, delusional disorder, major depressive disorder severe with psychotic features), and/or whether the psychosis is substance-induced–whether temporary while using or extended and lasting beyond active use. As with most other mental health disorders and conditions, early intervention can help, as it may reduce the duration and severity of the psychotic episode while increasing the likelihood of quicker recovery and more promising long-term outcomes. Treatment adherence is also important and may include a combination of medication and treatment. Medication helps stabilize the condition while treatment works on other life factors, such as learning about what triggers psychosis, how and when to implement personally effective coping skills, acquiring various resources to minimize episodes, and building a support network, among other factors.

Matthew Glowiak, PhD, LCPC, CAADC, ACS, NCC | Hazelden Betty Ford Graduate School

Duration of Different Types of Psychosis

Let’s talk about how long different types of psychosis typically last. Remember, each person’s experience is unique, but these timeframes can give you a general idea of what to expect.

Brief Psychotic Disorder

Sometimes psychosis appears suddenly after a major stress or trauma, like losing a loved one or experiencing a natural disaster. This is called brief psychotic disorder,4 and as the name suggests, it’s not permanent. Symptoms typically last between a day and a month, then go away completely. Most people who experience this type of psychosis make a full recovery without any long-term problems.

Drug-Induced Psychosis

Using certain drugs like marijuana, LSD, methamphetamine, or cocaine can trigger psychosis in some people. The good news is that substance-induced psychosis usually clears up within a few days to a few weeks after the person stops using the substance (which may require professional addiction treatment). But for some folks—especially those who used drugs heavily or for a long time—symptoms might linger for months. In some cases, drug use can unmask an underlying mental health condition that requires ongoing treatment.

To learn more about how substance use can affect psychosis, see our article on the link between addiction and schizophrenia.

When psychosis is part of schizophrenia,5 it follows a different pattern. People with schizophrenia often have episodes of psychosis that last between a few weeks and several months. Between these episodes, symptoms might decrease but rarely disappear completely without treatment. With proper medication and therapy, many people with schizophrenia can manage their symptoms well and reduce the frequency and intensity of psychotic episodes.

To learn more about comprehensive treatment options for schizophrenia and related psychosis, see our complete guide to schizophrenia rehab and recovery.

Infographic titled What Can Psychosis Come From? showing six root causes of psychosis. Categories include mental health conditions like schizophrenia and bipolar disorder, substance use, trauma or stress, medical or neurological issues, hormonal or biological triggers, and unknown or mixed causes. A brain illustration appears in the bottom right.

Mood Disorder Psychosis

Severe depression or bipolar disorder can sometimes include psychotic features.6 In bipolar disorder, psychosis usually appears during manic or depressive episodes and improves when the episode resolves. In a professional treatment program, the recovery process might take weeks to months. For depression with psychosis, symptoms often improve as the depression lifts, usually within a few months of starting treatment.

Postpartum Psychosis

Some new parents experience psychosis shortly after giving birth.7 This is a serious condition that usually develops within the first week after delivery. With quick treatment, postpartum psychosis typically improves within a few weeks to a few months. Most people recover completely, though they may have a higher risk of experiencing it again with future pregnancies.

Factors That Affect How Long Psychosis Lasts

Several factors can influence how long psychosis lasts and how well someone recovers. Understanding these can help you set realistic expectations about the recovery journey.

Early Intervention

One of the most important factors is how quickly someone gets help. The sooner someone starts treatment after their first episode, the better the outcomes tend to be. While research shows that it’s “common for a person to have psychotic symptoms for more than a year before receiving treatment,” says the National Institute of Mental Health (NIMH), “Reducing this duration of untreated psychosis8 is critical because early treatment often means better recovery.”

Treatment Approach and Adherence

The type of treatment someone receives—and how well they stick with it—makes a huge difference. Most effective treatment plans include a combination of medication, therapy, and social support. Missing medication doses or stopping treatment too early can lead to longer episodes or relapses. It’s like treating any other health condition: Consistent, high-quality care leads to better results.

Treatment adherence is an ongoing issue in patients with psychosis—one study shows that over 60% of psychotic patients “had adherence difficulties9 at some point” in their program. That’s why behavioral health experts use interventions like family involvement, psychoeducation, and motivational interviewing to try to improve treatment outcomes. 

Learn how therapists use specialized techniques to help you stay committed to your recovery journey in our guide to motivational interviewing.

What’s something people often misunderstand about psychosis recovery that you wish more people knew?

Psychosis is a mental health condition characterized by someone’s inability to stay connected to reality, which may include symptoms such as hallucinations, delusions, disorganized thinking, and poor insight/judgment. The most challenging part about psychosis is that people experiencing psychosis may have difficulty distinguishing their thoughts and their disordered thinking, hallucinations, and delusions. Recovery from psychosis is not linear or quick, and one of the most misunderstood ‘facts’ about recovery from psychosis is that people with psychosis always return to the exact state they were in before. They need time, they need adjustment; they can find ways to live and enjoy life while managing their symptoms.

Sorhaya Zamor, RN

Support System

Having supportive family, friends, and therapists can significantly shorten recovery time. People with strong support networks often recover faster10 because they have help navigating treatment, managing stress, and handling day-to-day responsibilities while they heal. If you’re supporting someone with psychosis, your patience and understanding matter more than you may realize.

Underlying Cause

The cause of psychosis affects its duration too. Psychosis triggered by stimuli like drug use or extreme stress often resolves more quickly than psychosis related to conditions like schizophrenia. Identifying and addressing the root cause is an important part of effective treatment.

Individual Factors

Every person is unique, and factors like previous psychotic episodes, stress levels, overall health, and even genetics can influence recovery time. As with physical illnesses, some people naturally recover more quickly than others. 

Stress and Environment

High-stress environments can prolong recovery from psychosis or trigger relapses. Creating a calm environment that supports psychosis recovery11 can help shorten episodes and prevent them from recurring. Sometimes, simple changes at home, at work, or in social circles can make a big difference in someone’s recovery.

While these factors influence recovery time, they don’t determine it completely. Even when circumstances aren’t ideal, many people still recover well with the right treatment and support.

Treatment and Recovery

Getting the right treatment can make a huge difference in how long psychosis lasts and how well someone recovers. Let’s look at the most common treatments and what recovery looks like.

Psychiatry (Medication)

Antipsychotic medications are usually the first line of treatment for psychosis.12 These medicines help reduce hallucinations, delusions, and confused thinking, usually within a few days to a few weeks. Some people notice improvement very quickly; others might need to try different medications to find the right fit.

Most people take these medications for at least 6-12 months after an episode. Your doctor might recommend longer treatment depending on the underlying cause and whether you’ve had multiple episodes. Never stop taking medication suddenly—always work with your healthcare provider to make changes safely.

To learn more about how to work with your doctor to make sure your medication works for you, see our guide to medication management.

Therapy Options

Medication works best when combined with therapy. The NIMH explains that effective psychosis treatment is a team effort: 12

Treatment also often includes other elements. There is substantial research support for coordinated specialty care, which is a multi-element, recovery-oriented team approach to treating psychosis that promotes easy access to care and shared decision-making among specialists, the person experiencing psychosis, and family members. 

When you access professional care, your treatment team can create a comprehensive treatment plan that combines medication, therapy, and other support. This might include psychotherapy like cognitive behavioral therapy (CBT), support groups, or social skills training, based on what best meets your needs. 

Day-to-Day Support

Recovery isn’t just about medical treatment—it’s also about redesigning your daily life. This might include help with housing, employment, education, or building healthy routines. Some people work with case managers13 who can connect them with community resources and provide practical support during recovery.

What to Expect During Recovery

Recovery from psychosis is usually gradual. Most people see significant improvement within a few months of starting treatment, though complete recovery can take longer. Schizophrenia survivor Sarah Ryan describes emotional recovery from psychosis14 as: 

  • Accepting a new normal: Accepting that while you may never be exactly the same person you were before psychosis, you can find pride in adapting to the new you 
  • Trusting yourself: Having patience and allowing positive experiences to accumulate over time, which gradually strengthens your confidence 
  • Believing in yourself: Choosing to value yourself despite a stigmatized diagnosis and maintaining hope that you can have a meaningful future
  • Wanting to be yourself: Letting go of comparing yourself to “normal” people and recognizing that your life has value and purpose despite the challenges you’ve faced

Some people recover completely from psychosis. Others learn to manage occasional negative symptoms while leading full, meaningful lives. Many people worry about having another episode, which is a common concern. Working with your care team to identify early warning signs and create a relapse prevention plan can help you manage this fear as you keep taking steps forward.

How can family members or loved ones best support someone recovering from psychosis, especially in the early stages?

Family members can best support someone recovering from psychosis by approaching them with empathy, patience, a calming demeanor, as much normalcy as possible, and a willingness to learn. Psychoeducation is key—understanding what psychosis is and what it isn’t helps reduce fear and stigma for both you and your loved one. Encourage ongoing treatment, stay aware of early warning signs, and have a plan in place in case symptoms reemerge. Most importantly, remind them they’re not alone—you’re in this together.

Rebecca Tenzer, MAT, LCSW, CCTP, CGCS, CCATP (Neuroscience), CCFP, CIMPH | Astute Counseling & Wellness Services

Finding Your Way Forward: Embracing Life After Psychosis

Recovery from mental health disorders is a challenging but rewarding process that involves ups and downs. But as Ryan says of her experience with psychosis recovery,14

For the first time, I can say with confidence that it is good and right to be me. My life is not a mistake, and good things have come out of my life that outweigh the bad. I can never truly make sense of what happened to me, but I have finally let go, because I have too many other great things to hold onto that are pulling me forward.

You, too, can come to see the great things that are pulling you forward—and professional care can help. If you’re experiencing symptoms of psychosis, don’t wait to get help. Reach out to a mental health professional today and give yourself the best chance of recovery. 

FAQs

Q: How long does it take to get out of psychosis?

A: Most people start to improve within a few weeks of beginning treatment. Recovery typically takes a few months to a year or more, though this varies widely depending on the cause, treatment approach, and other individual factors.

Q: Does the brain go back to normal after psychosis?

A: Research shows that the brain actively tries to heal itself after psychosis,15 even before treatment begins. While some brain areas show tissue loss, others actually increase in size. One study shows these tissue increases are linked to better outcomes, including milder symptoms and improved thinking skills. This suggests that psychosis isn’t simply a degenerative condition, as previously thought, but one where natural recovery processes are already happening when people first seek help. Proper treatment can support these healing processes, which improve long-term recovery.

Q: Can psychosis go away on its own?

A: Some brief forms of psychosis might resolve without treatment, but this is risky. Without proper care, psychosis often gets worse and can lead to dangerous situations or long-term problems. Professional help significantly improves outcomes and reduces suffering.

Q: What triggers a psychotic episode?

A: Common triggers for psychosis include extreme stress, sleep deprivation, drug use (especially cannabis, amphetamines, and hallucinogens), traumatic events, and hormonal changes like those after childbirth. For people with conditions like schizophrenia, even everyday stresses can sometimes trigger episodes.

Can psychosis be temporary?

A: Yes, psychosis can definitely be temporary. Many people who experience psychosis have just one episode in their lifetime, especially if it was triggered by stress, substance abuse, or a medical condition that gets treated. Even people with ongoing conditions like schizophrenia can experience long periods without psychotic symptoms when they receive consistent care.

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Xanax and Alcohol: 5 Critical Risks of Mixing These Substances

Mixing Xanax and alcohol is more common than you might think—and that’s concerning because this combination carries some serious risks. Both substances affect your brain in similar ways, and when they’re taken together, they can amplify each other’s effects to a potentially life-threatening degree. 

Most people don’t realize that having “just a few drinks” while taking Xanax can harm their health.

Some people mix these substances on purpose; others don’t fully understand their risks. Either way, the combination can cause lasting damage to your physical and mental health.

We’ll help you understand how Xanax and alcohol affect your body, why the combination is so risky, and how to get help if you’re concerned that you or your loved one is becoming dependent.

Illustration warning about the dangers of mixing Xanax and alcohol. A prescription bottle and liquor bottle pour into a bubbling beaker, symbolizing a dangerous chemical reaction. Text reads:

What Happens When You Mix Alcohol and Xanax?

When you mix Xanax (the brand name for alprazolam) and alcohol, you’re combining two substances that both slow down your central nervous system. Xanax works by boosting the effects of GABA1 (Gamma-aminobutyric Acid), a natural neurotransmitter that reduces brain activity. Alcohol affects many of the same brain systems, also increasing GABA’s effects while blocking other brain chemicals.

This creates what behavioral health experts call a synergistic effect. This means that when combined, Xanax and alcohol don’t just add their effects together—they multiply them. This is why the combination is especially dangerous.

Why do people mix Xanax and alcohol?

People mix Xanax (alprazolam) and alcohol primarily for enhanced sedative effects, as both substances depress the central nervous system which can lead to increased relaxation, euphoria, or intoxication. Some individuals may do this intentionally to heighten the effects, while others may mix them unintentionally, not realizing how dangerous the combination can be.  It is important to ask what intention the person had when mixing the substances or if it was consumed unintentionally.

Andrew J. Schreier, ICS, CSAC, LPC, ICGC-II, BACC

Infographic titled “What Happens When You Mix Xanax & Alcohol,” showing five risks: enhanced sedation, impaired judgment, memory blackouts, slowed breathing, and increased overdose risk. Visual icons accompany each effect, with illustrations of a prescription bottle and alcohol bottle on the right. Recovery.com logo appears in the bottom left.

1. Enhanced Sedation

Both Xanax and alcohol are central nervous system depressants2 that cause sedation on their own. When combined, this sedative effect becomes much stronger.

You might feel extremely drowsy, dizzy, or uncoordinated. Tasks that require alertness, like driving or using machinery, become highly dangerous. Even just walking around normally is more dangerous, as you’re more likely to fall and hurt yourself.

2. Life-Threatening Breathing Problems

One of the most life-threatening side effects of mixing Xanax and alcohol is respiratory depression—when your breathing becomes dangerously slow or shallow. Both substances suppress the part of your brain that controls breathing.

Together, they can slow your breathing to the point where your body doesn’t get enough oxygen, potentially leading to brain damage, coma, or death.

When combined, Xanax and alcohol suppress your autonomic respiratory drive.3 That means they interfere with the brain stem’s ability to detect carbon dioxide in your blood—the primary trigger that tells your body to breathe. Without this signal functioning properly, your breathing can slow or even stop completely without even feeling like you’re having trouble breathing.

3. Increased Overdose Risk

This combination increases your risk of overdose. Even amounts of each substance that would be safe individually can become deadly when combined. In fact, one report finds Alprazolam (Xanax) is even more toxic than other benzodiazepines in overdose,4 warning that “severe toxicity is often related to co-ingestants, especially alcohol.”

This is particularly dangerous because the effects of alcohol and Xanax can be unpredictable—what might seem like a small amount of alcohol can dramatically increase the effects of Xanax in your system.

Maybe you’ve taken your normal prescribed dose of Xanax with a moderate amount of alcohol before without serious consequences. But taking higher doses, changes in your physical condition, timing between doses, or even what you’ve eaten that day can suddenly make the same amounts deadly.

4. Memory Impairment and Blackouts

Both Xanax and alcohol affect your memory. Used together, they can cause severe memory problems. You might find yourself having more blackouts or periods of time you can’t remember at all.

One participant in a study on benzo use by young people in the UK5 reflects on his experience with frequent blackouts: 

I don’t know how many memories or experiences I have lost due to my benzo use back then, but they are parts of my life that I will never be able to get back.

These memory gaps can be frightening—and potentially dangerous—if you made decisions or took actions you can’t recall.

What are the risks of combining alcohol and Xanax?

In your brain, alcohol increases the release of the neurotransmitter GABA, which produces slower brain activity that you perceive initially as relaxation. But both alcohol and Xanax also enhance the effect of the GABA-A receptor, making the increased GABA levels much more potent. This creates a particularly dangerous situation since a dose of either Xanax or alcohol that might be “safe” on its own can combine in the brain in dramatically more powerful and unpredictable ways. They also have synergistic effects on muscle control, short-term memory, judgment, and breathing- meaning that alcohol and Xanax are incredibly dangerous and potentially fatal when combined.

W. Lee Warren, MD

Infographic showing the health impact of Xanax and alcohol individually and when combined. One Xanax leads to moderate sedation, and one alcoholic drink causes a mild buzz. Together, they result in severe health risks. A skull and crossbones image emphasizes the danger. The graphic is titled Xanax and Alcohol Dose Comparison, with a subtitle stating they are safe on their own but dangerous when combined. Recovery.com logo is visible at the bottom.

5. Behavioral Changes

Over time, the combination of substances can cause noticeable changes in how you feel and act. You might become more aggressive, emotional, or take risks you normally wouldn’t. Severely impaired judgment can lead you to make poor decisions with lasting consequences. While most people start taking Xanax for anxiety or panic disorders, abusing Xanax can make you feel more anxious or agitated rather than calmer.

Why Do People Mix Xanax and Alcohol?

People mix Xanax and alcohol for several reasons, often without realizing how serious the risks are.

  • Seeking Stronger Effects: Some people combine these substances intentionally to feel a stronger effect. Since both Xanax and alcohol reduce anxiety and make you feel relaxed, some people think taking them together will increase these pleasant feelings. They might be seeking deeper relaxation or trying to escape stress, anxiety, or other emotional discomfort.
  • Self-Medication: Someone whose prescribed Xanax isn’t fully controlling their anxiety disorder might drink alcohol for additional relief. This often happens when anxiety breaks through between doses6 or when someone has developed tolerance to their medication.

For more information on how substances can interact with each other and affect your body’s response to medication, see our article on cross-tolerance. Understanding this concept is especially important if you take Xanax or other prescription drugs.

  • Unintentional Mixing: Many people mix these substances unintentionally. Someone might take their prescribed Xanax and later attend a social event where they have a drink, not realizing the interaction they’re creating. Others might simply not know about the risks or might think that “just one drink” won’t cause problems.
  • Social Pressure: Social pressure can play a role too. In settings where drinking is expected, someone who takes Xanax might feel awkward explaining why they can’t drink, especially if they don’t want to discuss their mental health.

Regardless of the reason, mixing Xanax and alcohol is never safe, even in small amounts—the risks far outweigh any perceived benefits.

How Long After Taking Xanax Can You Drink?

If you’re taking Xanax, you might wonder if there’s a safe time to wait before having alcohol. The short answer is that there’s no truly safe window—the risks remain even after you think the Xanax has worn off.

Xanax has what medical professionals call a half-life, which is how long it takes for half of the drug to leave your system. For Xanax, the average half-life is about 11 hours,7 but this can range from 6 to 27 hours depending on several factors.

This means that even if you took Xanax in the morning, a significant amount could still be in your body when you have a drink that evening.

A few factors affect how long Xanax stays in your system:

  • Your age (older adults eliminate the drug more slowly)
  • Your liver function (liver problems can slow down elimination)
  • Your weight and metabolism
  • Whether you’re taking other medications that interact with Xanax
  • How long you’ve been taking Xanax (regular users may metabolize it differently)

Even if you can’t feel the long-term effects of Xanax, the drug is still in your body and can still interact with alcohol. Just because you don’t feel sedated from a dose you took earlier doesn’t mean it’s safe to drink.

If you’re taking Xanax, it’s best to avoid alcohol completely. If you’re concerned about interactions, talk to your healthcare provider about your specific situation.

How do you treat alcohol and Xanax addiction?

Xanax and alcohol use can lead to psychological and physiological dependence after long-term use. If a person is thinking about quitting Xanax or alcohol after prolonged use, it is crucial for them to consider the need for medically monitored withdrawal management, as these are two substances that can lead to death as a result of withdrawal. It’s important to assess the history of withdrawal, the intensity of those experiences, and the need for current medical support. Post-withdrawal management placement criteria should be performed to assess the level of care a person may need to move forward with their recovery goals. Outpatient and residential treatment, individual therapy, and self-help groups are all appropriate levels of care for people who struggle with Xanax and alcohol addiction.

Tanya Kraege LCSW, CSAC, CCAR RC, WI CPS | Ventus Rex

Do You Need Medical Detox for Alcohol and Xanax?

If you’ve been using both Xanax and alcohol regularly, especially in combination, you should not try to quit on your own. Withdrawal from either substance can be dangerous, but withdrawing from both at the same time can be life-threatening.

Withdrawal symptoms from Xanax8 and alcohol can include:

  • Seizures
  • Hallucinations
  • Severe anxiety and panic
  • Dangerous changes in blood pressure and heart rate
  • Delirium tremens (DTs),9 a severe (and potentially deadly) symptom of alcohol withdrawal

Professionally supervised detox is a safe environment where healthcare specialists can monitor your health and help you manage withdrawals. In a medical detox program, your doctor may give you medications to ease withdrawal symptoms and prevent complications.

Detox typically lasts 5-7 days but can take longer depending on your history of use. During this time, your medical team will gradually taper your dosage to minimize symptoms as your body adjusts to functioning without these substances.

After detox, it’s important to continue with a comprehensive treatment program to address your underlying reasons for substance use and learn strategies for long-term recovery.

Treatment Options for Alcohol and Xanax Addiction

Recovery from Xanax and alcohol addiction involves several phases of treatment: 

Medication-Assisted Treatment

Some medications can help manage cravings and support recovery. While there are no specific medications approved for benzodiazepine addiction, certain medications may help with anxiety symptoms or co-occurring conditions.

If you’re curious about medication options that can help with recovery from substance abuse, see our article on medication-assisted treatment (MAT) to learn if this approach might be right for you.

Inpatient Rehab

In inpatient Xanax and alcohol rehab, you live onsite and receive round-the-clock care in a structured, substance-free environment. Residential rehab typically lasts 30 to 90 days and includes:

  • Evidence-based and holistic therapies
  • Addiction education and recovery coaching
  • Learning and practicing healthy coping skills
  • Treatment for co-occurring mental health conditions

Outpatient Programs

For those with less severe substance use disorders or who have completed inpatient treatment, outpatient programs allow you to live at home while attending treatment sessions several times a week. These programs offer similar therapies to inpatient care but with more flexibility.

Support Groups and Aftercare

Long-term recovery often involves ongoing support through:

  • Ongoing one-on-one therapy 
  • Alumni programs through your treatment center
  • Meeting regularly with sober community via AA, SMART Recovery, or other support groups
  • Building your social support network

The best treatment plans are individualized and created specifically for you and your unique situation. They don’t just focus on helping you stop using substances—they also address any underlying trauma or mental health concerns that might have led you to use them in the first place. Everyone’s journey to well-being looks different, and finding the right combination of support is the key to long-term success.

Ready to find help for Xanax and alcohol use disorder? Our treatment finder can show you rehab options that match your location and specific needs—just a few clicks can connect you with centers that can help.

FAQs

Q: What happens when you mix alcohol and anxiety medication?

A: When you combine alcohol with anxiety medications like Xanax, you significantly increase the sedative effects of both substances. This can lead to extreme drowsiness, breathing problems, memory impairment, and increase your risk of overdose. The combination affects brain function more severely than either substance alone and can be life-threatening even “moderate” amounts.

Q: Do people go to rehab for Xanax?

A: Yes, many people go to rehab specifically for Xanax addiction. Benzodiazepine addiction is a serious condition that often requires professional help to overcome safely. Because Xanax withdrawal can be dangerous, addiction specialists typically recommend medically supervised detox, followed by comprehensive addiction treatment that addresses both physical dependence and underlying causes.

Q: Can you drink on Xanax if you wait long enough?

A: There is no completely safe time frame for drinking after taking Xanax. Even if you wait 24 hours or longer, residual amounts of the drug may remain in your system. Individual factors like age, liver function, and metabolism affect how long Xanax stays in your body. The safest approach is to avoid alcohol completely while taking Xanax.

Q: What are the main risks of combining Xanax and alcohol?

A: The main risks include respiratory depression (dangerously slow breathing), enhanced sedation, memory blackouts, impaired coordination, behavioral changes, increased addiction risk, and increased risk of fatal overdose. This dangerous combination creates unpredictable effects that can vary significantly from one person to another.

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Is This Untreated ADHD? The Adult Symptoms Nobody Talks About

Living with undiagnosed ADHD as an adult can feel like swimming against the current. You might wonder why everyday tasks seem harder for you than for others. Many adults with ADHD weren’t diagnosed as kids, especially women and those who aren’t hyperactive. Without proper diagnosis and treatment, ADHD can affect your job, relationships, and mental health. Understanding these challenges is the first step toward managing them. 

This guide explains how untreated ADHD shows up in adults, how it affects daily life, and ways to find help—whether you’re looking for a diagnosis or exploring treatment options.

What Is Adult ADHD?

ADHD stands for attention-deficit/hyperactivity disorder. It’s a brain condition that makes it hard to focus, stay organized, and control impulses. Many people think ADHD is just for kids, but that’s not true. We often underestimate its prevalence—over 4% of adults have ADHD,1 but many don’t know it.

Adult attention-deficit/hyperactivity disorder often looks different than childhood ADHD. Kids and adolescents with ADHD might be very active and run around a lot. Adults with ADHD might feel restless inside, struggle with distractibility and executive function, have trouble staying organized, and find it hard to finish tasks. You might always lose your keys, miss important deadlines, or feel overwhelmed by normal daily responsibilities.

Many people think ADHD only affects hyper little boys2 or that smart, successful people can’t have it. The truth is anyone can have ADHD, no matter their gender or how smart they are. Some very intelligent adults with ADHD find ways to hide their symptoms, but this often leads to feeling anxious and tired all the time.

If simple tasks seem harder for you than for other people, or if you can hyperfocus on things you like but not on other important things, you might want to look into whether you have undiagnosed ADHD.

Infographic titled 7 Common Signs of Undiagnosed ADHD in Adults. Signs include chronic procrastination, hyperfocus on favorite things, frequent disorganization, losing items, emotional overreactions, time blindness, and racing thoughts at night. Each sign is represented with a gear-shaped icon.

Signs of Undiagnosed ADHD in Adults

It can be hard to spot untreated ADHD in adults, because it can look like other conditions. Adult ADHD doesn’t always match what we see in kids who can’t sit still. In adults, ADHD can be quieter but still cause major problems in daily life.

You might have undiagnosed adult ADHD3 if you often:

  • Can’t focus on boring tasks, but can get super focused on things you enjoy for hours
  • Put things off even when you really want to get them done
  • Have a messy home or desk and can’t find important things when you need them
  • Forget appointments, deadlines, or where you put your keys or phone
  • Start projects but don’t finish them, leaving things half-done
  • Misjudge time, always thinking tasks will take less time than they really do
  • Have a busy mind with thoughts that won’t slow down, especially at bedtime
  • Get upset easily and have trouble calming down when frustrated

ADHD shows up differently in different people. If you mainly struggle with inattention, others might assume you’re spacey, lazy, or say you’re not trying hard enough. If you have the hyperactive-impulsive type, people might think you’re “too much” — talking too much, moving too much, or making quick decisions without thinking.

Women with ADHD are often underdiagnosed4 as kids because they don’t always show obvious hyperactive behaviors. Instead, they may try extra hard to please others to make up for their struggles, or just seem like daydreamers who worry a lot.

Infographic explaining the 3 types of adult ADHD and how they present. The inattentive type involves trouble focusing and organizing; the hyperactive-impulsive type includes restlessness and impulsive actions; the combined type features a mix of both. Each type lists common symptoms and behaviors in adults. Icons represent each category.

What’s one overlooked way untreated ADHD has affected your (or your clients’) daily life that people might not expect?

If ADHD is untreated/undiagnosed, one may judge themselves very harshly for not being able to “keep up” with the typical demands of life. They may struggle with shame, anxiety, or self-criticism because they assume something is wrong with them, rather than understanding that their brain has unique strengths and needs that other non-ADHD people’s brains don’t have. These emotional struggles, in turn, can feel overwhelming or can contribute to executive functioning difficulties, making it harder for the person to get out of feelings of stuckness.

Kiki Fehling, PhD, DBT-LBC

The Impact of Untreated ADHD on Daily Life

Untreated ADHD affects nearly every aspect of daily functioning. At work, you might feel like you’re working twice as hard as colleagues to produce the same results. You may excel in crisis situations but struggle with routine tasks and paperwork. Job-hopping is common as people with untreated ADHD seek environments that better match their cognitive style.

In academic settings, young adults with undiagnosed ADHD often underperform5 relative to their abilities. ADHDers are often told they’re “not living up to their potential” throughout their education, or default to procrastination and last-minute cramming that only heightens their stress.

Managing your home life with untreated ADHD presents unique challenges. You might find that you accidentally overlook bills, even when you have money to pay them. Cleaning the house can feel overwhelming without a clear structure, and grocery shopping without a list can mean forgotten essentials and impulse buys.

Financial difficulties often accompany untreated ADHD. Research shows that because ADHD affects how people manage money,6 adult ADHDers are more likely to have lower credit scores, higher debt, and impulsive spending habits. You might make good money but still struggle with financial stability because of how ADHD affects planning and organization.

These daily experiences can make adults with untreated ADHD feel perpetually behind and wonder why life seems easier for everyone else. But these challenges stem from differences in brain function—not from lack of effort or ability. People who manage their ADHD effectively often develop creative solutions that work well for their unique thinking style.

Infographic titled What You’ve Been Told vs. What’s Actually Undiagnosed ADHD. Common criticisms like lazy, flaky, or disorganized are reframed as symptoms of ADHD such as executive dysfunction, time blindness, masking and burnout, rejection sensitivity, initiation difficulty, recall gaps, and attention problems. Each misconception is paired with a purple icon and an ADHD-related explanation.

Emotional and Psychological Effects

The emotional toll of untreated ADHD often goes unseen by the neurotypical world. After years of missing deadlines, forgetfulness, and feeling like you’ve failed, you might start to doubt yourself or feel ashamed. 

A lot of people with ADHD also deal with anxiety7 and depression. Sometimes these develop because of the daily struggles with ADHD. These other conditions can also mask ADHD, so you may end up getting treatment for anxiety, but not for the ADHD that’s causing it.

Living with untreated ADHD can be exhausting. You might feel like you’re always putting out fires, dealing with one problem after another without having room to breathe. This ongoing stress can wear you down, especially in jobs that don’t make room for different ways of thinking.

Many adults with undiagnosed ADHD become very sensitive to criticism or rejection. This is sometimes called rejection-sensitive dysphoria (RSD).8 It means criticism or feeling rejected hurts more deeply, making work and social situations extra stressful.

For many people, understanding that these feelings come from how your brain works—not because there’s something wrong with you as a person—is the first step to feeling better.

Relationship Challenges With Untreated ADHD

ADHD can affect your relationships in several ways: 

Love and Partnership

In romantic relationships, your partner might have a hard time understanding when you forget things you promised to do, interrupt during talks, or have trouble finishing household chores. They may feel like they’re doing more of the work.

Communication Barriers

Talking with others can be tricky sometimes. ADHD can make it hard to stay focused during conversations or remember important things your loved one told you. This can make them feel like you don’t care, when really your brain just takes in information differently.

Family Dynamics

Family relationships can face challenges too. If you’re a parent with ADHD,9 keeping regular routines might be harder. If you’re an adult with ADHD, your parents may not have understood why some things were difficult for you as a child.

Strain on Friendships

In friendships, staying in touch regularly might not come easily. You might cancel plans or forget birthdays, sending the message that you don’t care when you really do. But with understanding friends and the tools to communicate your needs, these challenges don’t have to hurt your relationships.

The bright side is that learning about ADHD can make all your relationships better. When you and your loved ones see ADHD as a different way your brain works and not as a choice you’re making, things can start to improve. People can start appreciating the good things ADHD brings to relationships—like your creativity, your excitement about life, and interesting conversations.

Long-Term Risks of Untreated ADHD

When ADHD goes untreated for a long time, it can affect your well-being in a few ways: 

Stress and Physical Health

Research shows that adults with untreated ADHD have more physical health challenges10 because it’s harder to keep up with regular sleep, exercise, and healthy eating habits. The extra effort it takes to manage life with untreated ADHD can create ongoing stress for your body and mind. Over time, this stress can contribute to other health concerns.

Career and Professional Development

Your work life might also be affected. Even though you may have great skills and ideas, untreated ADHD can sometimes make it harder to stay at one job or advance in your career. This can affect your income over time.

Substance Misuse as a Coping Strategy

Some adults with untreated ADHD turn to substances like alcohol or cannabis to help manage their symptoms without realizing they’re self-medicating. Getting treatment for both addiction and ADHD often helps reduce these substance abuse patterns.

Pointing out these effects isn’t meant to worry you, but to show how getting proper guidance for navigating ADHD can make daily life easier and support your long-term health. Each person has their own feelings about receiving an ADHD diagnosis, but many adults say they feel relieved and empowered after getting diagnosed and finding treatments that work for them.

How do you help adults with ADHD reclaim a sense of control or confidence in their lives—especially if they’ve struggled for years without a diagnosis?

One of the first steps I take as a mental health occupational therapist when working with clients after a late ADHD diagnosis is helping them navigate self-acceptance and self-compassion. From there, we look at how ADHD impacts their daily life by breaking down the flow of their day through the lens of habits and routines. Many of my clients struggle with transitions and balancing the different roles they play, so we focus on creating anchor habits—small, intentional activities like changing clothes after work or having tea before bed—to make shifts between tasks feel more natural. I also help clients integrate tidying and decluttering strategies into their routines, which reduces cognitive load and makes it easier to follow through with daily tasks without feeling overwhelmed.

Sarah Anderson, OTD, OTR/L | Elevated Wellbeing OT LLC

Treatment Options and Support

If you see yourself in these descriptions of untreated ADHD, it’s important to know that there are plenty of effective treatments and support systems available to help you. The first step is usually a comprehensive evaluation by a mental health professional who’s experienced in adult ADHD.

Medication 

Treatment usually involves a combination of approaches. Medication is often an important part of ADHD treatment plans,11 as it helps balance brain chemicals that affect symptoms of ADHD. Stimulants are the most commonly prescribed ADHD medications, but there are also non-stimulant options for people who can’t take stimulant medications or don’t find them helpful.

Therapy

Therapy specifically for ADHD12 can also be hugely helpful. Cognitive-behavioral therapy (CBT) for ADHD, for example, teaches practical skills for getting organized, managing time, and regulating emotions during mood swings. ADHD coaches can help you create systems that work with your brain instead of against it.

Support Groups

ADHD support groups, both in-person and online, connect you with others who understand what you’re going through. Sharing tips and challenges with people who “get it” can help you feel much less alone.

Supportive Work Environments

Workplace changes can help you succeed on the job. Simple adjustments like getting written instructions, using noise-canceling headphones, or having some flexibility in your work environment can help you make the most of your strengths while managing the challenges ADHD presents.

What’s one myth about adult ADHD you wish more people understood—and how do you respond to it?

One myth I wish more people understood is the belief that adult ADHD is just about being ‘distracted’ or ‘unfocused.’ I often remind clients that ADHD is deeply connected to how the nervous system regulates safety, energy, and connection. What looks like ‘procrastination’ or ‘lack of motivation’ is often a body that’s stuck in a state of overwhelm or shut down. When we start to explore ADHD through the lens of the whole person, not just the brain but the body, the environment, and relationships, it becomes easier to offer ourselves compassion and find what actually helps.

Amanda Stretcher, MA, LPC-S | Crescent Counseling

Living Successfully With ADHD (With or Without Medication)

It’s a proven fact that ADHD is, in some ways, an advantage13—especially when it comes to certain types of creative thinking. Research scientist Holly White at the University of Michigan points out:

ADHD may also bring with it an advantage: the ability to think more creatively. Three aspects of creative cognition are divergent thinking, conceptual expansion and overcoming knowledge constraints. Divergent thinking, or the ability to think of many ideas from a single starting point, is a critical part of creative thinking. Previous research has established that individuals with ADHD are exceptionally good at divergent thinking tasks, such as inventing creative new uses for everyday objects, and brainstorming new features for an innovative cell phone device. In a new study, college students with ADHD scored higher than non-ADHD peers on two tasks that tapped conceptual expansion and the ability to overcome knowledge constraints.

Many adults thrive with ADHD, with or without medication. The key is developing strategies that align with how your brain works. Instead of forcing yourself to conform to neurotypical expectations, successful management often means leaning into your unique cognitive style.

Coping Strategies for Adult ADHDers 

Many people find techniques like these helpful for improving their quality of life with ADHD:

Outside structure is vital when it’s hard to organize yourself. Try using timers, reminders, and visual cues to help with time awareness. Make big tasks smaller to help you get started. Work next to someone else (called body-doubling) to stay focused and accountable.

Technology can help a lot. There are ADHD apps14 that help with things like reminding you to take medicine or prioritizing tasks. When writing seems too hard, try making voice recordings of your thoughts instead.

Moving your body throughout the day can help with restlessness and improve your focus. Even small movements like fidgeting or working at a standing desk can help your brain work better.

And finally, remember the good things about having ADHD. Many adults with ADHD are great at creative thinking, solving problems in emergencies, and bringing excitement and energy to the things they care about. Finding places that value these strengths can turn ADHD from a challenge into an advantage.

Recovery isn’t about eliminating all ADHD symptoms—it’s about building a life that works with your brain rather than against it.

Reclaiming Your Potential: Next Steps for Adults with ADHD

Untreated ADHD doesn’t have to control your future. While living with ADHD has its challenges, learning more about how your brain works is a great step toward positive change. Whether you’re just now seeing these patterns in yourself or have wondered about adult ADHD for years, talking to a qualified healthcare provider can help you find an effective path forward.

Having trouble with organizational skills, focus, and time management does not say anything about how smart you are or your value as a person. ADHD is simply a different way your brain is wired. With the right support—like medication, therapy, coaching, or a mix of these—many adults with ADHD find that life gets easier and more enjoyable.

If you recognize yourself in the descriptions here, think about reaching out to a professional who’s experienced in working with adult ADHD. A thorough evaluation can help you learn how ADHD is affecting your life and what kinds of support might work best for you. Recovery.com can help you find treatment centers that understand adult ADHD and offer proven approaches to manage it.

You deserve a life that lets your uniqueness shine. 

FAQs

Q: What does untreated ADHD lead to in adults?

A: Untreated ADHD can lead to problems with work performance, relationship difficulties, financial struggles, executive functioning challenges, higher rates of anxiety disorders and depression, increased risk of substance use, and lowered self-esteem.

Q: Can you be successful with unmedicated ADHD?

A: Yes, many adults with ADHD succeed without medication by implementing effective strategies, creating supportive environments, and learning how to leverage their ADHD-related strengths like creativity and problem-solving abilities.

Q: How does untreated ADHD impact relationships?

A: Untreated ADHD can strain relationships through miscommunications, forgotten commitments, emotional reactivity, and unequal responsibilities, which can cause patterns of misunderstanding and frustration.

Q: What are the long-term effects of untreated ADHD in adults?

A: Long-term effects can include chronic stress, career underachievement, financial struggles, higher risk of accidents, substance use disorders, and ADHD-related physical and mental health conditions.

Q: Can untreated ADHD in adults lead to other mental health issues?

A: Yes, untreated ADHD often leads to mood disorders like anxiety, depression, and low self-esteem, which sometimes develop as responses to ongoing ADHD-related challenges.

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Step One of AA: 4 Essential Ways to Understand the Foundation of Recovery

Taking that first step toward recovery can feel a lot like standing at the edge of an unfamiliar path. If you’re looking into Alcoholics Anonymous (AA) as a possible way to help with drinking problems, understanding Step One is a good place to start.

This first step introduces an idea that many people find challenging: The thought that alcohol may have taken control over parts of your life.

In this article, we’ll break down what Step One of AA really means, how it functions within the program, and how people typically work with it.

We’ll also answer common questions and clear up misunderstandings to help you figure out if this approach might be a good fit for your recovery needs.

Illustration of a person sitting in a sinking boat with one hand covering their face, representing denial. Text on the left reads that you can't fix a problem if you don't admit it exists. The message highlights the importance of acknowledgment in recovery.

What Is Step 1 of Alcoholics Anonymous?

Step One of AA1 simply states: “We admitted we were powerless over alcohol—that our lives had become unmanageable.”

These words from the Big Book introduce the idea of honesty—what they call the first spiritual principle in the program. Basically, this step asks people to recognize that they can’t control their drinking, and that alcohol has created problems in their lives.

When AA began back in 1935,2 founders Bill Wilson and Dr. Bob Smith came up with this step based on their own struggles with problematic substance use. They noticed that many people with drinking problems spent a lot of time trying to control their drinking before they finally asked for help.

In AA’s approach, Step One works like a doorway into the program: It’s about recognizing there’s a problem and that trying to solve it on your own hasn’t worked. AA sees this acknowledgment as necessary before moving on to the other steps in the program.

How do you explain the concept of “powerlessness” to someone new to recovery who may find it disempowering or difficult to accept?

I tell people new to recovery that feeling powerless is a very normal part of the process. Feeling powerless doesn’t mean you’re weak—it means you’re finally being honest with yourself during a very difficult time. It’s saying, ‘This isn’t working, and I can’t do it alone,’ which is actually acknowledging the power substance use has had over you in the past and that you’re ready to make a change. Admitting powerlessness is about taking your power back by choosing a new way forward.

Rebecca Tenzer, MAT, LCSW, CCTP, CGCS, CCATP, CCFP, CIMPH | Astute Counseling & Wellness Services

1. Why AA Emphasizes Admitting Powerlessness

The idea of being “powerless” might sound strange, especially since we live in a culture that values taking control and handling things on our own. But within AA, acknowledging this powerlessness is considered helpful for a few reasons.

People who support this approach say it takes away the mental and emotional drain of constantly trying to control drinking behaviors. Many folks share that they’ve spent years trying different strategies to manage their drinking—like promising they’d stop after just one drink, switching from hard liquor to beer, or only drinking on weekends. From AA’s perspective, accepting that you can’t control alcohol allows you to stop wasting energy on these efforts and redirect it toward actually getting better.

This admission can also open the door to considering outside help. AA believes that as long as someone thinks they can fix their drinking problems through sheer willpower, they’ll probably resist asking others for support. Step One is designed to help you become more open to the and structured approach and community support system that make AA so effective.3

Honesty in Recovery

This step establishes the importance of honesty when working the Steps of Alcoholics Anonymous. Self-honesty is the foundation of recovery,4 because breaking through denial is often what allows someone to recognize their relationship with alcohol has become unmanageable. Many people only become willing to change when the evidence of alcohol’s impact becomes too overwhelming to ignore.

The Power in Admitting Limitations

Step One represents a basic paradox in AA’s thinking: The idea that admitting your limitations can actually be empowering. Step One states5 that while no one likes to admit powerlessness, 

Upon entering A.A. we soon take quite another view of this absolute humiliation. We perceive that only through utter defeat are we able to take our first steps toward liberation and strength. Our admissions of personal powerlessness finally turn out to be firm bedrock upon which happy and purposeful lives may be built.

This shift—from struggling alone to accepting help—is one that many AA members describe as life-changing. 

Infographic illustrating Step One of Alcoholics Anonymous: Admitting Powerlessness Over Alcohol. Key points include acknowledging alcohol's control over thoughts and behavior, recognizing its negative impact, understanding powerlessness is not weakness, and accepting this as the first step to recovery. A handcuffed hand holds a bottle in the corner.

2. Different Perspectives on Step One

Some people worry that talking about “powerlessness” might make you feel weak, or like you’ve somehow failed. But AA members explain that this step isn’t about personal weakness. It’s about recognizing addiction as a condition that can affect anyone.

Terry G, who has been in recovery from alcohol use disorder6 for over 30 years, explains:

I think a lot of us have a problem with this part of this step: Powerlessness over alcohol. I had a major problem with powerlessness because when I drank I felt powerful. Booze did a lot of things for me that I couldn’t do for myself. Now, I believe powerless over alcohol simply means that when we start drinking, we don’t know where it’s going to end. Powerlessness means I’ve come to a conclusion in my life that I cannot drink safely.

It’s worth noting that some recovery approaches take a different angle, focusing more on empowerment rather than powerlessness. These different approaches highlight an important truth: The recovery process isn’t one-size-fits-all, and different methods may work better for different people depending on their experiences and beliefs.

In your experience, why is Step One considered foundational in the 12-Step model, and how does it set the stage for the rest of the recovery process?

Step One is considered foundational in the 12-Step model because it helps individuals move from a sense of control to surrender, recognizing that their addiction has taken over their lives. It encourages humility by fostering an honest self-assessment, allowing them to see the unmanageability caused by their substance use. This step also opens the door to seeking help, shifting the focus from isolation to connection with a supportive recovery community. By accepting powerlessness, individuals create the foundation for lasting change and growth in the recovery process.

Andrew Schreier, ICS, CSAC, LPC, ICGC-II, BACC

Infographic titled Common Strategies that Fail to Control Problem Drinking. It lists ineffective approaches like switching to beer or wine, drinking only on weekends, setting drink limits, drinking only when eating or socially, and taking short breaks like Dry January. Background features a wine glass and splashes of red liquid.

3. How People Typically Approach Step One

In AA, working through Step One isn’t just a declaration—it’s more of a process. Here’s how AA members engage with this concept in practice:

People often start by assessing how alcohol has affected their lives7—a practice often referred to as “taking inventory.” This might include listing times they drank more than they planned to, failed attempts to cut back, and how drinking has impacted their relationships, work, and health. This exercise helps people see their relationship with alcohol more clearly and objectively.

If you’re exploring Step One, you might ask yourself questions like: 

  • What happens when I try to control my drinking?
  • How has alcohol affected my relationships?
  • If a friend described my drinking patterns to me, what advice would I give them?

AA meetings that focus on Step One give you a chance to hear how others have navigated similar challenges. Realizing you’re not alone in your struggles helps normalize your experience and ease feelings that you’re somehow uniquely flawed when it comes to substance use disorders.

What are some practical ways people can begin working Step One, especially if they’re struggling to see how alcohol has made their life unmanageable?

For many, the very first step of Alcoholics Anonymous (AA), admitting powerlessness over alcohol and that life has become unmanageable, is most challenging because use has become essentially ingrained into every fabric of one’s life. People are naturally creatures of habit, and change is a daunting process, especially when it involves a holistic lifestyle and environmental change. Rather than envision the entire process as a whole, begin by taking it one day and step at a time. Optimistically reframe your mindset to one where you can see the benefits of recovery, perhaps so much so that your life will be even better than before you started drinking. This requires a true inventory of self and others, which likely requires prosocial and/or professional support. Remember, there was a time when you used to have more control of your drinking before it got out of hand. Channel that younger, wiser voice within your head to let you know that everything will ultimately be okay.

Matthew Glowiak, PhD, LCPC, CAADC, ACS, NCC | Hazelden Betty Ford Graduate School

4. How Step One Fits With the Rest of AA

In the AA program, Step One is the entry point into the AA framework. Understanding this relationship helps clarify how the recovery program works as a complete system. Anne Marie, an AA member who has been sober since 2018, recalls how hard—and ultimately helpful—it was to admit she was powerless over alcohol:8

Something happened and for the first time I could see I was not the only person affected by my drinking, and I admitted I needed help. I was terrified that because of this admission I couldn’t withdraw it. There was also relief in outing my ‘little’ problem. 

Step One is the foundation that makes all the other steps of AA (Step Two of accepting help from a higher power, and so on) relevant. All of the following steps build upon the initial idea established in Step One—that alcohol has become unmanageable and we need help. “We need to be honest and admit that we are alcoholics9 and be honest with ourselves and start working a program of recovery, because it’ll reinforce Step One,” says Terry G. “All the other steps reinforce Step One.” 

Many long-term AA participants say they revisit Step One throughout their recovery journey. During challenging times, reconnecting with their original motivation for seeking help serves as a reminder of their personal experiences with alcohol addiction and strengthens their commitment to staying sober.

Exploring Your Alcohol Treatment Options

Learning about Step One of the Twelve Steps helps you understand one approach to recovery, but it’s definitely not the only way forward. There are many paths that can lead to healing.

Some people benefit from peer-led 12-Step programs like AA,10 while others prefer non-12-Step options like SMART Recovery. Some find help through medication-assisted treatment, while others do best with therapy or holistic modalities. Most people find they benefit from a combination of approaches that meet their needs. Support groups like Al-Anon also exist to help family members of those struggling with alcohol and drug addiction.

If you’re not sure where to start, talking to an addiction specialist can help. They can suggest options based on your specific situation, whether it’s meeting with a counselor once a week, joining a more intensive outpatient treatment program, or spending time in inpatient treatment center or sober living. They can also help you determine if detox is necessary.

Ready to Find Your Path Forward? Personalized Recovery Support Is Here

When you’re ready to take the next step toward your new life, our addiction treatment finder can help you connect with programs that match what you’re looking for. Remember, there’s no one “right way” to mental health and wellness—what matters is finding a path that makes sense for you or your loved one.

FAQs

Q: What does Step 1 of AA mean?

A: Step One means recognizing that you can’t control your drinking and that alcohol has made your life difficult to manage in some ways.

What is the principle behind Step 1 in AA?

A: The main principle of Step One is honesty: Facing the truth about your relationship with alcohol without minimizing or denying the problems.

Do I have to believe in the concept of powerlessness to recover?

A: No. While AA emphasizes this concept, many people recover through other approaches that focus on different principles. The important thing is finding an approach that works for you.

Can I work Step 1 without joining AA?

A: Yes. While Step 1 is part of AA’s program, you can explore its concepts independently or within other addiction recovery frameworks to see if they’re helpful for you.

How long does it take to complete Step 1?

A: There’s no set timeline. Some people connect with this concept quickly, while others may spend more time working through it. In AA, the Twelve Traditions aren’t considered “completed” but rather ongoing practices.

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4 Stages of Alcoholism: What to Know About How Drinking Problems Evolve

Alcoholism doesn’t happen overnight. For many people, it develops gradually through several stages, each with its own set of signs and challenges. Understanding these stages can help you recognize problems in yourself or your loved one and intervene before the consequences get worse. 

The Disease Model: How Alcoholism Progresses

This framework for understanding alcoholism progression comes from E.M. Jellinek, the first to propose the disease model of alcohol addiction that’s now widely accepted by medical professionals. His model outlines 4 distinct stages that show how alcohol dependence develops.1

Let’s break down each stage in simple terms so you know what to watch for.

Infographic stating that around 90 percent of people in the pre-alcoholic stage of alcoholism do not believe their drinking is a problem. A stylized hand holds a beer mug on the right side of the image. The background features light purple tones.

Stage 1: Pre-Alcoholic Stage

In this early stage, a person starts using alcohol not just for enjoyment, but to feel better. They might drink to relax after work or to feel more comfortable at parties. This might not seem like a problem yet, but it’s the start of using alcohol as a solution rather than a choice.

Signs you might be in the pre-alcoholic stage:

  • You look forward to drinking alcohol as a way to unwind or feel comfortable
  • You can handle more alcohol than before (increased tolerance)
  • You sometimes drink alone
  • You finish alcoholic beverages faster than others around you
  • You feel a little anxious when you can’t drink

Most people in this stage still function normally in daily life. Friends or family may not notice anything unusual about your drinking habits.

This is the easiest stage to make changes. Try setting limits on your drinking, tracking how much you consume, or finding alcohol-free ways to relax and socialize.

Alcohol use doesn’t just suddenly become a problem—issues with alcohol use can build slowly over time, in ways that are easy to overlook. By understanding the stages of alcoholism, we can better identify early warning signs and intervene before more challenges and consequences occur.

— Caroline Beidler, MSW
Infographic titled 4 Stages of Alcoholism, showing a progression from balanced drinking to late-stage alcoholism. The stages include balanced drinking, pre-alcoholic, early stage, middle stage, and late stage. Each stage includes descriptions of behavior, binge frequency, and withdrawal symptoms, with visual indicators increasing in severity.

Stage 2: Early Stage

In the early stage, casual drinking shifts toward a more concerning pattern and early warning signs begin to appear. The person develops regular drinking routines, and alcohol starts causing problems.

Finding the Right Support

  • You experience occasional blackouts (can’t remember what happened while drinking)
  • You feel defensive when someone mentions your drinking
  • You make excuses for drinking or downplay how much you consume
  • Your relationships start to suffer because of alcohol
  • You drink to deal with problems caused by previous drinking

During this stage, a dangerous cycle begins. Drinking causes problems, which creates stress, which leads to more drinking to cope with that stress. Getting help at this stage is still relatively easy, and the chance of successful recovery is high with proper support.

Stage 3: Middle Stage

The middle alcoholic stage (or “crucial” stage) is when physical dependence takes hold. Your body now expects alcohol regularly, and you feel uncomfortable without it. Many people realize they have a problem at this point and try to control their drinking.

Signs of the middle stage:

  • You feel withdrawal symptoms when you’re not drinking2 (shakiness, anxiety, sweating)
  • You’ve tried to cut back or quit but couldn’t maintain it
  • You hide your drinking from others
  • You sometimes need a morning drink to steady your nerves
  • You black out more often 
  • You feel deep shame or guilt about your drinking
  • Hangovers get worse because your body’s ability to process alcohol is compromised as liver function declines
  • Physical health problems start to appear

People often try ineffective methods to control their drinking, like switching from liquor to beer or limiting drinking to weekends. These attempts usually fail without adequate support.

Many people in this stage keep up appearances outwardly while struggling privately. They might hold down jobs and maintain relationships—however problematic—while denying the severity of their problem.3

Infographic titled Top 5 Signs You Might Have a Problem with Alcohol. It lists five warning signs: drinking to cope with stress, hiding or lying about drinking, drinking more than planned, feeling anxious without alcohol, and being unable to cut back. Each sign is represented by a different glass with a red flag.

Stage 4: Late Stage

The late stage (or “chronic” stage) is when alcohol abuse completely takes over and a person feels a total loss of control over their drinking. It’s no longer a choice but a powerful compulsion that directs most of their decisions and behaviors.

Signs of the late stage:

  • You can’t control when or how much you drink
  • You have severe withdrawals when not drinking
  • You’ve abandoned activities and interests you once enjoyed
  • Your work performance has significantly declined
  • Relationships are severely damaged or broken
  • You continue drinking despite serious physical and mental health problems
  • You may have had alcohol-related legal issues like DUIs

Alcohol-related health complications4 are an increased risk at this stage. Liver damage or cirrhosis, heart problems, digestive bleeding, and changes in brain function are common. You may have visible symptoms even when you’re not drinking.

Despite how serious this stage is, recovery is still possible with professional help. Medical treatment is usually necessary, starting with medically supervised detox followed by comprehensive addiction treatment.

Things began innocently enough when I began drinking socially in high school, but quickly escalated when I realized how much more confident I felt when intoxicated. It was a bad combination that I used for many years in social settings, to numb out “bad feelings” and ultimately use alcohol as daily self-medication. I trained my brain and body to think they “needed” alcohol for any kind of stressful situation or negative emotion. This was very destructive for me and eventually I had to make a change or I didn’t know what might progress even further.

— Ericka Anderson

Understanding Alcohol Addiction

Substance use is commonplace in many aspects of our daily lives. From celebrating achievements to unwinding after a stressful day, drinking is normalized in ways that can mask developing problems. This cultural acceptance can make it hard to recognize when casual drinking is crossing into problematic territory.

Health experts increasingly recognize “gray area drinking“—a space between moderate consumption and severe alcohol use disorder. In this middle ground, you might not meet the clinical criteria for addiction, but your relationship with alcohol is causing subtle problems in your health, relationships, or daily functioning. 

Many people exist in this gray area without realizing it: The 2023 National Survey on Drug Use and Health by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that 10.2% of people in the U.S had an alcohol use disorder.5 People regularly exceed the limits for moderate drinking (or even heavy drinking or binge drinking) without noticing. (According to medical guidelines, moderate drinking6 means up to 1 drink daily for women and 2 for men.) 

While most people can drink moderately without causing immediate problems in their lives, research increasingly shows there is no completely “safe” amount of alcohol consumption7 when it comes to long-term health outcomes.

Consider these warning signs about your drinking habits:

  • Do you often drink more or for longer than planned?
  • Have you found it hard to stop or cut back, despite wanting to?
  • Do you find yourself preoccupied with thoughts of drinking?
  • Have you noticed yourself prioritizing drinking over activities or hobbies you used to enjoy?
  • Are your relationships with family or friends being affected by your alcohol misuse?
  • Do you sometimes take risks while drinking, like driving or having unsafe sex?
  • Do you need more drinks to feel the same effects of alcohol?
  • When you stop drinking, do you have any physical discomfort like shakiness, trouble sleeping, or nausea?

If you answered yes to more than one of these questions, it could indicate problem drinking.8 Recognizing these patterns doesn’t necessarily mean you have a diagnosable addiction, but they are important signs that your relationship with alcohol could benefit from some attention and possibly professional help.

Recovery Is Possible at Any Stage

No matter which stage of alcoholism you may be experiencing, recovery is always possible. Many people have found their way to healthier, happier lives after struggling with alcohol, and you can too. 

Alcohol treatment options include:

  • Medical detox to safely manage alcohol withdrawal and cravings
  • Inpatient alcohol rehab for structured, intensive care
  • Outpatient programs that allow you to live at home while attending intensive therapy
  • Sober living homes that provide a supportive, alcohol-free environment as you transition to independent living
  • Continuing care: Ongoing counseling, support groups like AA or SMART Recovery, and social support

These resources can help you start the process:

  • Your primary care doctor (who can refer you to addiction specialists)
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline: 1-800-662-HELP (4357)
  • Local Alcoholics Anonymous (AA) or other support group meetings

Wondering what might work best for you? Check out our complete guide to finding an addiction treatment program for an easy-to-use breakdown of programs, costs, and how to choose the right fit for your needs.

Recovery is not only possible, it is probable when we have the right supports and treatment.

— Caroline Beidler, MSW

A Note on the Modern Understanding of Alcohol Use Disorder

While Jellinek’s stages offer a helpful framework for understanding how alcohol problems typically progress, modern medicine has evolved toward a more nuanced approach. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) views alcohol problems as existing on a spectrum9 rather than in distinct stages.

Today, healthcare professionals diagnose alcohol use disorder (AUD) as mild, moderate, or severe based on how many criteria a person meets out of 11 possible symptoms. This spectrum approach recognizes that alcohol problems can develop in different ways for different people. Some individuals may experience certain symptoms but not others, and the progression isn’t always linear. Both models offer valuable perspectives for understanding how casual drinking can develop into more serious problems over time.

Find the Right Support for Your Journey

If you’re concerned about your relationship with alcohol, reaching out for professional guidance is a great first step. Whether your goal is to reduce harm from drinking or stop entirely, an addiction specialist can point you in the right direction and help you stay on track. 

Our addiction treatment finder helps you explore options that match your specific needs, connecting you with qualified treatment providers who can support your path to a healthier life.

FAQs

Q: What are the 4 stages of alcoholism?

A: The 4 stages of alcoholism in Jellinek’s disease model are: 

  1. Pre-alcoholic stage, where drinking is used to cope with stress
  2. Early stage, where patterns form and blackouts may begin
  3. Middle stage, where physical dependence develops with withdrawal symptoms
  4. Late stage, where excessive drinking becomes compulsive and health complications become serious

Q: How does alcohol addiction progress through different stages?

A: Alcohol addiction typically begins with using alcohol to cope with problems (pre-alcoholic stage). It progresses to regular patterns of drinking that cause life problems (early stage), then to physical dependence with withdrawal symptoms (middle stage), and finally to compulsive drinking despite serious consequences (late stage).

Q: What are the early signs of alcohol dependence?

A: Early signs of alcohol dependence include: 

  • Needing more drinks to feel the same effect (increased tolerance)
  • Looking forward to drinking as your main way to relax
  • Drinking alone more frequently
  • Feeling anxious when you can’t drink
  • Occasional blackouts
  • Becoming defensive when others mention your drinking

Q: How can I identify the different stages of alcoholism?

A: You can identify the stages of alcoholism by looking for specific signs: 

  • Pre-alcoholic stage shows increased tolerance and drinking to cope
  • Early stage includes blackouts and making excuses for drinking
  • Middle stage involves withdrawal symptoms and failed attempts to quit
  • Late stage is marked by compulsive drinking, severe health conditions, and an inability to control consumption

Q: What is late-stage alcoholism and what are the effects?

A: Late-stage alcoholism involves compulsive drinking where a person loses control over their alcohol consumption. Side effects include severe withdrawal symptoms, abandoned interests and activities, declining work performance, broken relationships, serious health complications (liver damage, heart problems, brain damage), and alcohol-related legal issues.

Q: Where can I find help for alcohol addiction?

A: Help for alcohol addiction is available through your primary care doctor, local support groups, and specialized treatment centers. Recovery.com is here to help. Options range from medical detox and inpatient programs to outpatient care and harm reduction approaches like setting drinking limits or creating alcohol-free days.

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How Do I Stop Being Codependent? 5 Expert-Backed Steps to Transform Your Relationships

How to stop being codependent.

Do you find yourself constantly putting others’ needs before your own? Are you the person everyone relies on, even when it drains your energy and emotional resources? You might be experiencing codependency—a pattern where your own sense of purpose and self-worth become tangled up in another person’s life and problems

Codependent relationships create strong emotional patterns. “Helping” people can become almost addictive, even though it leaves you feeling empty and exhausted in the long run. Breaking free from these patterns takes time. But with consistent effort, you can build a healthier relationship with yourself and others. 

Here are 5 key steps you can start taking now:

1. Recognize Your Codependent Patterns

The first step toward change is becoming aware of your codependent behaviors.1 Start paying attention to situations where you feel responsible for others’ emotions or problems. Notice when you automatically put someone else’s needs before your own or when you feel anxious about setting boundaries.

Try keeping a journal to track moments when you feel resentful, exhausted, or unappreciated. Look for the situations or relationships that typically trigger these feelings. You can ask yourself questions like: “Am I doing this because I want to, or because I’m afraid of the consequences if I don’t?” You can even use journal prompts for codependency to help.

Pro tip: Keep in mind that awareness doesn’t mean judgment. These patterns developed for a reason—often as ways to cope with difficult situations. Observing them with curiosity rather than criticism will help you make lasting changes.

Illustration featuring a quote that reads, “You shouldn’t set yourself on fire to keep someone else warm.” The image shows a distressed man surrounded by flames and a relaxed woman lounging under an umbrella, symbolizing the emotional toll of codependency and the importance of self-care.

What Is Codependency?

Codependency is not officially recognized as a mental illness, but it is taken seriously by mental health professionals, who define it as “an unhealthy devotion to a relationship2 at the cost of one’s personal and psychological needs.” It describes a relational pattern where you become so focused on the problems and needs of others that you neglect your own well-being. It’s more than just caring deeply—it’s when your emotional state, identity, and sense of purpose become excessively wrapped up in someone else’s life.

  • Codependency in Romantic Relationships: In romantic relationships, codependency can look like constantly sacrificing your own preferences, walking on eggshells to avoid conflict, or feeling responsible for your partner’s happiness. You might stay in unhealthy situations because you believe your love can “fix” the other person.
  • Codependency in Family Systems: Within families, codependency often appears as enmeshment—where boundaries between family members become blurred. You might feel obligated to solve everyone’s problems, shield relatives from consequences, or struggle to make decisions without family approval. This is often the case when one family member is struggling with substance abuse.3 
  • Codependency in Friendships: In friendships, codependent behaviors include being the perpetual advice-giver or emotional support while rarely asking for help yourself. You might maintain one-sided friendships because you feel needed, even when these relationships drain you.

How can you discover the signs of being codependent?

Codependency is often rooted in an attachment wound where the nervous system learned early on that safety comes from attuning to others, sometimes at the expense of self. It can look like feeling responsible for managing other people’s emotions while ignoring your own. Another sign is the feeling of unease or even panic when someone is upset with you, leading to people-pleasing or over-functioning in relationships. This can present as feeling tightness in your chest, a constant state of hypervigilance, or struggling to feel grounded in your own body.

Amanda Stretcher, MA, LPC-S | Crescent Counseling

2. Work on Building Self-Esteem

Codependency and low self-esteem usually go hand in hand. When you don’t value yourself, you might look for validation through helping others or staying in unhealthy relationships.

You feel good about yourself mainly when you’re helping others or when people need you. Instead of feeling relieved when a loved one says they don’t need your help, you feel hurt or like you don’t matter anymore.

Start building your self-worth by practicing self-compassion.4 Talk to yourself the way you would talk to a good friend—with kindness and understanding. Make a list of your positive qualities that have nothing to do with what you do for others.

Small acts of self-care also build self-esteem. When you treat yourself with respect—by keeping promises to yourself, taking time for activities you enjoy, or meeting your physical needs—you send yourself the message that you matter.

Pro tip: Daily affirmations can help you shift away from negative self-talk and toward a more positive sense of self. Simple statements like “I’m worthy of love and respect” or “My needs matter” can start to shift your perspective when you say them regularly.

Infographic titled “Common Codependency Behaviors,” showing eight heart-shaped rope loops with icons and labels: people-pleasing, lack of boundaries, excessive care-taking, fear of abandonment, low self-esteem, fixing instead of supporting, and ignoring your own needs. Visual metaphor emphasizes emotional entanglement in codependent relationships.

Why is boundary setting important in healing from codependency?

When it comes to codependency, one tends to slip away from autonomy, creating enmeshment with the enabler. Setting healthy boundaries, such as adopting and maintaining one’s own intellectual boundaries in a new relationship, is crucial for healing codependency. While maintaining codependency, and therefore not setting boundaries, one loses one’s own identity and essentially forgets how to behave independently due to the behavioral and emotional habits developed through the codependent relationship. Setting boundaries will contribute to an increased sense of self, more confidence, and may even decrease anxiety or depressive symptoms, which can significantly enhance the relationship as a whole.

Jennifer Chicoine, MA, LCPC, CCTP | Peaceful Healing Counseling Services

3. Set and Enforce Healthy Boundaries

Boundaries allow you to create rules or set limits that define where your responsibilities end and another person’s begin. They protect your emotional well-being while allowing you to support others in healthy ways.

Setting boundaries can be uncomfortable at first, especially when you’re not used to it. As you do so, keep in mind that boundaries are for you,5 says boundary expert Nedra Glover Tawwab, LCSW:

Changing your behavior and not forcing others to change can be a significant part of setting boundaries…It would be nice if everyone automatically knew how to respect our boundaries. We often have to communicate them clearly and enforce consequences when they are not respected. So, when someone crosses one of my boundaries, I will take action to protect myself and my needs.

Be clear and direct when communicating boundaries. Use “I” statements that focus on your needs rather than accusing the other person. For example, “I need some alone time to recharge” works better than “You’re demanding too much of my time.”

Prepare yourself for pushback. Some people in your life may resist your new boundaries because they benefit from your codependent behaviors. Remember that their reaction isn’t your responsibility, and temporary discomfort is part of creating lasting change.

Consistency is key. When you set a boundary, follow through with it. Each time you maintain a healthy boundary, even when it’s difficult, you’re building new patterns that will eventually replace codependent ones.

4. Learn to Prioritize Your Needs

For many people with codependent tendencies, identifying their own needs can feel foreign. Get in the habit of asking yourself: “What do I want right now?” or “What would feel good to me in this situation?”

Practice making decisions based on your preferences. Start with small choices like what to eat for lunch or what movie to watch, then work up to bigger decisions.

Prepare phrases for when you need to put yourself first. Simple statements like “I need to take care of myself right now” or “I’ll need to check my schedule before committing” give you space to consider your own needs.

Pro tip: Remember that prioritizing your needs isn’t selfish—it’s necessary for your well-being and actually leads to healthier relationships. When you’re not depleted from ignoring your own needs, you have more genuine energy to share with others.

Codependency vs. Interdependence

Unlike healthy independence—where 2 people mutually rely on each other while maintaining individual identities—codependency creates an imbalance. Healthy relationships involve give-and-take, with both people supporting each other while respecting boundaries. Both parties feel free to express needs, disagree respectfully, and maintain outside interests and relationships.

The key distinction here is that interdependence strengthens both individuals, while codependency tends to diminish at least one person’s wellness and autonomy over time.

Does your partner or loved one exhibit signs of being codependent?

“Loving someone who is codependent can feel like an emotional roller coaster, but it’s important to remember—you can’t fix them. Their actions often come from a place of love, but they struggle to put themselves first. The best thing you can do is communicate your needs clearly, set firm yet compassionate boundaries, and encourage them to cultivate their own interests. By modeling self-care, independence, and balance, you show them what a healthy, fulfilling relationship looks like.”

Rebecca Tenzer, MAT, LCSW, CCTP, CGCS, CCATP, CCFP, CIMPH | Astute Counseling & Wellness Services

Signs of Codependency

Spotting codependent patterns6 in your life is the first big step toward making real change. Everyone’s experience with codependency looks a bit different, but here are some common signs you might recognize in yourself:

  • Excessive caretaking: You almost always put other people’s needs ahead of your own, even when it hurts you. For example, you might stay up all night helping a friend with their project even though you have an important meeting tomorrow, cook fancy meals for your family while you just eat whatever’s left over, or say “yes” to additional tasks when you already feel overburdened.
  • Difficulty setting boundaries: You find it really hard to say “no” when people ask you for favors or your time. You may cancel plans you were looking forward to because a coworker asked for help at the last minute, or you let family members call you during your workday for things that aren’t emergencies.
  • People-pleasing tendencies: You make decisions based on what will make others happy, not what’s best for you. You might agree with someone’s opinion even when you actually think differently, just to avoid any conflict. Or you might take on extra tasks because you’re scared of letting someone down.
  • Fear of abandonment: A codependent person will often work extra hard to keep relationships going because they’re scared people will leave them. This could mean putting up with someone treating you badly or staying in relationships that don’t make you happy because the idea of being alone feels too scary to face.
  • Controlling behaviors: In an attempt to be helpful, you try to control situations or people out of anxiety. This can look like constantly offering unsolicited advice or getting frustrated when someone doesn’t follow your suggestions about how to handle their problems.
  • Difficulty identifying your own feelings: You’re tuned into others’ emotions but disconnected from your own. You might be able to sense when your partner is upset before they even realize it but struggle to answer when someone asks how you’re feeling.
  • Unhealthy attachment to drama or crisis: You feel most purposeful when solving problems and might even unconsciously create or seek out chaotic situations where you can play the rescuer. When times are crisis-free, you may feel anxious, uncertain, or uncomfortable.
Infographic titled “Examples of Boundaries: Small to Big Ways to End Codependency,” illustrating five progressive steps: don’t offer unsolicited help, say no to favors, speak up about your needs, disagree without fear, and walk away from toxic dynamics. A person walks upward across rising blocks symbolizing personal growth.

5. Seek Support and Professional Help

Overcoming codependency is challenging work, and you don’t have to do it alone. Professional support can make a huge difference in your healing journey.

Therapy, especially with someone who specializes in codependency, family systems, or trauma, can help you understand the roots of your codependent patterns and develop strategies to change them. Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are particularly effective approaches for addressing codependency.

Support groups like Codependents Anonymous (CoDA)6 offer connection with others facing similar challenges. Spending time around others who share your experiences can reduce shame and provide insights for your recovery.

Self-help books about codependency, boundaries, and self-esteem can supplement other forms of support. Look for resources by recognized mental health professionals that offer practical exercises alongside information.

Pro tip: Codependent No More2 and its accompanying workbook by codependency expert Melody Beattie are classics on the topic, and a great place to start. There are also treatment resources available.

Life Beyond Codependency: Your Journey to Emotional Freedom

Breaking free from codependent patterns opens the door to relationships where you can truly be yourself. Working with a professional can accelerate your progress, giving you tools that fit your specific situation and background. Whether you choose one-on-one therapy or a structured program, having expert support gives you the guidance and follow-through that helps make real, lasting change possible.

FAQs

Q: Is it possible to stop being codependent?

A: Yes, codependency is a learned behavior that can be unlearned with self-awareness, therapy, and personal growth. According to Mental Health America, addressing underlying self-esteem issues, setting boundaries, and seeking support are key steps toward breaking free from codependency.

Q: How do you break the codependency cycle?

A: Breaking the cycle of codependency involves recognizing unhealthy relationship patterns, developing self-worth, and learning to set and maintain boundaries. Codependents Anonymous recommends a 12-step recovery process, while therapy and support groups can also be helpful in fostering independence and healthier relationships.

Q: What triggers codependency?

A: Codependency often stems from childhood experiences, such as growing up in an environment where emotional needs were not met or where a caregiver had addiction or mental health struggles. Other triggers include fear of abandonment, low self-esteem, and seeking validation through others.

Q: How do you heal codependent tendencies?

A: Healing from codependency involves building self-esteem, practicing self-care, and learning healthy communication. The National Center for Biotechnology Information suggests cognitive behavioral interventions can help individuals develop healthier thought patterns and coping strategies.

Q: How do you prevent a codependent relationship?

A: Preventing codependency starts with self-awareness and setting clear boundaries. Maintaining individual interests, fostering self-worth, and communicating openly with partners or loved ones can help establish interdependent, rather than codependent, relationships.

Q: How does a codependent person feel?

A: A codependent person may feel anxious, responsible for others’ happiness, or emotionally drained. They often struggle with low self-esteem and fear abandonment, leading them to prioritize others’ needs over their own.

Q: Does your partner or loved one exhibit any signs of being codependent?

A: Signs of codependency in a loved one may include excessive caretaking, difficulty setting boundaries, fear of being alone, and reliance on others for self-worth. Mental Health America highlights that codependency can occur in romantic relationships, friendships, or family dynamics.

Q: Why did I develop codependent tendencies?

A: Codependent tendencies often develop from early childhood experiences, such as growing up in a family where emotional neglect, addiction, or controlling behaviors were present. Research indicates that past trauma and adverse childhood experiences significantly contribute to codependency.

Q: How do you overcome codependency?

A: Overcoming codependency requires self-awareness, boundary-setting, and shifting focus to personal well-being. Therapy, support groups, and mindfulness practices have been found to be effective in fostering emotional independence.

Q: What are narcissistic traits?

A: Narcissistic traits include a lack of empathy, an inflated sense of self-importance, manipulation, and a need for excessive admiration. Codependents often find themselves in relationships with narcissistic individuals due to their caretaking tendencies.

Q: What steps can I take to stop being codependent?

A: Steps to stop being codependent include recognizing unhealthy patterns, building self-esteem, practicing self-care, and seeking therapy or support groups. Developing hobbies and interests outside of relationships can also help foster independence.

Q: What are effective strategies to stop being codependent?

A: Effective strategies include therapy (such as cognitive-behavioral therapy), practicing mindfulness, learning assertiveness skills, and setting firm boundaries. Research suggests that increasing self-awareness and engaging in self-affirmation exercises can aid in breaking codependent habits.

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Rewiring Your Brain From Addiction: 7 Things You Need To Know

Illustration of a robotic arm manipulating a brain with circuit-like patterns, placed on a microchip, symbolizing artificial intelligence and neuroscience integration.

When you stop using drugs and alcohol, it takes time to rewire your brain. The exact timeframe depends on several factors. Certain drugs, for example, lengthen the brain rewiring process. Some practices can also help you recover faster.

Here’s what experts know about helping your brain rebuild after addiction:

1. Understanding How Addiction Changes Your Brain

Dopamine and the Brain’s Reward System

Your brain has a natural reward system1 that makes you feel good when you do things that help you survive and thrive. This system uses a neurotransmitter called dopamine, which creates feelings of pleasure and happiness. When you eat good food, exercise, or spend time with people you love, your brain releases small amounts of dopamine.

Alcohol and drug use release far more brain chemicals2 than natural activities do. This creates an unnaturally strong surge of pleasure signals in your brain. When this happens repeatedly, it can overwhelm your brain’s normal reward system.

Over time, your brain tries to adjust to these high levels of dopamine by becoming less sensitive to it. This means you need more and more of the substance to feel the same effects: a process we call tolerance.3 Regular stimuli that used to make you happy might not feel as good anymore, because your brain’s reward system isn’t working like it should.

Infographic titled top 6 triggers of substance abuse, featuring icons of flames to represent six key triggers: stress and anxiety, negative emotions, social pressure and environments, boredom or lack of fulfillment, mental health struggles or trauma, and chronic pain or medical issues. A lit fuse leading to a cartoon-style bomb symbolizes the risk of relapse.

Areas of the Brain Affected by Addiction

Addiction affects 3 main parts of your brain.4 Each plays a crucial role in helping you think, feel, and make decisions.

The basal ganglia is your brain’s pleasure center. It helps you feel good when you do healthy things like eating or exercising. With substance use disorders, this area becomes less sensitive to normal pleasures and more focused on substances.

The amygdala is your brain’s stress manager. When addiction develops, this area becomes more sensitive. This can make you feel anxious, irritable, or uncomfortable when you’re not using addictive substances.

The prefrontal cortex5 helps you make good decisions and control impulses. Addictive behaviors make this area weaker, which makes it harder to resist cravings or think about long-term consequences.

Rewiring your brain from addiction is real, and it works. Research suggests meaningful neural shifts can happen in weeks, but full recovery takes months or years of consistent effort involving identifying and replacing toxic thought patterns, creating new neural pathways, and reinforcing them with repetition, consistency, and community.

– W. Lee Warren, M.D. | Brain Surgeon and Author

How Habits and Triggers Form

Your brain is designed to help you repeat behaviors that make you feel good. During addiction, your brain creates strong connections between certain situations (called triggers) and substance abuse. These connections form through repeated use over time.

Triggers can be places, people, feelings, or times of day that your brain associates with drug abuse. When you encounter these triggers, your brain automatically generates cravings. Learning to understand and manage your triggers (and their associated coping mechanisms) is an important part of recovery.

Infographic titled how addiction rewires your brain, illustrating the cycle of dopamine and tolerance. A man runs in a hamster wheel surrounded by stages: substance consumed, dopamine surges, short-term pleasure, brain adapts, tolerance increases, dopamine crash, negative feelings, and cravings. Arrows show the repeating cycle of addiction.

2. The Timeline of Brain Recovery

The recovery process happens in stages, and everyone’s path is different. While your brain health starts to improve as soon as you stop using substances, the full process takes time. Knowing what to expect during each stage can help you see the progress you’re making, which helps you stay motivated.

What to Expect in the First Month

The first month of recovery usually involves the biggest changes as your body adjusts to being substance-free. During the first week, you might experience withdrawal symptoms as your brain chemistry starts to reset. These symptoms can be uncomfortable, but they usually peak within a few days.

After the first week, many people notice their thinking becomes clearer and their sleep starts to improve. You might have mood swings or strong cravings during this time, which is normal. Your brain is working hard to restore its natural chemical balance.

Some people also notice changes in their appetite and energy levels during this first month. These changes are signs that your brain and body are beginning to heal.

Changes During Months 2-12

During these months, your brain continues to heal and rebuild healthy pathways. A lot of people in this stage find their mood becomes more stable and they start enjoying regular activities again. Your sleep quality and energy levels will continue to improve during this time.

Your brain’s ability to think clearly and make decisions also typically gets better during these months. But you might still experience occasional cravings—especially during stressful times. If this is the case for you, you’re not doing anything wrong! It’s totally normal and tends to happen less often as time goes on.

Your dopamine reward system will gradually become more responsive to natural pleasures like food, exercise, and social connections. This is a great sign that your brain is returning to its normal way of functioning.

Infographic from Recovery.com titled “How Long Until Your Brain Recovers?” comparing recovery timelines for six addictive substances: alcohol, cocaine, meth, opioids, cannabis, and benzodiazepines. Categories include dopamine restoration, cognitive recovery, and cravings fading. Timelines vary by substance, ranging from months to several years for full brain recovery.

Long-Term Recovery: One Year and Beyond

After a year, many people find their brain function has significantly improved. While some people still experience occasional cravings, these are usually less frequent and easier to manage. Your brain continues to heal and strengthen new, healthy patterns throughout your recovery journey.

Factors That Affect Your Recovery Timeline

Several things can influence how quickly your brain heals. These include the type of substances used, how long you used them, your overall health, and whether you have other mental health conditions. Having good support and treatment can help speed up the healing process.

When someone actively works to rewire their brain in recovery, they experience several key benefits: regaining self control, restoring emotional balance, breaking destructive patterns, improved stress response , enhanced cognitive function and a greater sense of purpose and joy. Rewiring the brain in recovery isn’t just about breaking free from addiction—it’s about reclaiming your life, restoring your mind, and creating a future built on strength and resilience.

– Dr. Zoe Shaw | Psychotherapist and Author

3. Stages of Brain Rewiring

Just like healing from a physical injury, your brain goes through different stages as it recovers from drug addiction. While everyone’s journey is unique, knowing what to expect at each stage can help you feel more confident about the path ahead. Let’s look at how your brain heals over time.

Stage 1: Getting Through Withdrawal

The first stage of recovery starts when you stop using substances, and it’s often the most challenging part of the journey. During this time, your brain works hard to adjust to life without substances. You might feel physically and emotionally uncomfortable, which is completely normal.

Most people experience withdrawal symptoms for about a week, though this can vary depending on the substance. It’s very important to get medical support during this time, as some types of withdrawal can be dangerous. Remember, these difficult feelings are temporary and are signs that your brain is beginning to heal.

Stage 2: Early Recovery Changes

After withdrawal, you’ll enter a period where your brain is actively rebuilding healthy patterns. While you might still have cravings, they’ll likely feel less intense than before. This is the perfect time to start learning new ways to handle stress and challenging emotions.

During this stage, many people find it helpful to work with counselors or join support groups. These supports can teach you practical tools for managing cravings and building a healthy lifestyle. Your brain is becoming more receptive to new experiences and ways of coping.

Stage 3: Long-Term Healing

As you move into long-term recovery, your brain continues to strengthen its healthy pathways. While the journey doesn’t end here, many people find that cravings become less frequent and easier to handle. Each day of recovery helps your brain build and maintain these positive changes.

4. Supporting Your Brain’s Recovery

Fortunately, there are plenty of ways you can support your brain’s natural healing process. Think of recovery like tending a garden: The more care and attention you give it, the better it grows. Simple daily choices can make a big difference in how quickly and effectively your brain recovers.

Regular Exercise and Physical Activity

Moving your body is one of the best gifts you can give your healing brain. Exercise naturally boosts your mood6 by releasing feel-good chemicals, similar to the ones your brain is learning to produce again on its own. Even a 15-minute walk can help!

You don’t need to live at the gym or start running marathons. Start with activities you enjoy, whether that’s dancing, swimming, or taking an easy walk around your neighborhood. As your energy improves, you’ll gradually be able to do more.

Sleep and Nutrition

Your brain does much of its repair work while you sleep, making good rest essential for recovery. Try to go to bed and wake up at the same time each day, even if you don’t feel tired at first. Your sleep patterns will naturally improve over time.

Eating nutritious foods gives your brain the building blocks it needs to heal. Instead of worrying about perfect eating habits, focus on adding healthy foods like fruits, vegetables, and proteins to your meals. Even small improvements in your diet can help your brain recover.

Stress Management

Finding healthy ways to handle stress is essential to your recovery journey. Deep breathing, taking short walks, listening to music, or talking with supportive friends all help calm your mind. Remember that it’s okay to start small—working in small moments of relaxation throughout your day can go a long way in calming your nervous system.

Building New Routines

Creating new daily routines helps your brain build healthy patterns. Start with one or 2 simple habits, like having breakfast at the same time every day or taking a walk after dinner. As these become comfortable, you can gradually add more supportive activities to your day.

5. Treatment Options That Help Rewire the Brain

Recovery isn’t a journey you need to take alone—there’s no shame in asking for help. Professional addiction treatment and support can have a huge impact on how quickly your brain heals. These interventions are like tools in your recovery toolkit: you can choose the ones that work best for you.

Therapy and Counseling

Working with a counselor or therapist gives you empowering tools for addiction recovery. These professionals understand how addiction affects the brain and can teach you practical ways to handle cravings and stress. Many people find cognitive behavioral therapy (CBT)7 especially helpful, as it teaches you how to change thought patterns that lead to substance abuse.

Your therapist can act as a guide on your recovery journey, helping you understand your triggers and develop strategies that work for your specific situation. It’s a great idea to find a therapist you like and start building a relationship with them, so help is there when you need it.

Support Groups

Meeting others who understand what you’re going through can be incredibly motivating. Support groups are safe spaces to share your experiences, learn from others, and build connections with people who support your recovery goals.

Lifestyle Changes

Small changes in your daily life can support your brain’s healing process. Focus on one change at a time, like improving your sleep schedule or adding healthy activities you enjoy.

When you rewire your brain, you stop being a passive passenger in your own life and start taking control. Old, destructive circuits weaken, and new, healthier ones take over. This means fewer cravings, better decision-making, and a stronger sense of purpose. It’s not just about avoiding addiction—it’s about building a brain that works for you, not against you. The result? A life where you’re free to think clearly, choose wisely, and move forward with confidence and hope.

– W. Lee Warren, M.D. | Brain Surgeon and Author

6. The Science of Hope and Healing

Understanding Brain Plasticity

Your brain has the ability to change and heal throughout your life. Scientists call this “plasticity,” which means your brain can create new neural pathways as it adapts to changes. This incredible ability is what makes recovery possible, no matter how long you’ve struggled with addiction.

Evidence of Recovery

Brain scanning studies show that people’s brains do heal during addiction recovery.8 While everyone’s timeline is different, many people see improvements in their cognitive functions, including memory, impulse control, decision-making, and emotional regulation. These positive changes only continue as you move forward in your recovery.

Setting Realistic Expectations

Recovery is more like a marathon than a sprint, and that’s okay. Some days will be easier than others, and healing happens gradually. Being patient with yourself and celebrating small victories along the way can help you stay on track.

7. Getting Help and Support

Finding Treatment

Taking the first step toward addiction treatment takes some courage, but the rewards of a life in recovery are well worth it. There are plenty of different treatment programs available to meet your specific needs, from detox to outpatient treatment to residential care. To learn more about choosing the right program, see our guide to finding a treatment center.

Building a Support System

Recovery is stronger when you have people in your corner. Loved ones, family, friends, counselors, support groups, and others in recovery can all be part of your support network. Don’t be afraid to let people know what you need.

If you’re ready to start recovery, a comprehensive rehab program can be a great starting point for your journey. This immersive experience gives you a chance to focus entirely on healing in a substance-free environment. Search for an addiction treatment center that matches your criteria and reach out to their team directly today.

FAQ

Q: How long does it take to rewire your brain from addiction?

A: The brain’s rewiring process varies by individual, but significant changes often occur within 12 to 18 months. Early improvements can be seen within weeks, while full recovery may take years, depending on factors such as substance type, duration of use, and lifestyle changes.

Q: Can dopamine levels return to normal after addiction?


A: Yes, dopamine levels can return to normal over time. The brain gradually restores its natural dopamine balance through healthy activities like exercise, proper nutrition, and stress management. However, this process can take several months to years.

Q: How long does it take to rewire your brain from a bad habit?


A: Breaking and rewiring a habit can take anywhere from 21 days to several months, depending on the habit’s intensity and duration. Consistently practicing new behaviors and avoiding triggers helps establish long-term changes.

Q: Can brains recover from addiction?


A: Yes, the brain has the ability to heal itself through neuroplasticity. While addiction alters brain structure and function, recovery is possible with time, therapy, and healthy habits that support brain repair.

Q: How long does recovery from addiction take?


A: Recovery is an ongoing process that unfolds in stages. While withdrawal symptoms may last days to weeks, brain healing continues for months or even years. Long-term recovery depends on individual factors and continued support.

Q: How long does it take to rewire the brain from addiction?


A: The timeline varies, but research suggests that noticeable improvements occur within 3 to 12 months, with continued healing over several years. Factors like substance type, overall health, and treatment interventions influence recovery speed.

Q: What are the benefits of rewiring the brain from addiction?


A: Rewiring the brain from addiction improves mental clarity, emotional stability, impulse control, and overall well-being. It also restores natural pleasure responses, strengthens decision-making skills, and enhances quality of life.

Q: What are the benefits of brain rewiring?


A: Brain rewiring helps create healthier thought patterns, reduces cravings, improves emotional regulation, and supports better decision-making. It also aids in forming positive habits and strengthening coping mechanisms.

Q: What is brain rewiring in addiction recovery?


A: Brain rewiring in addiction recovery refers to the process of forming new neural pathways to replace substance-related behaviors with healthier alternatives. This involves breaking old habits, reducing cravings, and restoring normal brain function.

Q: How can you increase dopamine in your brain?


A: You can naturally increase dopamine through regular exercise, a healthy diet rich in protein and antioxidants, sufficient sleep, mindfulness practices, social interactions, and engaging in enjoyable activities.

Q: Are there any ways to speed up this process or aid in the brain’s recovery from addiction?


A: Yes, brain recovery can be supported through consistent sleep, regular exercise, balanced nutrition, therapy, mindfulness, and positive social connections. Professional treatment, such as cognitive behavioral therapy (CBT), can also accelerate healing.

Q: What is the timeline for brain recovery from addiction?


A: Brain recovery follows a general timeline:

  • First month: Initial withdrawal symptoms, mood swings, and sleep disturbances.
  • Months 2-12: Improved cognitive function, emotional stability, and reduced cravings.
  • One year and beyond: Strengthened neural pathways, increased natural pleasure responses, and long-term behavioral changes.

Q: What factors influence the time it takes to rewire the brain from addiction?


A: Several factors impact the brain’s recovery timeline, including the substance used, length of addiction, overall health, mental health conditions, treatment interventions, and the presence of a supportive environment.

Q: How long does it take for the brain to heal after quitting an addiction?


A: The brain begins healing immediately after quitting, with significant improvements seen within the first year. However, full recovery, including emotional regulation and cognitive function, can take multiple years, depending on individual circumstances.