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Lapse vs. Relapse

A lapse or relapse is a dysregulation of neurochemicals, a return to old behaviors.  We hear the terms lapse and relapse used often in reference to people who use substances.  But we can also apply it to other behaviors, such as acting out in rage or anger, actively pursuing pornography, gambling, spending, gaming, engaging in a binge and purge cycle with food or shopping, and more.

One might ask, “What is the difference between a lapse and a relapse?”  Nearly everyone has behaviors that they want to change or eliminate from their lives.  When one has been working at reducing or eliminating such behaviors, a lapse can be looked at as a one-time slip, an accidental or temporary decline in the desired behavior or condition, a short-term return to old behaviors.  A relapse can be considered a complete return to an old pattern of obsessive, destructive or consuming behaviors, typically for an extended period of time. 

Allowing ourselves to fall into a danger zone adds to and nearly guarantees that we will be on slippery slopes, likely leading to a lapse or relapse.  Danger zones can be as simple as HALT, being too Hungry, Angry, Lonely or Tired.  These danger zones can also be people, places and things in our everyday lives, such as strong emotions, an upcoming stressful event, interactions with people, going to a bar, seeing provocative images, in real life or in imagery such as porn on the Internet, becoming too confident in our “sobriety” and more.  Add a little fear, depression, frustration, embarrassment, grief, boredom, anger, guilt or shame and the odds of relapse have increased even greater.  Attempting to soothe ourselves during these times, with the use of a substance or two, such as prescription drugs like anti-depressants or anti-anxiety pills that our doctors so readily prescribe or other substances such as alcohol, marijuana, cocaine, methamphetamine or even something as simplistic and “benign” as a a strong cup of coffee, a “Red Bull”, a glass of wine or a cigarette, can increase the danger.  The addition of any type of substance can enhance dysregulation and the “high” can be even stronger and more pronounced. 

When old patterns of neurotransmitters are reactivated and a rush of neurochemicals occurs, often the use of our prefrontal cortex is diminished and our survival brain takes over. This means we go from using the higher functioning portion of our brains, the part that helps us to make rational, calculated, logical decisions, to the reactionary part of our brain, the part of our brain that helps us to react quickly when feeling our safety is being threatened.  Re-regulation of our neurochemicals can take time, even with a one-time lapse. This re-regulation of neurochemicals can lead us to withdrawal symptoms such as insomnia, feelings of agitation, panic, angry outbursts, headaches, isolation as well as strong emotions and feelings of hopelessness, remorse, frustration, anger, guilt, shame, and more. 

Not being aware and guarding ourselves against dangerous areas of our lives, can become a volatile formula for relapse.  And dysregulation of our neurochemicals can happen to nearly everyone.  But to an individual who has faced the challenges of addictive traits or full-blown addiction in the past, reactivation of the neurochemicals, can send the person seeking the rush of neurochemicals they had become so accustomed to, the “high.”  Gaining knowledge and understanding of the progression and impact of addiction and the relapse cycle, can become an effective tool to keep ourselves safe, ultimately leading to better choices and the pursuit of health and stability in a better, stronger and more productive way.

Patty Shirley
LMFT, CATC, CCTP