Recovery is different for everyone where mental illness and addiction are concerned, but there are still many common misconceptions and stigmas that surround relapse.
Yesterday, Demi Lovato debunked some of them when she released her first statement since being admitted to hospital following a relapse and suspected drug overdose. She told fans: “What I’ve learned is that this illness is not something that disappears or fades with time. It is something I must continue to overcome and have not done yet.”
The 25-year-old singer has been widely praised for consistent, high-level awareness raising on mental health, and her recent words are no exception.
To learn more about relapse, HuffPost UK spoke to four people with first or second-hand experience to shed light on the realities of addiction recovery and how loved ones can best support anyone who experiences a set-back.
Poorna Bell, journalist and author of ′Chase the Rainbow’, feels that stigma surrounding relapse still represents a significant barrier for people on their journey to recovery. “Relapse shouldn’t be seen as the addict ‘not trying hard enough,’” she says.
Poorna’s husband died by suicide and struggled with a secret heroin addiction, and since then she’s written widely on grief, mental health, and addiction. “If they have entered recovery even once, it shows that they are trying hard and want their life to be different,” she says. She reflects that we should challenge the idea that addiction is intentionally self-destructive: “A person doesn’t relapse because they are being selfish — it’s because they are struggling internally or with other things in their life.”
Relapse is often to be expected as it involves changing deeply rooted behaviours — between 40% and 60% of people recovering from addiction will experience one. Dr Peter Rice of the Royal College of Psychiatrists notes: “Relapse is common in recovery as it is with other behaviour change such as cigarette smoking, dieting or committing to an exercise plan.”
Despite the prevalence, many people do still feel ashamed and guilty after a relapse. Reflecting on her feelings during her three relapses after a 20-year addiction to prescription drugs, 50-year-old Nicki Hari says she felt like a failure.
“It’s so painful because you have broken promises to both yourself and all your loved ones,” she explains. “The fear of rejection is so massive that you tend to not go back and get the help and support needed.”
She also points out stigma can paradoxically make it harder to come back from a relapse: “I was too scared to reach out for fear of being judged; and that led me into using for another year.”
Relapse can also be closely tied to your environment. Outside of rehab, there are a variety of real-world triggers, which may range from certain smells, places and people, to emotional states, that can make relapse more likely. Eytan Alexander, former addict and founder of leading addiction treatment firm UKAT, explains: “Addicts will face triggers for relapse almost daily. Hopefully, the treatment the addict received will have addressed what life will be like outside of rehab, so the individual should have good coping mechanisms.”
Nicki agrees: “There’s a trigger with every addiction. In the end I went into rehab and that’s when I realised that’s what my triggers were.”
There is no universally accepted definition of ‘recovery’, but many people say the definition of a ‘relapse’ can also be vague and blurry. In some cases this can be empowering, as it can give some choice back to the individual in framing their journey.
“I quit alcohol for eight years — at one point I drank for a couple of weeks, though I didn’t call it a ‘relapse’ — I called it ‘drinking for a couple of weeks’,” says Jenny Valentish, who wrote ’Woman of Substances: A Journey into Drugs, Alcohol and Treatment’.
“It was vital that I didn’t frame it as a disaster, because that shame would have only made me go on a destructive bender.”
After eight years, Jenny actually decided to cautiously reintroduce alcohol, which she reminds us isn’t possible or desirable for everyone, but was right for her: “For me it had chiefly been a psychological dependence, and I felt that with continued support from a psychologist and occasional SMART Recovery meetings I was able to moderate my drinking. Not everyone can.”
Many are now calling on the media to reevaluate how it portrays addiction and treats celebrities experiencing relapse. Poorna is among those voices. “It’s an invaluable opportunity for us to examine how we report around addiction in the spotlight,” she remarks. “I hope people respect Demi’s wishes and leave her alone — recovery is hard enough being done in private, let alone with the gaze of the world’s media on you.”
Jenny also points out Demi’s statement and continual transparency has positioned the singer firmly as an advocate and mental health and addiction activist: “Demi has consistently been a huge advocate for people with addiction and mental health issues – which are one and the same in my view. She’s dedicated to educating the public.”
After a relapse has happened support and understanding of friends and family can be vital, but Eytan says unfortunately, relapse can lead to lost trust between friends and family.
“The addict will probably be judged negatively and thought of as perhaps a lost cause, but that is absolutely not the case. It’s an illness, not a choice,” he says.
This lack of understanding is also something Poorna was susceptible to when trying to support her late husband: “When Rob relapsed, I didn’t understand it — because I thought it was as simple as him not using drugs and if he used them then it meant he didn’t care about me. I couldn’t have been more wrong.”
But if someone you knew was in recovery relapsed, would you know what to do, or how to talk to them about it? Dr Rice advises “practical supportive measures” should be the priority in the immediate aftermath of a relapse, and then thinking through triggers afterwards.
A strong support network is important to Eytan: “They need their family and friends to be empathetic, understanding, kind and firm.” Eytan says the focus should be on allowing the person to “adjust to addiction-free life rather than just being expected to be ‘better’ immediately after treatment.” Nicki also emphasises the value of support and communication: “Always be loving and caring. Put down consequences and boundaries. One thing that gets broken with loved ones is the trust, so you have to learn to build up this trust again.”
Everyone we spoke to talked about the importance of trusting in the personal experiences of those who have been through relapse first hand, and working against feelings of suspicion and blame. Jenny feels some parts of Alcoholics Anonymous’ famous 12-step programme have undertones of blame, sometimes suggesting people who can’t stick to the program have “failed” — an example of how deep stigma runs. “If the world’s most famous treatment program is that judgey, how can you expect the public to be any better?” she says.
Poorna also points out that those with lived experience are best placed to lead the conversation. “If you haven’t struggled with addiction it’s impossible for you to understand that it’s not a question of just stopping,” she says. “We have to get better at understanding that.”
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk
- If you need help with a drinking problem, call the Alcoholics Anonymous national helpline for free on 0800 9177 650 or email help@aamail.org.
- For advice on how to reduce drinking, visit Drinkaware’s website or Alcohol Concern.
- Find alcohol addiction services near you using this NHS tool.