The English philosopher and author Alan Watts famously said, “To have faith is to trust yourself to the water. When you swim you don’t grab hold of the water, because if you do you will sink and drown. Instead, you relax, and float.” This is symbolic of how one can best manage triggers in treatment (as well as post-treatment in their recovery). One highly effective method to use is the H.A.L.T. method, which stands for hungry, angry, lonely, tired – a checklist to go through to see if one (or multiple) of these reasons may be the cause of the trigger.
The Prevalence of Addiction in the U.S.
Addiction remains highly prevalent in the U.S. and around the world. There are millions of people and their families affected by drugs and alcohol every day. According to the National Institute on Drug Abuse (NIDA), “40.3 million people in the United States had an SUD in 2020. In 2020, only 6.5 percent of people with SUD received treatment,” and, in 2021, “about 107,000 people died of drug overdoses.”
These are not insignificant numbers; they have grown exponentially since the COVID-19 pandemic. Due to the pandemic, many people are also struggling with co-occurring issues of addiction and mental health.
Better Understanding Addiction and Mental Illness
Co-occurring issues of addiction and mental health are more common than many people may think. According to NIDA, “7.7 million adults have co-occurring mental and substance use disorders…. Of the 20.3 million adults with substance use disorders, 37.9% also had mental illnesses.” Also, “Among the 42.1 million adults with mental illness, 18.2% also had substance use disorders.”
The issue with co-occurring disorders is that many people fail to address multiple issues because the signs and the symptoms of the issues often overlap and/or overshadow the other. This is why better knowing the signs and symptoms of addiction and mental illness can be so crucial.
The Signs and Symptoms of Addiction and Mental Illness
Now, of course, the signs and symptoms of addiction and mental illness are not a monolith. The spectrum of issues is far too broad. However, there are many more universal signs and symptoms that may help an individual (or an individual’s loved ones) determine whether or not there is a problem. The following are just a few of those signs and symptoms:
- Isolating away from one’s family and close friends
- Losing interest in activities and hobbies once enjoyed
- Having otherwise unexplained physical ailments
- Trouble with sleep cycles, including sleeping too much and not sleeping enough (insomnia)
- Negative changes in appetite
- Struggling with otherwise unexplainable physical symptoms like gastrointestinal problems and body aches
- Feeling overly anxious, nervous, or “stressed out”
- Being depressed and having feelings of worthlessness, uselessness, and hopelessness
- Not being able to stop drinking or using once started
- Exhibiting excessive mood swings
- Committing self-harm
- Having suicidal ideations
As one can see, these are significant signs and symptoms; ones that should never be ignored. That is why if any, many, or all of these symptoms are present, it is important to seek professional help sooner than later. Doing this may help a loved one avoid serious long-term consequences of their alcohol and drug use.
How to H.A.L.T. And Handle Triggers in Treatment and Recovery
In treatment and recovery, it is important to be able to step back and take a pause when times get tough. Now, this doesn’t matter if it’s one’s first day in treatment or if they have been in recovery for many years.
This pause allows one to recalibrate their thoughts and avoid a potentially catastrophic decision, such as using or drinking again. One exceptional way of taking this pause and handling triggers in treatment and recovery is by using the H.A.L.T. protocol.
What Exactly Is H.A.L.T.?
H.A.L.T. stands for Hungry, Angry, Lonely, Tired. These are four significant contributing factors to one’s discomfort in recovery. Actually, these are four significant contributing factors to anyone’s life, regardless of whether they are in recovery or not.
Now, the key is to engrain this protocol into one’s psyche so that it can be utilized at the drop of a hat. The reason is because that is how fast a trigger in treatment can lead to a relapse. One has to be ready to step back and think immediately.
Many people don’t realize just how prevalent relapse is in the U.S., and also how biologically related relapses are. According to the peer-reviewed journal Current Psychiatry Reports, “High levels of stress and trauma exposure are commonly associated with substance use disorder. Increases in irritability, anxiety, emotional distress, sleep problems, dysphoria, aggressive behaviors, and drug craving are common during early abstinence from alcohol, cocaine, opiates, nicotine, and marijuana. The dependent state is marked by negative affect, distress, and anhedonia during early abstinence, which relates to neuroadaptations in brain reward and stress pathways.” H.A.L.T. can help to prevent these relapses from happening.
Hungry: Handling Triggers in Treatment and Recovery
While it may seem rather basic, the fact of the matter is that hunger can lead to a lot of bad decision-making. It can cause someone to become severely “restless, irritable, and discontent.” These are the feelings that lead to a relapse in recovery.
It should also be noted that for people in recovery from alcohol use disorder (AUD), food can be particularly important, especially sugar. When one struggles with active AUD, their body becomes accustomed to the high amounts of sugar that is in the alcohol. It is when that sugar is no longer there that the body begins to crave it. This can lead to a specific alcohol craving.
This is why keeping some type of candy or soda on hand can be so helpful, especially in early recovery. The sugar can help ease those triggers in treatment.
Many people get concerned about the potential for weight gain from an intervention like this. The key is to remember that it may be a few pounds versus a lifetime of misery and suffering. Besides, it is also important to incorporate physical activity into one’s recovery. This will also help ease any discomfort that may come from changing one’s diet.
Angry: Handling Triggers in Treatment and Recovery
When thinking of the previous category of hungry, it is also important to remember that there is now a term called “hangry.” This is when someone is so hungry they get angry, and it is a perfect transition into the next part of H.A.L.T. – Anger.
In recovery, there is a saying that goes, “Resentment is the number one offender.” What this means is that in recovery an individual is more likely to relapse over a resentment than anything else. In fact, it is this resentful thinking that is actually going to be the first part of the relapse and not the actual use of the drink or the drug.
This is why one needs to remember to step back and halt when one gets angry. After all, anger ultimately only hurts the individual who is angry and not the other way around. Holding onto anger is like “hitting oneself in the head with a hammer in hopes of curing a headache.”
Being able to step back and process one’s anger is a major accomplishment in recovery, and it is one that can best ensure one stays sober in the long term. Another way to ensure long-term sobriety is by connecting to others in recovery.
Lonely: Handling Triggers in Treatment and Recovery
Connecting and working with others in recovery is so important that the primary text of 12-Step recovery (commonly referred to as the Big Book) named a chapter after it – “Working With Others.” The chapter states, “Practical experience shows that nothing will so much insure immunity from drinking [and using] as intensive work with other alcoholics. It works when other activities fail… You can help when no one else can.”
As previously mentioned, it is very easy to isolate in addiction. The same is true of people in recovery. This is why it is important to stay connected to other people both inside and outside of treatment. Now, this could be individuals one met in residential or day treatment, or it could be individuals that one met in recovery communities like Alcoholics Anonymous (A.A.), Narcotics Anonymous (N.A.), or Al-Anon (a program for families affected by addiction).
Avoiding loneliness can also happen by staying connected to one’s set treatment plan and staying connected to the recovery professionals who have established that plan. This includes recovery coaches, therapists, and counselors.
Tired: Handling Triggers in Treatment and Recovery
Another way to let one’s guard down is to become overly tired in treatment and recovery. Being tired makes handling triggers in treatment extremely difficult. The fact of the matter is that being tired can make any situation more difficult.
Active addiction and early recovery can disturb one’s healthy sleep cycles. This is why creating a routine with healthy sleep hygiene is so critical. It means trying to go to sleep and waking up at the same time, as well as having healthy activities that surround those times, such as morning and evening prayer and meditation.
When all of the components of H.A.L.T. come together, one’s chance at success goes up exponentially. But, where can one learn to utilize the H.A.L.T. protocol to its fullest capacity? One effective place is day treatment.
The Benefits of Day Treatment
Day treatment is an ideal place for an individual to go and get the help they need without fully committing to residential care. This means that they can get highly focused and intense treatment while still getting to keep one foot in their day-to-day lives. It is ideal for individuals who have family and financial responsibilities that cannot be put fully on hold.
Many people view day treatment as a less effective form of recovery than residential care. This could not be further from the truth. Day treatment is highly intensive, often involving eight hours a day, five days a week of focused addiction treatment. This treatment also uses all of the modalities that most residential treatment facilities use.
The Many Modalities for Handling Triggers in Treatment and Recovery
When it comes to recovery, it is important to make sure that one’s recovery is both individualized and comprehensive. The only way to ensure that this happens is to choose a recovery center that focuses on multiple, means, methods, and modalities for treatment.
This means that an effective recovery center should pull from all areas of addiction and mental health care. It includes holistic healing methods like yoga and meditation, experiential therapies like nature immersion therapy and art therapy, and psychotherapies like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT).
Utilizing Psychotherapy
Many of the most effective recovery plans that help to avoid triggers in treatment begin with a baseline of evidence-based therapies like CBT and DBT. They are simply considered evidence-based because there has been enough time and enough studies to show their efficacy.
CBT and DBT can be particularly beneficial because they make the individual an “active participant” in their own recovery. According to the peer-reviewed journal, Cognitive Therapy and Research, “Consistent with the medical model of psychiatry, the overall goal of treatment is symptom reduction, improvement in functioning, and remission of the disorder. In order to achieve this goal, the patient becomes an active participant in a collaborative problem-solving process to test and challenge the validity of maladaptive cognitions and to modify maladaptive behavioral patterns. Thus, modern CBT refers to a family of interventions that combine a variety of cognitive, behavioral, and emotion-focused techniques.” Experiential therapies can also be highly effective.
Utilizing Experiential Therapies
Experiential therapies are highly effective because they focus on the individual’s experiences and creative outputs rather than strictly on what they voice to a therapist (though this can be a crucial part of the process as well). There are many types of effective experiential therapies.
One highly effective type of experiential therapy is nature immersion therapy. In this therapy one better connects to themselves by better connecting to the world around them. Another common and effective type of experiential therapy is art therapy.
Art therapy is both highly therapeutic and highly informative. It lets an individual be extremely creative which offers an exceptional outlet, and it gives a recovery professional the types of insights needed to help an individual fully recover at the cellular level. A big part of recovering at the cellular level also comes from utilizing holistic healing methods.
Utilizing Holistic Healing Methods
One of the best types of holistic healing methods that one can utilize to best ensure that one gets all of the benefits of the H.A.L.T. protocol is mindfulness meditation. Meditation truly offers an authentic way to heal physically mentally, emotionally, and spiritually. It can also be combined with physical activities like yoga and breathwork to truly bring about a sense of balance and essential serenity.
Healing Whole Mind-Body-Spirit at NorthStar Recovery Center
Allan Watts also famously said, “No work or love will flourish out of guilt, fear, or hollowness of heart, just as no valid plans for the future can be made by those who have no capacity for living now.” That is one of the major keys to recovery – staying in the moment and taking it “one day at a time.”
Here at NorthStar Recovery Center, we believe in taking recovery one day at a time and celebrating successes. We also believe in healing the whole mind, body, and spirit, which is why all of our recovery plans are individualized and comprehensive.
Remember that recovery is about the journey, never the destination, and that journey of a lifetime can start right here at NorthStar Recovery Center. Recovery is out there. It’s time to go out and get it.
“Hungry, Angry, Lonely, and Tired” (H.A.L.T.) is an excellent acronym for helping people when they feel triggered in treatment and recovery. It is important to use H.A.L.T. as a framing mechanism to navigate all of the different “triggers” while in treatment (such as day treatment). H.A.L.T. is also a tool that can help to avoid relapse and aid in long-term recovery. If you feel like you or a loved one is struggling with issues of addiction, mental illness, or both, we can help get you on the positive path toward long-term recovery right away. You don’t have to go through this process alone. For more information about H.A.L.T. and day treatment, reach out to NorthStar Recovery Center at (888) 311-0911.