Smokers and Alcoholics may face withdrawal symptoms amidst Lockdown 2.0

India has witnessed a sudden upsurge in patients facing withdrawal symptoms due to the abrupt constraint on the availability of liquor and cigarettes. The sudden realisation that this essential (for some) is not readily available can trigger severe withdrawal symptoms among addicts. The same goes for those who are dependent on alcohol or even drugs.

Drinkers and smokers can be classified into three categories -- social (who consume occasionally), dependent (who consume moderately) and addicts (who cannot survive without nicotine or alcohol even for a day). While the first two categories can tackle this lockdown easily, the third category will suffer from withdrawal symptoms.

People who are heavily dependent on alcohol or smoking --- often face a range of cognitive and physical symptoms when they abruptly stop consuming. Alcohol and nicotine are sedative drugs that slow brain function. To compensate, many brain circuits increase the basal level of activity. Without alcohol present, these circuits become hyperactive, resulting in anxiety, hallucinations, seizures, and even death.

In order to contain the further spread and contamination of Covid19 novel coronavirus, liquor and tobacco shops were closed temporarily on March 24, 2020 and continue to be shut during Lockdown 2.0. Non-availability of these items during this time is likely to adversely affect the mental health of people who are binge-alcoholics or smokers.

IANSlife spoke to By Dr Paras, Life-leadership Coach and Psychotherapist regarding patients who may suffer from physical and psychological ailments, due to the unforeseen break in their classic pattern of consumption of alcohol or nicotine.

Alcohol and Nicotine trigger the release of serotonin in the brain's reward system, which makes them so addictive. Addicts are not aware that regular consumption of alcohol or cigarettes changes their chemistry. Serotonin or the 'feel good' neurochemical is a mood enhancer. The short-term effect of alcohol may boost serotonin, to increase feelings of happiness and wellbeing, while the long-term repercussions of heavy alcohol use often include a decrease in serotonin production, leading to an increased chance of depression.

With long-term abuse of alcohol or nicotine, the brain's reward systems slow down, however, when an addict chooses to abruptly break the habit of regular consumption instead of gradually decreasing consumption, the stimulatory effects on the reward system are no longer present. As a result, activity in the brain's reward systems drops, which can include symptoms like depression and irritability. This applies to people who abuse drugs as well or are drug addicts.

People struggling with depressive withdrawal symptoms may have the highest manifestation called 'delirium tremens.' Severe withdrawal symptoms like shaking, confusion and hallucinations, after one suddenly quits requires proper counselling intervention to stabilise their overall mental wellness.

9 quintessential Symptoms of Withdrawals (Symptoms can range from mild to serious).

The intensity and length of these withdrawal symptoms can vary widely, depending on the noctoine, alcohol or drug addiction and your biological make-up. But the psychological symptoms can last for longer.

• Unexplained craving: The craving factor tends to get stronger. The craving for smoking, alcohol or drugs can be so intense that the person is willing to do anything, even something which might be considered to be unethical, immoral or fatal.
• Physical dependency: Like nausea, sweating, shaky hands, strong stomach cramps and vomitings.

• Develop a high level of intolerance
• Throbbing headache: Carving leaves you with throbbing headache
• Anxiety, depression
• Hallucination, about 12 to 24 hours after that last drink to seizures within the first 2 days after you stop. You can see, feel, or hear things that aren't there.
• Insomnia or Hypnagogic hallucinations. These can occur in the consciousness state between waking and sleeping.
• Depression or dysphoria can last for longer
• Constant mood swings

9 ways to keep your mental health from descending into chaos

• By eliminating worry from the equation, you can better understand your mental health and determine what it is that you need to feel your best during this lockdown. Remember, the presence of any survival mechanism, which has a potential to make you feel "happy." The brain releases four main 'feel good' chemicals - endorphin, oxytocin, serotonin, and dopamine which inexplicably help you to cope up with the symptoms.
• Practice Self-Hypnosis
• A relaxation technique - Mental imaginary technique - Hypnosis is the answer to reduce peripheral conditions engrossed within you and the best way to learn self-meditation. You can practice daily for 10 to 15 minutes during bedtime and early in the morning as soon as you awake.

It is a tranquillity-like state in which you can heighten your focus and concentration. Hypnosis will allow you to bypass your conscious mind and introduce mindfulness with positive thoughts and ideas into your subconsciousness. Proper online counselling to demonstrate the procedure would be helpful.

You can relax on the bed, breath slowly and evenly from the stomach and not from the chest and deep dive into the past, remembering good things which can make you feel relaxed and very happy.

Exhale with every word that the way you want to feel, for instance - 'energised' and 'calm'

By closing both the eyes, recalling a pleasing and a joyful image from the past, allow yourself to vividly experience the same by remembering the sound, smell, colour and taste of the moments.

After 10-15 minutes come back with the feeling of goodness you garnered from those memories.

• The power of escapism

Opposite to mindfulness, are the miraculous benefits of the imagination and distractions. Escapism offers a way to take the pressure off and temporarily disconnect.

Who doesn't love getting lost in the fantasy series or spending time on the best part of a movie because these appear as a part and parcel of the methods of escapism? It's about creating your own fantasy in your imagination and living it. It is the tendency to seek distraction and relief from unpleasant realities. In taking some time to escape our everyday lives, we find ourselves better equipped to deal with situations and handle any obstacles we may be facing.

Escapism can take many forms, whether it's going away to spend some time in a new place, watching every new film that comes out, or listening to music on the train and pretending you're in a music video. It's basically anything that removes you from your current situation. By engaging in some healthy escapism, you can leave any pressing concerns or worries behind. In a lot of cases, emotions are fleeting, and we simply need to ride them out. With distractions to remove you from the toxic headspace, this can happen without dragging you along for the process. It is advisable to take proper online counselling to demonstrate the procedure.

• Nicotine Chewing gum

The idea is to keep your mouth busy for 18 hours continuously for a week or so. Nicotine replacement therapy, like gum, lozenges, or the patch or crunchy (healthy) food can come to the rescue. Nicotine chewing gum is believed to reduce cravings to smoke and is used to help people quit smoking. Nicotine chewing gum should be used together with a smoking cessation program, which may include counselling or specific behavioural change techniques.

• Nicotine Inhalers

A nicotine inhaler looks similar to a large cigarette with a mouthpiece, but it's actually a thin plastic tube that contains a nicotine cartridge inside. When you take a puff, the cartridge puts out a pure nicotine vapour that delivers most of the nicotine vapour to the mouth, where it's absorbed into the bloodstream. Because it looks and acts like a cigarette, it can ease some of the habitual withdrawal symptoms as well. (Only recommend to use for 3 months or as per the smoking cessation program)

• Talk to a friend, family member or a professional counsellor

It is natural to notice changes in your mood. You may feel impatient, irritable, anxious, nervous, angry, or sad. Talking about your feelings is very beneficial. Ask your family and friends for support and remind them to be patient with you. Make sure there is someone you can talk to during major discomfort or pain escalating due to carving during the process of giving up cigarettes. Take an immediate approach to a professional counsellor or talk to a friend to rationalise your mistaken thoughts about the symptoms.

• Intellectual activities

Brain games are always the best choice for cognitive stimulation. Brain games could be the best component in helping manage and forget the craving and keep you engrossed over long periods of time. Scrabble. Sudoku. Crossword puzzles are best to go with.

• Art therapy

Expressive art therapy is the use of creative arts as a form of therapy and is a fantastic field that has proven to work wonders in many people's lives. Practising or creating art, is a phenomenal pathway of healing and life-enhancing. Art therapy involves the use of creative techniques such as drawing, painting, collage, colouring, or sculpting to help people express themselves artistically and examine the psychological and emotional undertones in their art can help a lot to cope with the symptoms of withdrawal.

• Sound Healing Therapy

Also known as vibrational medicine for your brain to get cured quickly. Become independent and develop the ability to heal yourself holistically. Sound healing techniques harmonize the listener with the rhythms of nature. Sound healing sends your mind in a constant elemental state of vibration. When we are in resonance with the sound, our mind is in perfect balance. With the right sounds and scientific process of application, you can align yourself with the vibrations that foster health, happiness, success and unity. During a lockdown, grab your headphones, open your youtube and select some of the best crystal bowls sound sessions or tibetan singing bowl sessions.

• Chakra Balancing

Chakra balancing is the process of restoring a harmonious flow of energy across the chakra system.The effect of well balanced chakras often translates into a feeling of well-being, relaxation, centeredness, increased vitality and embodiment of oneself. Smoking is loaded with toxins ranging from the obvious nicotine (highly addictive substance) to all the different chemical bound additives such as benzene, formaldehyde (embalming fluid), ammonia (toilet cleaner), acetone (nail polish remover), tar, carbon monoxide, arsenic, hydrogen cyanide, etc. Smoking affects the entire aura of the energy body in particular the throat chakra, the root chakra and especially the heart chakra. Using guided meditation, one can also activate all the chakras. Take a counselling to demonstrate a step-by-step meditation and align your chakras perfectly.

As the body and brain begin to heal, you will experience renewed motivation towards healthy habits in your life.