Does post-acute withdrawal syndrome (PAWS) occur with porn addiction?

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withdrawalPAWS, or post-acute withdrawal symptoms, refers to withdrawal-like misery that recurs periodically for months or even years after the initial withdrawal process is complete. The term evolved in connection with recovery from substance addictions, but some people who quit porn describe a similar phenomenon. This is not surprising, as all addictions cause some of the same fundamental brain changes, and withdrawal brings on additional neurochemical changes. Read more about PAWS on a substance addiction recovery site.

In recent years men of porn recovery forums have hypothesized that lingering symptoms such as low libido, depression, anxiety, and lethargy may be PAWS-related.

Here are some guys describing it:

This is SO clearly PAWS, or post acute withdrawal syndrome. Absolutely no doubt. The "up and down" nature of the symptoms, the slowwwwww nature of the recovery, and the symptoms themselves. For well over a year and a half, I haven't been able to find joy in much of anything. Now, I'm beginning to feel music the way I used to, I can enjoy a conversation with a stranger instead of struggling through the social anxiety associated with it. Simply put, as much hell these past couple years have put me through, I am truly improving. There's no doubt about it. And I echo those who say rewiring is the most important part--my healing clearly increased more once I moved to the same place as my girlfriend, where regular (and usually successful) sex is the norm.

Just keep moving forward. LINK - I can feel music again. I enjoy conversations with strangers. I'm 1.5 years in.

Another guy:

After we broke up in early 2012, I abstained from orgasm, at first out of post-breakup depression. I for some reason never gained the desire to watch porn during this brief period, and during this inadvertent "streak", I experienced what many describe as the "super powers" gained from abstinence or healing PIED. I was in what can only be called a blissful flow state for several months.

Eventually in August of that year, the bliss came to an abrupt end as I spiraled into the deepest hole of my life which I am just now climbing out of. Was this the end of the initial "superpower" spike from abstinence and the start of porn's version of post-acute-withdrawal-syndrome? If Gary's science is right, I'd say it's possible considering the depth and duration of my case.

When I started feeling INSANE social anxiety and depression, I panicked and started trying to watch porn again. I say "trying" because I couldn't even get it up to porn at this point (still can't). Honestly, this period of my life is blurry because I wasn't monitoring any of this. I hadn't discovered YBOP yet.

Finally came across Gary's site in June of 2013 and have not PMO'd since. I masturbated off and on at the start of the reboot, often pathetically and 20% soft. Finally, I decided to go hard-mode outside of sex with my long distance girlfriend.

Between June '13 and June '14, I saw my girlfriend every 1.5 months or so. We would have a lot of sex, some successful some unsuccessful, and without fail I would notice physical symptoms following orgasm. Nausea, headaches, fatigue, brain fog, depression, anxiety, and complete social incompetence. These are the symptoms I've been experiencing off and on for almost 3 years, but I noticed an even bigger fluctuation after orgasm. Any time I started doubting the reboot process and PIED science, an orgasm would wake me up to the reality that something was not right. That's really the only way I can explain what my brain has been throughout this. Not right. The only thing that kept me alive was the recognition of my sllllloowwwwwlyyy improving symptoms. I was miserable, but i was 1% less miserable than a month ago. And that was enough.

I mentioned the up and down nature of my symptoms, and I think that this roller coaster effect is the most overlooked important part of this entire process/discussion. The way our mental symptoms come and go during reboot is EXACTLY how post acute withdrawal is described from hard drugs. They say the dark periods get lighter and less frequent, and the good periods get better and more frequent as you move forward through withdrawal, which is exactly what's happened with me.

Guys, I can't even tell you how low I felt at one point. I was brain dead, socially incompetent even around friends and family, depressed, unmotivated, etc. Now, the symptoms are infrequent and less intense.

My girlfriend and I live in the same city now, so sex is relatively abundant. We're busy and stressed so it's usually a weekend thing, but it's almost always enjoyable and successful. The only physical symptom I sometimes experience is PE.

More importantly for my daily life, my mental symptoms have greatly improved. I'm not fully back yet, but I'm closer than ever.

As far as advice goes.....MEDITATION is a very big one for me. It's weight lifting for the mind, and the mind can either be our biggest ally or worst enemy in this fight. Just sit still for 10 minutes a day and focus on your breath. I started this practice as my new year's resolution, and this is when my improvements began to accelerate.

An additional note on meditating and exploring the mind: I read something interesting yesterday. "Trying to calm your mind WITH your mind is like trying to bite your own teeth." Thus, we focus on calming the body, and the mind naturally follows suit. Just sit there for a minute and focus on releasing the tension in your shoulders. Do the opposite of shrugging them to your ears. Give in fully to gravity and allow the stress to fall off your body. This simple practice has helped me profoundly.

Anyways, thanks to everyone on this site who has added value. The best stuff on this site involves trying to get to the bottom of this fucking thing. I've never clicked on a "NOFAP (insert month here)!!' thread in my life but I've spent hours reading thoughtful posts about the flatline, D2 receptors and scientific studies. This needs to keep happening because many more guys are eventually going to drop by. This should be a research hub, not a social media site for guys who can't quit for more than 10 days.

Keep on keepin on. "Whatever has the nature to arise...shall also pass away." LINK - Success almost two years in. PIED is undoubtedly a thing.

Another guy:

I used to be a heavy porn user for many years but i pretty much stopped doing porn about 3 years ago. I guess i was very addicted, which is probably why i am still having lots of trouble today.
Since then i have been suffering from PAWS:
-depression
-Anxiety
-Irritability
-Insomnia (occassionaly)
-repetetive negative thinking
-loss of lipido
-somethink i would describe as craving for being "high"

Things are getting better with the time but the progress is very slowly.

I started thinking about medication now.

In general, the things that help the most are exercise, meditation, time in nature, socializing and beneficial stressors like cold showers. You may also find some of the suggestions here helpful: Started on Internet porn and my reboot is taking too long


[From a 2015 study]

Post-Acute Withdrawal

Dealing with post-acute withdrawal is one of the tasks of the abstinence stage [1]. Post-acute withdrawal begins shortly after the acute phase of withdrawal and is a common cause of relapse [17]. Unlike acute withdrawal, which has mostly physical symptoms, post-acute withdrawal syndrome (PAWS) has mostly psychological and emotional symptoms. Its symptoms also tend to be similar for most addictions, unlike acute withdrawal, which tends to have specific symptoms for each addiction [1].

These are some of the symptoms of post-acute withdrawal [1,18,19]: 1) mood swings; 2) anxiety; 3) irritability; 4) variable energy; 5) low enthusiasm; 6) variable concentration; and 7) disturbed sleep. Many of the symptoms of post-acute withdrawal overlap with depression, but post-acute withdrawal symptoms are expected to gradually improve over time [1].

Probably the most important thing to understand about post-acute withdrawal is its prolonged duration, which can last up to 2 years [1,20]. The danger is that the symptoms tend to come and go. It is not unusual to have no symptoms for 1 to 2 weeks, only to get hit again [1]. This is when people are at risk of relapse, when they are unprepared for the protracted nature of post-acute withdrawal. Clinical experience has shown that when clients struggle with post-acute withdrawal, they tend to catastrophize their chances of recovery. They think that they are not making progress. The cognitive challenge is to encourage clients to measure their progress month-to-month rather than day-to-day or week-to-week.