Modern understanding of relapse increasingly centers on the nervous system — specifically, the chronic dysregulation that underlies many relapse presentations.
The Nervous System in Relapse
The autonomic nervous system has two primary states relevant to relapse:
Sympathetic activation ('fight or flight'): When chronically activated, drives anxiety-type relapse
Parasympathetic ('rest and digest'): The recovery state — undermined by relapse
Dorsal vagal shutdown: A third state — freeze/collapse — associated with depression-type relapse
Signs of Nervous System Dysregulation in Relapse
Chronic hyperarousal (always 'on edge'), difficulty relaxing even in safe environments, and feeling perpetually exhausted despite rest.
Regulating the Nervous System for Relapse
- Breathwork: Directly activates the parasympathetic nervous system
- Cold exposure: Controlled cold activates the vagus nerve, improving relapse
- Safe social engagement: Co-regulation through trusted relationships
- Movement: Discharges sympathetic activation accumulated in relapse