In the room of recovery fellowships, there’s a common acronym that gets passed on to people who are new to recovery: HALT. It is a reminder to not let yourself get too Hungry, Angry, Lonely, or Tired, because these factors will leave you more vulnerable to relapse. Like many things in recovery fellowships, it seems to have been born of the hard experience of people who were trying to turn their lives around from addiction and other mental health issues. As this post will explain, this may have been discovered by trial and error, but there is solid scientific evidence to support it.
What We Know So Far
People who are trying to recover from any serious mental health disorder, including addiction, are facing an uphill battle. Unfortunately, no matter how long recovery has been sustained, there is always the risk of relapse. This means that anyone who is trying to recover needs any advantage they can get and likewise needs to avoid any pitfall they can.
While much of this will be accomplished through working on the person’s thinking, and in some cases their spirituality, there are some factors that are more obviously neurological. Some of these are the types of chemical imbalances that a prescriber needs to treat with medications, but others are simple enough that anyone can tend to them by themselves.
Enter HALT. This simple acronym can help a recovering person remember four simple but profoundly influential factors that can affect their brain health, and thus their chances of sustaining recovery. They are also things that are good for anyone to be aware of, whether they have a mental health issue or not. That’s because the vulnerabilities associated with these factors are not unique to people who are trying to recover. They apply to any one of us.
Let’s look at each one in turn and see what research can tell us about its effects and thus its importance for relapse prevention.
Hungry – When we let ourselves get too hungry, we may be experiencing hypoglycemia, or low blood sugar. This has been shown to reduce our ability to think clearly, and many people associate it with heightened emotional responses, such as getting angry more easily. It can also reduce how well we respond to stress. These things leave us more likely to make risky choices, such as deciding to relapse or otherwise abandon healthy caution.
In a particularly dangerous twist, some people who are trying to get sober from alcohol find that they have trouble telling pre-meal hunger from alcohol craving. This may be a fluke of genetics, but it has been shown to put such individuals at significantly higher risk of relapse. It should be noted that even if the person’s primary issue is not related to alcohol use, drinking alcohol can still have a cascade of negative effects on mental health in general and lower that person’s inhibitions around other self-destructive behavior. Thus, a person whose hunger leads them to alcohol use is putting themselves in greater danger of using other drugs, falling into a depressive episode, or even attempting suicide while under the influence.
Angry – Anger is a natural emotion associated with threat response. While it is a normal part of life, how we handle it can make a big difference in our lives. Unfortunately, when we are trying to give up old behaviors and engage in a recovery-oriented lifestyle, we often find that no matter how positive the changes we are making, this process can feel threatening all by itself. We may feel self-doubt and some level of uncertainty about whether these changes are really the best thing for us. Can we be okay functioning without our “old trusty friends” such as alcohol and other drug use, avoiding people, or pretending to be okay when we are not? When we aren’t sure about such things, anger can come up unexpectedly.
Anger changes our brain function, such that we do not reason as well and thus may make worse decisions. Almost anyone can think of a time when they said or did something in anger that they regretted, whether that regret came right away or much later. Anger can lead to taking greater risks and also increase self-justification. Unfortunately, this means that someone trying to recover is at greater risk of doing something that undermines that recovery when they are angry. Thus, even though anger is natural, “indulging” in it is often not safe for someone in recovery.
Lonely – Humans are social creatures. Loneliness has been shown to have terrible effects on mental and physical health, such as increased depression and anxiety. In fact, loneliness does as much to shorten lifespans as obesity or nicotine use. Loneliness makes us more vulnerable to wanting to consume things as a way to make up for the emotional pain and perceived threat of feeling alone. It can also make us more self-centered. In a particularly dangerous spiral, greater loneliness can breed mistrust of others, making future loneliness more likely. Loneliness can also contribute to feelings of self-pity.
These thoughts and behaviors are bad for anyone, but they are particularly dangerous for those trying to stay in recovery. The desire to consume could easily translate into compulsive shopping, a return to alcohol or other drug use, or spending and then regret, which can then further exacerbate mental health issues. Self-centeredness and self-pity can lead to self-justification for self-destructive behavior. Mistrust of others makes it easier to push away the social supports that are so vital to people in recovery. All of this makes relapse a much greater danger.
Tired – Fatigue is known to be a leading cause of accidents and poor judgment, yet it often goes either unnoticed or unreported. When we are fatigued, we are less likely to notice or react to danger, and we can become a danger to ourselves and others. Research has found that working or driving while tired is as dangerous as driving while drunk. In recent years, work and driving accidents due to intoxication have been going down while fatigue-related accidents have not. This is likely because most of us don’t realize how much being tired impairs our judgment.
When it comes to relapse, the dangers of being too tired are clear. Because fatigue leaves us more neurologically vulnerable due to reduced judgment and more prone to irritability, anxiety, and self-pity, it becomes easier to make a self-destructive decision that leads to relapse.
What Can Be Done?
While it’s not possible to always avoid getting hungry, angry, lonely, or tired, there are things you can do to avoid these factors turning into a relapse. First, be aware of how you are doing in each area. Noticing when you are vulnerable can do a lot to help you avoid disaster. When you see one of the factors becoming a problem, take care of it. Second, if there is one you can’t do much about at the moment, such as having a tired day because of insomnia the night before, take extra care with the others. Make sure you are well fed, emotionally regulated, and in touch with supportive people. By cultivating this awareness and using it to guide self-care, relapse need not happen.
The Bottom Line
There is good scientific evidence to support the use of the HALT acronym. Each factor is one that warrants attention by itself, and extra effort should be put into making sure they don’t stack up. By being aware and exercising self-care, nothing about HALT needs to lead to relapse.
Created specifically for those who have loved ones that struggle with addiction.