You stopped drinking. Or using. You expected to feel better. Instead, you feel worse.
This is normal. It's also temporary. But tracking your mental health through recovery shows you what's happening beneath the surface and helps you stay the course when it gets hard.
Why recovery feels terrible at first
Your brain adapted to the substance. Alcohol, opioids, stimulants: they all hijack the brain's reward and mood regulation systems. Your brain stopped producing normal amounts of dopamine and serotonin because the drug was doing the job.
When you stop, your brain has to relearn how to function without help. That process takes time. In the meantime, you might experience:
- Depression that feels crushing
- Anxiety that came out of nowhere
- Sleep problems
- Mood swings
- Difficulty feeling pleasure (anhedonia)
- Fatigue and low motivation
This isn't you failing at recovery. It's your brain recalibrating.
The timeline most people experience
Week 1: Acute withdrawal. Physical symptoms peak (sweating, shaking, nausea for alcohol; flu-like symptoms for opioids). Anxiety and sleep problems are common.
Weeks 2-4: Physical symptoms subside. Mental symptoms often intensify. Depression and mood swings may peak during this period.
Months 1-3: Gradual improvement in mood and cognitive function. Cravings typically decrease. Sleep begins to normalize.
Months 3-6: Significant improvements in both physical and mental health. Many people report feeling substantially better by month 6.
Months 6-12: Continued healing. Most people experience major quality-of-life improvements by the one-year mark.
But here's the catch: this timeline varies enormously. Some people feel better in weeks. Others struggle for a year or more. Your history (how long and how heavily you used, whether you have co-occurring mental health conditions, your overall health) affects your trajectory.
Post-Acute Withdrawal Syndrome (PAWS)
After acute withdrawal ends, many people experience PAWS: prolonged psychological symptoms that can last months or even years.
Common PAWS symptoms:
- Depression
- Anxiety
- Irritability
- Sleep disturbances
- Difficulty concentrating
- Memory problems
- Low energy
- Mood swings that come out of nowhere
PAWS is frustrating because it's unpredictable. You might feel fine for two weeks, then suddenly hit a wall. This is why tracking matters. It helps you see that these dips are temporary, not permanent setbacks.
Why tracking through recovery is essential
To separate brain chemistry from "real" depression
Some depression in early recovery is chemical, your brain adjusting. Some people also have underlying depression that existed before the addiction (and might have contributed to it). Tracking over time helps distinguish:
- Chemical rebound: Scores that gradually improve over months, even with ups and downs
- Underlying depression: Scores that don't improve or get worse after the initial period
If your depression isn't lifting after 3-6 months of sobriety, that's important information. You might need treatment for depression alongside your recovery work.
To catch warning signs
Relapse often follows a predictable pattern: mental health deteriorates before the relapse happens. Rising depression or anxiety scores can be an early warning that you need more support, before it becomes a crisis.
To see progress you can't feel
Recovery is slow. Day to day, you might feel stuck. But a chart showing your PHQ-9 dropping from 18 to 10 over four months tells a different story. That data can keep you going when motivation is low.
To communicate with your treatment team
"I feel bad" is vague. "My PHQ-9 has been above 15 for the past six weeks" is specific. Tracking gives your doctor, therapist, or sponsor concrete information to work with.
What to track
Primary mental health assessments:
- PHQ-9: Depression symptoms
- GAD-7: Anxiety symptoms
- DASS-21: Depression, anxiety, and stress together
Alcohol-specific (if applicable):
- CAGE: Brief alcohol use screening (useful for checking in on cravings and behaviors)
- MAST: More detailed alcohol screening
Frequency: Weekly during the first 3 months, then monthly once you're more stable.
What to expect from your scores
Months 1-2: Scores may be high and volatile. Depression in the moderate-to-severe range is common. This doesn't mean treatment isn't working. It means your brain is healing.
Months 3-6: Gradual decline in scores. You might still have bad weeks, but the trend should be downward.
After 6 months: Most people see significant improvement. If scores are still elevated, consider whether additional mental health treatment is needed.
The "pink cloud" and its aftermath
Some people experience a "pink cloud" in early recovery, a period of euphoria and optimism, often in the first few weeks or months. Everything feels possible. You wonder why you didn't quit sooner.
This usually fades. When it does, depression and anxiety can feel worse than expected because you're comparing to the pink cloud, not to your baseline.
Tracking helps here too. If your scores were actually good during the pink cloud and then rose after, that's different from scores that were always elevated. The data shows what's really happening.
When to get additional help
Recovery includes mental health support. But sometimes you need more. Consider reaching out if:
- Depression scores stay in the moderate range (10+) after 3-4 months of sobriety
- Scores are climbing instead of falling
- You're having thoughts of self-harm
- Symptoms are interfering with your ability to work or maintain relationships
- You're struggling with cravings that feel unmanageable
Medication for depression or anxiety doesn't mean you're failing at recovery. Treating underlying mental health conditions actually supports sobriety. Untreated depression is a relapse risk factor.
Why you shouldn't stop tracking when you feel better
This is important: many people stop monitoring once they feel good. That's exactly when tracking matters most.
Feeling better doesn't mean you're done healing. The brain continues to recover for 1-2 years after stopping substance use. Early warning signs of trouble, like subtle increases in depression or anxiety, are easiest to catch when you have a consistent data history.
Monthly check-ins with a mental health assessment take 5 minutes. That small investment can catch a downward trend before it becomes a crisis.
Building the habit
1. Start now. Take the PHQ-9 and GAD-7 today as your baseline.
2. Set a weekly reminder for the first 3 months. Same day, same time.
3. Record your scores somewhere accessible. Include the date and any notes about context (stressful week, poor sleep, milestone reached).
4. Review monthly. Look at the trend, not individual scores. Is the overall direction down?
5. Share with support. Your sponsor, therapist, or doctor can help interpret patterns and adjust support accordingly.
6. Keep going after you feel better. Monthly tracking takes minutes and provides important early warning.
Recovery is a long process. Your brain needs time to heal. Tracking shows you that healing is happening, even when it doesn't feel like it, and catches problems early when they're easiest to address.
The goal isn't just sobriety. It's mental health. Track both.
Start tracking your recovery
Survey Doctor makes it easy to take the PHQ-9 and GAD-7 on a regular schedule and monitor your progress through recovery. Set up weekly reminders and watch your trajectory over time. Take your first assessment.