Mental Health and Mood Changes in Early Recovery

Early recovery is a big emotional shift.

Your body is detoxing, your brain is rewiring, and your daily routines are changing. In the middle of all that, it’s very common to feel “up and down” emotionally, energized one day, flat the next; hopeful in the morning, discouraged by evening.

Those mood changes can feel scary, especially if you worry they mean you’re “doing recovery wrong” or that relapse is around the corner. In reality, mental health changes are a normal part of healing from substance use disorders. They deserve attention, support, and care, not shame.

This guide walks through:

• What “mental health” means in recovery
• Common mood changes in early sobriety
• Why these shifts happen (brain, psychology, and social factors)
• Practical ways to cope and when to ask for more help

If you’re in early recovery now, you are not alone in feeling this way. Mood changes are part of the story for many people, and with the right support, they can be managed safely.

‍What Do We Mean by “Mental Health” in Recovery?

Mental health isn’t only about whether someone has a diagnosis like depression or anxiety.

The World Health Organization describes mental health as a state of well-being that helps a person cope with daily stress, work or learn, and contribute to their community.

In early recovery, mental health includes things like:

• How steady or unstable your mood feels
• How much stress you can tolerate before feeling overwhelmed
• How clearly you can think and make decisions
• How connected (or isolated) you feel from others
• How hopeful you feel about the future

Because substances have been affecting brain chemistry, any shift toward sobriety is going to affect these areas, sometimes in waves. That doesn’t mean you’re broken; it means your brain and body are adjusting.

‍Common Mood Changes in Early Recovery

Many people notice emotional ups and downs in the first weeks and months after stopping alcohol or other drugs. Some of the most common changes include:

1. Anxiety

• Feeling keyed up, restless, or on edge
• Worrying about the future or “waiting for something bad to happen”
• Physical signs like a racing heart, tight chest, or stomach discomfort

2. Low mood or depression-like symptoms

• Feeling sad, hopeless, or “numb”
• Loss of interest in activities that used to matter
• Low energy, sleeping too much or too little

3. Irritability and anger

• Getting frustrated or angry quickly
• Snapping at people you care about
• Feeling like “everything is too much”

4. Mood swings

• Feeling okay in the morning, exhausted or overwhelmed by afternoon
• Days of feeling strong and hopeful followed by days of doubt or apathy

Some of these changes can be part of post-acute withdrawal symptoms (PAWS), which can affect mood, energy, and sleep for weeks or months as the brain heals. 

‍Why Do Mood Changes Happen in Early Recovery?

Mood shifts usually don’t have a single cause. In recovery, biological, psychological, and social factors often overlap.

1. Biological Factors

Substance use affects brain systems that regulate stress, reward, sleep, and mood. Over time, the brain adapts to regular use of drugs or alcohol by changing how it uses neurotransmitters like dopamine, GABA, glutamate, and stress-related hormones. When you stop using:

• Your brain no longer gets the same artificial “boost” from substances.
• Natural dopamine and stress responses may feel “off” for a while.
• Sleep, appetite, and energy can all be disrupted.

That adjustment period can show up as:

• Anxiety and restlessness
• Low mood or lack of motivation
• Feeling emotionally flat or “foggy”

These changes aren’t a sign that recovery isn’t working, they’re often a sign that your nervous system is recalibrating.

“We see this every day in early recovery: emotions feel louder because substances are no longer muting them. That doesn’t mean something is wrong - it means the brain is doing the work of healing. When mental health is treated alongside addiction, those mood shifts become manageable and far less frightening.”

— Dr. Nicole Erkfitz, LCSW, Chief Operating Officer

2. Psychological Factors

Many people used substances to:

• Push away painful emotions
• Cope with trauma, grief, shame, or chronic stress
• Manage social anxiety or low self-esteem

Once substances are removed, all those feelings become more visible. It’s common to experience:

• Old grief or trauma rising to the surface
• Guilt or regret about past behavior
• Fear about who you are without substances

If there is an underlying mental health condition (like depression, bipolar disorder, PTSD, or an anxiety disorder), those symptoms may also become more noticeable once substances are gone. Co-occurring mental health and substance use disorders are very common and need integrated treatment. 

3. Social Factors

Recovery often involves major social changes, such as:

• Stepping back from relationships that centered around using
• Rebuilding trust with family, partners, or friends
• Adjusting to new routines (treatment, work, meetings)

These shifts can bring both relief and stress. For example:

• You may feel lonely while building a sober support network.
• Loved ones may still be cautious or unsure how to relate.
• Work, finances, or legal issues may still be unstable.

All of this can affect mood, even if you’re doing “everything right” in treatment. 

‍How Mood Changes and Relapse Risk Are Connected

Mood swings don’t automatically mean a relapse is coming. At the same time, untreated emotional distress is a known risk factor for relapse.

Some warning patterns to watch for include:

• Bottling up emotions and isolating
• Skipping therapy sessions, treatment days, or support groups
• Letting sleep and eating habits slide
• Feeling that “nothing is working” or that recovery is pointless
• Increasing thoughts like “One drink/pill wouldn’t matter”

If you notice these patterns in yourself, it’s not a moral failure. It’s a sign to add support as early as possible, before a lapse becomes a full relapse.

‍Strategies for Coping with Mood Changes

You don’t have to simply “ride it out.” There are practical tools that can make mood shifts more manageable.

1. Professional Help and Therapy

Working with clinicians who understand both addiction and mental health is one of the most effective ways to stabilize mood in early recovery. 

Helpful options can include:

• Individual therapy
  
  • Cognitive-behavioral therapy (CBT): helps identify unhelpful thought patterns (like “I’ll always be this way”) and replace them with more balanced, realistic thoughts.
  • Trauma-focused therapies (like EMDR or trauma-informed CBT) for those with a history of trauma.
• Group therapy
  
  • Offers validation: hearing “me too” from others who’ve been there.
  • Teaches skills for emotion regulation, communication, and boundary-setting.
• Medication support
  
  • For some, medications for mood, sleep, anxiety, or cravings can be part of a safe, evidence-based plan. These should always be managed by a qualified prescriber who understands addiction medicine.

If you’re in a Partial Hospitalization Program (PHP), Intensive Outpatient Program (IOP), or Virtual IOP, many of these supports are built into your weekly schedule. 

2. Self-Care Practices That Support Mood

Self-care isn’t a cure-all, but it genuinely helps your brain and body stabilize:

• Regular sleep routine
  
  • Aim for consistent bed and wake times.
  • Build a wind-down routine (dim lights, screens off, calming activities).
• Balanced meals and hydration
  
  • Eating regularly supports blood sugar and energy, which can steady mood.
  • Drinking enough water helps with headaches, fatigue, and concentration.
• Gentle movement
  
  • Walking, stretching, yoga, or light exercise a few times per week can reduce anxiety and improve mood.
• Mindfulness and grounding
  
  • Short breathing exercises
  • Noticing your senses (what you can see, hear, feel in the room)
  • Journaling about emotions without judging them

For a simple toolkit of everyday tools, see our blog “10 Everyday Coping Skills for Cravings and Stress.” Many of those same skills like grounding, breathwork, and small daily routines are also helpful for mood swings.

3. Building a Support Network

Recovery is much harder in isolation. A support network can include:

• Family members or partners who are willing to learn about addiction and mental health
• Sober friends or peers from groups like 12-step, SMART Recovery, or other mutual-help meetings
• Sponsors, mentors, or recovery coaches
• Clinical teams in PHP, IOP, or residential care

If you’re a loved one reading this, simply being consistent, calm, and non-judgmental is already a powerful form of support.

‍When Are Mood Changes a Red Flag?

Some emotional ups and downs in early recovery are expected. But there are times when mood symptoms may signal the need for urgent or higher-level support.

It’s important to reach out to a professional if you notice:

• Mood changes that are getting worse over several weeks, not slowly improving
• Severe anxiety or panic that makes it hard to function day to day
• Persistent, deep depression: feeling hopeless, worthless, or empty most of the time
• Thoughts like “What’s the point?” or “People would be better off without me”
• Thoughts of self-harm or suicide
• Strong, frequent cravings that feel harder and harder to resist
• Major changes in behavior: staying in bed all day, missing work or treatment, withdrawing completely from others

These symptoms can reflect PAWS, a mood or anxiety disorder, or a combination of both. A clinician familiar with addiction and mental health can help sort out what’s going on and adjust your treatment plan accordingly. 

If you are in immediate crisis or thinking about harming yourself:

• In the United States, you can call or text 988 to reach the Suicide & Crisis Lifeline 24/7.
• If you are outside the U.S., check your local emergency number or crisis line resources.

‍How PHP, IOP, and Virtual IOP Support Mental Health

Structured programs are often where mood changes become more manageable.

At Mainspring Recovery’s rehab center in Virginia, levels of care like Partial Hospitalization (PHP) and Intensive Outpatient (IOP) are designed to address both substance use and mental health together, through:

• Regular individual and group therapy
• Education on brain changes, PAWS, and mental health symptoms
• Skills for coping with anxiety, low mood, anger, and stress
• Medication management when appropriate
• Support in rebuilding routines, relationships, and relapse-prevention plans

For those balancing work, family, or school, Virtual IOP can offer similar support with added flexibility. Mainspring’s blogs on virtual IOP, balancing work, family, and IOP, and relapse prevention strategies are helpful companion reads for this topic.

If mood changes are making it hard to stay on track in recovery, stepping into PHP, IOP, or Virtual IOP can be a strong, proactive choice, not a step backward.

‍Conclusion: Being Patient With Your Healing Brain

Mood changes in early recovery are common, and they are manageable.

They reflect several things happening at once:

• Your brain’s chemistry slowly recalibrating
• Your emotions surfacing without substances to blunt them
• Your relationships, routines, and identity shifting into something new

That process can feel messy and uncomfortable, but it is part of healing, not a sign that you’ve failed. With time, treatment, and support, most people see their mood become more stable and their emotional life feel more genuine and grounded again. 

If you’re in early recovery, remember:

• It’s okay to say, “I’m struggling.”
• It’s okay to ask for more help.
• It’s okay to take your mental health as seriously as your sobriety.

At Mainspring Recovery, our team in Virginia understands how closely mental health and addiction are linked. Through residential treatment, PHP, IOP, and Virtual IOP, we help people navigate mood changes, cravings, and life stress with evidence-based care and compassionate support. If you or someone you love needs help, you don’t have to walk this road alone - reach out to our admissions team to explore the next right step in your recovery.