Ask The Therapist: “I’ve been a smoker for 10 years. I want to quit but it seems impossible. What should I do?”

In 2016, the number of people estimated to be suffering from mental health issues like depression and anxiety amounted to roughly 1.1 billion. Since then, numbers have likely continued to rise. Moreover, studies have also shown women especially on average are a) more likely to suffer from mental health issues, and b) less likely to talk about them. The taboo in Pakistan surrounding depression and anxiety disorders only serve to aggravate the individuals suffering even more. For the women who cannot seek out full time therapy, or simply need advice about their problems, we’ve enlisted the help of a trained counsellor. You sent us in your questions – here are the answers!

“I’ve been a smoker for the last 10 years. Now I would like to quit. However, I cannot seem to. I’m over eating, even when I’m not hungry. I’m constantly in a bad mood.  Please help! I want to quit but this seems impossible. What should I do?”

Anam’s Response:

Dear Anonymous:

The symptoms you are describing – eating when you’re not hungry and being irritable – are textbook withdrawal symptoms of nicotine. And let me be the first to tell you, you are not alone in facing this. These are very common side effects when you’re trying to quit smoking. And for someone who’s been smoking for such a long time, quitting isn’t going to be an easy journey.

But all hope is not lost! The fact that you want to quit and have shown this willingness is a big step in the right direction. The first thing you need to do is prepare yourself – overeating and mood swings are just two of the many symptoms associated with nicotine withdrawal.

Here are some of the symptoms of nicotine withdrawal and why they occur:

1. Overeating and Weight Gain: Smokers feel the urge to snack once they’ve quit not only because they’re subconsciously replacing cigarettes with food, but because nicotine used to trigger the release of glucose (sugar) which is no longer happening. That’s why the urge to consume carbs and sweets is higher – you want to curb that sudden drop in blood sugar.

2. Mood Swings: Having extreme mood swings, stress and irritation are extremely common symptoms of early nicotine withdrawal. It’s because of a change in your hormonal and central nervous system. Along with mood changes, this can also cause increased blood pressure, increased heart rate and difficulty concentrating.

3. Sleep Problems: It’s quite common to have sleep problems when you quit smoking. It can be anything from having insomnia to napping throughout the day and needing extra sleep. Sleep is affected due to a disturbance in the levels of dopamine and your REM (rapid eye movement) cycle.

4. Cough: While it’s strange to develop a cough after you quit smoking, it’s actually a sign that your lungs are getting better! The coughing is basically your lungs pushing out all the toxins so just bear with it – it’ll clear up soon!

5. Nicotine Cravings: This is the most common, and perhaps the most unbearable one. The craving is because your brain is no longer releasing dopamine, which makes you feel good. But the good news is that these cravings only last 5-10 minutes. If you can wait them out, you’ll be done with the worst.

6. Quitter’s Flu: Getting flu-like symptoms, coughing, body aches and mild fever, is just your body getting used to an unfamiliar state.

When you decide to quit smoking, you should keep these symptoms in mind, because you will experience some (if not all) of these. But these symptoms shouldn’t deter you from quitting because they’re temporary and there are ways to make them go by easier. Having a strong support system around you, that will keep encouraging you and motivating you, is important. They’ll also hold you accountable and sometimes, you’re going to disappoint. It happens. But, again, that shouldn’t stop you from quitting.

Here are some ways you can make quitting a little bit easier for yourself:

1. Find a Replacement

Using replacement therapy, which includes using a nicotine-patch or chewing nicotine gum, can help you curb that nicotine craving without succumbing to smoking. It’ll also help you wean off cigarettes if you can’t quit cold turkey.

2. Get a New Hobby

Smoking is more habitual than anything. You’ve developed this habit that takes up a good chunk of time and you’ve formed a routine around – taking smoke breaks at work etc. Getting a new hobby, preferably one that involves your hands, will set a new routine for you and become habitual, taking place of smoking.

3. Start Exercising

It seems like the answers to all of life’s problems are in exercising but it actually does help! If you’ve been a smoker for a long time, exercising is going to be tough for you – you’re going to have trouble with stamina and breathing – but that’s all the more reason to push through. Exercise will release endorphins, boost your mood, give you an adrenaline rush and help you control any weight gain you may face from nicotine withdrawal.

4. Avoid Triggers

There are certain moments and occasions when one really craves a cigarette – after a heavy meal out, going out with smoker friends, when you’re in a high-stress or vulnerable situation. If you can, try avoiding these situations for at least a month after you’ve quit smoking. Don’t put yourself in a position where you’ll relapse – you’re only hurting yourself. And if you’re in an emotional situation you cannot avoid, like a breakup, make sure you have a strong support system around you that will keep you from reaching for cigarettes.

5. Get Rid of All Evidence

If you’ve made the decisions to quit smoking, then it’s time to get rid of all the paraphernalia. It’s the same as going through a bad breakup; you need to do a deep clean and delete all the photos. Similarly, you need to do a detox and get rid of anything that will remind you of cigarettes, be it ashtrays, lighters, matches etc. It’s time for a clean slate.

6. Get Professional Help

Sometimes you can’t conquer everything on your own and that’s okay. There could be a deeper-rooted reason to why you were smoking to begin with, perhaps some emotional baggage that you don’t want to bring to the surface. In that case, seek out a professional who could help you figure out why you are so attached to smoking and how to combat it. There’s no harm in getting a little help now and then.

The journey to quit smoking is hard and full of times where you’ll just want to give up and go back to smoking – it’s the easy thing to do. But, as a very wise Shah Rukh Khan said in Dilwale Dulhania Le Jayenge, the right path is often full of hardship but you’ll come out on top at the end!

Good luck!