DEAR MAYO CLINIC: I've tried to quit smoking several times. But when I get to the second week without cigarettes, I become depressed and anxious. Is this normal? Is there a way to avoid this part of withdrawal? It is by far the worst symptom and has kept me from quitting.
ANSWER: Changes in mood, including feeling depressed and anxious, affect many people when they try to stop smoking. Although these withdrawal symptoms are common, they can be a big obstacle to leaving cigarettes behind for good. If you haven't done so already, talk to your health care provider about medications that can help manage your symptoms. In addition, he or she can direct you to resources in your area that offer support to people who want to quit smoking.
When you try to stop smoking, withdrawal symptoms occur. These may include strong cravings, increased hunger, insomnia and changes in bowel habits. Nicotine withdrawal can affect your mood, too. It can make you irritable and restless. It can make it hard to concentrate. You may easily become angry or frustrated. And, as you've experienced, you may feel depressed or anxious.
Withdrawal symptoms can be very challenging. You are not alone in making multiple attempts to stop smoking, only to have your efforts hampered by these symptoms. Most smokers try to stop smoking several times before they achieve long-term freedom from smoking. The good news is you don't have to stop smoking on your own. There are many treatments that can help you manage and curb withdrawal symptoms, including symptoms of depression and anxiety.
There are two non-nicotine medications available that decrease the feeling of pleasure when you smoke and lessen withdrawal symptoms. The medications are often coupled with nicotine replacement therapy. Nicotine replacement therapies include patches, gum, lozenges, inhalers and a nasal spray. They give your body nicotine without the other harmful chemicals in tobacco smoke. Using nicotine replacement therapy helps relieve withdrawal symptoms and cravings.
But medications alone usually are not enough. Working with a tobacco treatment specialist coupled with medication greatly raises the likelihood that you will stop smoking. You can connect with such a specialist in a variety of ways. Many are on the staff of nicotine treatment programs associated with health care facilities. Some specialists facilitate face-to-face or internet-based support groups. Others work through individual counseling programs that may be conducted in person or over the phone.
A tobacco treatment specialist can work with you to change your behaviors that make it hard to stop smoking. He or she also can help you create a plan to deal with the challenges that come with quitting, including withdrawal. Also available are residential treatment programs, where a patient is treated in a special smoke-free unit for eight days of intensive treatment, including combinations of medications, education sessions, exercise and group therapy.
Keep in mind that getting to the point of long-term freedom from tobacco is a process. Changing behaviors and getting your body used to living without tobacco can take a considerable amount of time, often several months or more. But your efforts to stop smoking will be worth it. Being smoke-free has enormous health benefits. Over time, your risk of coronary artery disease, heart disease, stroke and many kinds of cancer dramatically drops after you say goodbye to cigarettes.
Make an appointment with your health care provider to discuss your desire to quit and to find support for your efforts. With aid and guidance from professionals trained to help people stop smoking, your chances of success are good. -- Richard D. Hurt, M.D., Nicotine Dependence Center, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. E-mail a question to firstname.lastname@example.org. For more information, visit http://www.mayoclinic.org.)