Delusions are fixed, false beliefs that are not based in reality, persisting despite evidence to the contrary. These beliefs are not typically shared by others from the same cultural or social background. Alcohol can indeed cause delusions through various mechanisms, impacting the brain’s complex functions. The brain’s response involves intricate changes in neurochemistry and structure.
Alcohol’s Impact on Brain Function
Alcohol is a central nervous system depressant that significantly affects brain function. Its primary actions involve key neurotransmitters. Alcohol increases the activity of gamma-aminobutyric acid (GABA), the brain’s main inhibitory neurotransmitter. Conversely, alcohol inhibits the activity of glutamate, the brain’s major excitatory neurotransmitter. This dual action disrupts the delicate balance between excitation and inhibition in the brain, altering perceptions and thought processes. Over time, the brain adapts to alcohol’s presence, leading to further changes in these systems.
Delusions During Acute Intoxication
High levels of alcohol can directly induce temporary delusional states. These delusions are often transient, manifesting as paranoid beliefs or grandiose self-importance. Delusions during acute intoxication are distinct from hallucinations, though they can sometimes co-occur or lead to delusional interpretations of real events, such as misinterpreting a sound as a conspiracy. A single episode of heavy drinking can trigger acute psychosis, with symptoms typically appearing during or shortly after drinking.
Chronic Alcohol Use and Psychosis
Long-term, heavy alcohol consumption can lead to more persistent and severe forms of psychosis, including alcohol-related delusional disorder. This condition involves fixed, false beliefs that endure even when the individual is not acutely intoxicated or in withdrawal. Chronic alcohol use can also contribute to alcoholic hallucinosis, which primarily involves auditory hallucinations and strong delusional interpretations. Prolonged alcohol abuse can cause structural and functional brain damage, making individuals more susceptible to developing fixed, false beliefs. In some cases, chronic alcohol use can lead to thiamine (vitamin B1) deficiency, associated with Wernicke-Korsakoff syndrome, which may involve delusions and hallucinations.
Delusions During Alcohol Withdrawal
Delusions are a serious symptom that can emerge during alcohol withdrawal, particularly in severe cases such as Delirium Tremens (DTs). When alcohol is removed after prolonged heavy use, the brain experiences a rebound effect, becoming hyperexcitable. This heightened excitability is due to the brain’s attempt to restore balance after adapting to alcohol’s depressant effects. Delusions during withdrawal are often persecutory, causing individuals to feel threatened or believe people are trying to harm them. These beliefs can be accompanied by intense fear, confusion, and other withdrawal symptoms like tremors, agitation, and vivid hallucinations. Symptoms of DTs typically appear within 48 to 96 hours after the last drink, though they can manifest up to 7 to 10 days later.
When to Seek Professional Help
Any instance of alcohol-induced delusions, especially if persistent or severe, warrants immediate professional attention. Signs indicating a need for help include danger to oneself or others, inability to function, or the presence of severe withdrawal symptoms. Delirium Tremens, in particular, requires emergency medical care due to its life-threatening potential. Seeking help from medical professionals, addiction specialists, or mental health professionals is important. Treatment often involves medical detoxification to manage withdrawal symptoms safely, along with therapy and medication management.