Alcohol, commonly recognized for its depressant effects on the central nervous system, can, in some instances, trigger a severe mental state known as psychosis. While not every individual who consumes alcohol will experience this, alcohol-induced psychosis is a serious concern that necessitates immediate attention and understanding.
What is Alcohol-Induced Psychosis
Alcohol-induced psychosis describes a mental state where hallucinations, delusions, and paranoia emerge directly from alcohol intoxication or withdrawal. It is a secondary psychosis, a consequence of alcohol misuse.
This condition can manifest in different ways depending on the timing relative to alcohol consumption. Acute alcohol intoxication psychosis occurs while an individual is still under the influence of alcohol. Conversely, alcohol withdrawal psychosis, often associated with Delirium Tremens (DTs), develops when a person significantly reduces or stops heavy, prolonged alcohol intake.
Recognizing the Signs
The symptoms of alcohol-induced psychosis can be distressing and vary. Individuals may experience hallucinations, which are sensory perceptions that are not real. These can be auditory, such as hearing voices or sounds, or visual, involving seeing objects or people. Tactile hallucinations, like feeling things crawling on the skin, are also possible.
Delusions are another common sign, characterized by false beliefs that are not based in reality and are resistant to reason. These can include paranoid delusions, where the individual believes others are plotting against them or are in imminent danger. Alongside these, disorganized thinking, severe confusion, and agitation are frequently observed. These symptoms can appear suddenly and, in acute cases, may be transient once the alcohol is metabolized or withdrawal is managed.
How Alcohol Affects the Brain
Alcohol significantly impacts brain chemistry, influencing various neurotransmitters that regulate perception and reality. Ethanol affects proteins associated with dopamine, serotonin, glutamate, and gamma-aminobutyric acid (GABA) pathways. Specifically, alcohol enhances the inhibitory effects of GABA, leading to a calming effect, and inhibits the excitatory action of glutamate at NMDA receptors.
Chronic alcohol use causes the brain to adapt, leading to neuroadaptation. When alcohol is suddenly removed, this adaptation can result in an excitatory imbalance. The brain, accustomed to alcohol’s suppressive effects, becomes overactive, leading to symptoms like agitation, seizures, and psychosis. This sudden removal can cause a hyper-glutamatergic state, contributing to psychotic features during withdrawal. Certain brain abnormalities, such as perfusion irregularities, can also contribute to hallucinations and delusions.
Navigating Recovery and Seeking Help
The duration of alcohol-induced psychosis varies, typically resolving once alcohol is metabolized or withdrawal is effectively managed. Psychotic symptoms related to intoxication usually clear within 24 to 48 hours after drinking stops. Symptoms arising from withdrawal, such as those in Delirium Tremens, manifest within 48 to 72 hours of cessation and can last up to two weeks, though often subsiding within a few days.
Immediate medical attention is necessary if someone is experiencing these symptoms. This often involves calling emergency services or going to an emergency room. Treatment typically begins with supportive care and managing withdrawal symptoms, which may include administering benzodiazepines to mitigate the risk of seizures and delirium tremens. Antipsychotic medications may also be prescribed to manage hallucinations and delusions. Long-term sobriety and addressing any underlying alcohol use disorder are essential to prevent recurrence.