Alcohol-Induced Psychosis: Signs and Symptoms
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You’ve been drinking heavily for a while. Every day, it’s the same routine: you get home from work, fix dinner, and plop down on the couch with a bottle of wine to enjoy while you watch your favorite show. Pretty soon, you’re uncorking a second bottle of your favorite red. As you sit back down on the couch, something strange happens: you hear someone talking — or, at least, you think you do. What’s going on?
Let’s explore the rare, disturbing condition known as alcohol-induced psychosis — what it is, what causes it, and what you can do about it.
Alcohol-induced psychosis is a serious mental health condition that causes us to experience hallucinations, delusions, or both due to excessive drinking. It’s relatively rare among the general population, but alcohol-induced psychosis occurs at higher rates in those struggling with alcohol dependence.
Someone experiencing alcohol-induced psychosis might see, hear, or feel things that aren’t there either while drinking or after drinking. Typically, people who have psychosis lose touch with reality and have difficulty telling the difference between real and imagined experiences. They also become paranoid, frightened, easily confused, and sometimes aggressive.
People can experience a range of alcohol-induced psychosis symptoms. Here are some of the more common:
These are some other alcohol psychosis symptoms:
Keep in mind that alcohol-induced psychosis symptoms can vary in severity and intensity. For instance, some people might see or hear things that aren’t there for a brief moment, while others will see or hear things continuously, frightening them.
To an outsider, it can sometimes be difficult to determine if a person is simply intoxicated or if they have developed alcohol-induced psychosis. However, diagnoses can be made based on how long the symptoms last.
Alcohol-induced psychosis can be triggered in three different ways:
The symptoms of psychosis will last much longer than typical alcohol intoxication. In fact, for someone to be diagnosed with alcohol-induced psychosis, their symptoms typically persist for at least 48 hours. Symptoms will also be much more severe than the disorientation and reduced inhibitions usually associated with being drunk.
While the symptoms of alcohol-induced psychosis tend to occur in the aftermath of heavy drinking, they might not become evident for up to two weeks. They can last for a couple days or longer. In some cases, episodes of alcohol-induced psychosis have lasted for up to six months.
In rare cases, alcohol-induced psychosis can become permanent due to a condition called Wernicke-Korsakoff syndrome (WK). This is a serious complication of heavy alcohol use caused by low levels of thiamine (vitamin B1). Low thiamine levels can cause brain inflammation that creates dangerous neurological symptoms. If untreated, inflammation can lead to permanent brain damage that leads to psychosis and hallucinations.
Anyone who drinks excessively or has alcohol use disorder is at risk for alcohol-induced psychosis. According to a 2018 review, about 4% of people who develop alcohol use disorder will experience alcohol-induced psychosis. If we’ve experienced an episode previously, we’re at an even greater risk of having another one.
These are some other populations who are at greater risk for developing alcohol-induced psychosis:
Research also indicates that alcohol-induced psychosis is highest among working-age men, people who became addicted to alcohol at a young age, those of low socioeconomic status, and individuals who live alone or have little social support.
Similarly, researchers have associated alcohol-induced psychosis with higher rates of anxiety, depression, and suicide. Furthermore, about 37% of people diagnosed with alcohol-induced psychosis have a co-occuring mental health disorder.
Alcohol cannot cause schizophrenia. However, the symptoms of alcohol psychosis can be similar to those of schizophrenia. For instance, many people with schizophrenia experience delusions or hallucinations that cause them to see or hear things that aren’t there.
In the case of alcohol-induced psychosis, these symptoms are brought on by heavy alcohol use, whereas a person with schizophrenia will experience them in the absence of alcohol or other influential substances. Consuming alcohol can make symptoms of schizophrenia worse or more intense.
While they are two separate conditions, alcohol-induced psychosis and schizophrenia can co-occur in the same person.
Alcohol-induced psychosis can be dangerous if left untreated. For instance, people with untreated alcohol-induced psychosis could be subject to these risks:
If you or someone you know is experiencing alcohol-induced psychosis, it’s important to get medical help immediately. Treatment usually involves eliminating alcohol and getting through withdrawal symptoms.
In chronic cases of alcoholic hallucinosis, neuroleptic medications (like haloperidol) or atypical antipsychotics (such as olanzapine or ziprasidone) may be necessary to control symptoms. Medical professionals might also administer benzodiazepines like lorazepam if there is a risk of seizures and alcohol withdrawal.
Because heavy drinking is often to blame for alcohol-induced psychosis, treatment also involves a long-term recovery plan for living an alcohol-free life.
Abstinence from alcohol — not drinking at all — is the best way to prevent this condition. Anyone who drinks heavily or has an alcohol use disorder is at risk for alcohol-induced psychosis. And people who’ve already experienced one episode are at greater risk of having another one.
we or one of our loved ones is struggling with alcohol use, it’s important to get help right away before it causes more severe complications such as alcohol-induced psychosis. The best thing we can do is contact a medical professional and be upfront and honest about our alcohol consumption. They can help direct us develop a treatment plan or direct us to resources that can help, such as an in-patient or out-patient rehabilitation center. It’s never too late to get the help we need.
If you’re drinking more than you’d like and want to cut down on your alcohol consumption, consider trying Reframe. We can help you change your drinking habits and offer tools and tips for enhancing your health and well-being.
1. What is alcohol-induced psychosis?
Alcohol-induced psychosis is a condition that causes people to experience hallucinations, delusions, or similar symptoms due to excessive drinking. It’s relatively rare, but people who drink heavily are at a greater risk of developing this condition.
2. What causes alcohol-induced psychosis?
Alcohol-induced psychosis can be caused in three different ways: by consuming large amounts of alcohol in one sitting, drinking heavily for a long period of time and then stopping, or drinking heavily for a long period of time.
3. What are the symptoms of alcohol-induced psychosis?
People with alcohol-induced psychosis can experience a range of symptoms, including visual hallucinations, auditory hallucinations, paranoia, or delusions. They might become agitated, leading to outbursts of violence and aggression. They also might start speaking incoherently or in jumbled sentences that are difficult to follow.
4. How long do symptoms of alcohol-induced psychosis last?
Symptoms can last anywhere from a couple days to a couple weeks. Very severe cases can last several months.
5. Who is at risk for developing alcohol-induced psychosis?
People with alcohol use disorder are at a greater risk of developing this condition. It’s also been shown to occur more frequently in working-age men, heavy drinkers over the age of 40, people with schizophrenia or mental health disorders, those of low socioeconomic status, and those with little social support.
6. What is the treatment for alcohol-induced psychosis?
Treatment usually involves eliminating alcohol and developing a plan to become alcohol-free. In some cases, medications will be used to control symptoms or help with withdrawal.
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