Psychosis is one of the most serious complications of long-term alcohol abuse. In some addicted individuals, hallucinations, delusions, perceptual distortions, and delusional ideas may appear. Alcohol not only damages internal organs but also disrupts brain function, which can lead to loss of contact with reality and a sharp deterioration in health. We explain what alcoholic psychosis is, what the symptoms are, and what the treatment involves.
Alcoholic Psychosis – What It Is and What Are Its Causes
Alcoholic psychosis is a severe mental disorder in which proper contact with reality is lost. A person affected by this condition may experience hallucinations, delusions, delusional ideas, as well as severe anxiety and disorientation. These symptoms are not ordinary intoxication but a sign of serious impairment of brain functioning. The main cause of psychosis after alcohol is long-term and intensive drinking. The toxic effect of ethanol leads to damage to the nervous system, disturbances in water-electrolyte balance, and nutrient deficiencies, especially B vitamins. Alcohol also affects the dopamine system, increasing receptor sensitivity in the brain, which promotes the development of hallucinations, alcoholic paranoia, and other forms of psychosis. Their occurrence is one of the signs of advanced disease progression.Alcoholic Psychosis – Symptoms
The symptoms of alcoholic psychosis include both mental and neurological disorders. Most commonly these are:- auditory hallucinations – voices commenting on behavior, accusing, or giving commands, typical hallucinations after alcohol,
- visual hallucinations – seeing figures, shadows, or scenes, so-called alcoholic delusions,
- alcoholic delusions – false, firmly established beliefs, often of a persecutory nature (alcoholic paranoia),
- mood decline – feeling of hopelessness, anxiety, irritability,
- psychomotor agitation – excitement, difficulty calming down, tension,
- disorientation in time and space – disorientation, difficulty determining place and time of day,
- memory disorders – memory gaps, difficulty recalling events,
- sleep disorders – insomnia, frequent awakenings, nightmares,
- alcoholic delirium – severe form of consciousness disorder with disorientation and hallucinations,
- epileptic seizures – which may occur in severe alcoholic psychoses.
Alcoholic Psychoses – Duration of Symptoms
The duration of alcoholic psychosis can be very varied and depends on factors including the length of drinking, the patient's health condition, and the speed of treatment implementation. The appearance of psychotic symptoms is always an indication for psychiatric consultation. The doctor assesses whether temporary or long-term pharmacotherapy is necessary and rules out other causes of consciousness disorders, such as neurological diseases or primary psychoses. In some cases, treatment must be continued for a longer time to prevent relapses and further deepening of damage.Types of Alcoholic Psychoses
Alcoholic psychoses do not have a single, constant course. In some people, hallucinations and delusions dominate, in others primarily delusional ideas (e.g., persecutory or related to jealousy). Below are the most common forms.Acute Alcoholic Psychosis – Delirium Tremens
Acute alcoholic psychosis (alcoholic delirium, delirium tremens) usually appears after sudden cessation of intensive drinking. This is a health and life-threatening condition that requires urgent medical help:- typical are consciousness disorders, severe anxiety, agitation, disorientation,
- hallucinations after alcohol may occur (often visual), as well as autonomic symptoms (e.g., severe sweating, palpitations),
- usually lasts several days, and after stabilization of the body's condition, symptoms may subside.
Chronic Alcoholic Psychosis – Alcoholic Hallucinosis
In this form, hallucinations and delusions after alcohol dominate, especially of a persecutory nature. It is this form that patients and their relatives sometimes colloquially call "alcoholic schizophrenia," although this is not a precise medical term. Characteristic are:- frequent auditory hallucinations (e.g., commenting, threatening voices) and delusions after alcohol,
- delusional ideas and increasing suspiciousness (paranoia),
- symptoms may resemble schizophrenia, so proper differential diagnosis and psychiatric evaluation are crucial.
Alcoholic Paranoia – Othello Syndrome
This form is sometimes referred to as alcoholic jealousy delusion, as the main problem is delusional ideas regarding partner infidelity:- pathological jealousy based on delusional "evidence" dominates,
- often leads to conflicts, control, and risky behaviors in the relationship,
- described more often in men than in women.
Korsakoff's Psychosis – Amnestic Syndrome After Alcohol
Korsakoff's psychosis is a severe complication of long-term alcohol abuse, associated with deficiencies (especially vitamin B1) and nervous system damage:- serious memory disorders appear: difficulty remembering new information, memory gaps,
- the patient may "fill in" gaps with fabricated stories (confabulations) without doing so intentionally,
- in advanced cases, significant functional impairment and dementia symptoms occur.
Treatment of Alcoholic Psychosis and Hallucinations After Alcohol
When alcoholic hallucinations, delusions, or delusional ideas appear, medical evaluation is necessary. Treatment, regardless of whether it concerns acute or chronic psychoses, is based on one condition: complete alcohol abstinence. Continued drinking usually intensifies psychosis and increases relapse risk. Most commonly used are:- pharmacotherapy recommended by a doctor, including antipsychotic medications as well as sedatives and anti-anxiety drugs (in selected situations benzodiazepines, especially with withdrawal symptoms)
- body stabilization: hydration, electrolyte balance restoration, and supplementation of deficiencies (especially B vitamins)
- differential diagnosis, to distinguish alcoholic hallucinosis from other mental disorders.
Alcoholic Psychosis – When to Call for Help and How to React Safely
If a person is highly agitated, disoriented, has clear hallucinations, delusional ideas, or symptoms of severe withdrawal, safety and quick medical help are the priority. In cases such as delirium tremens, the condition can be life-threatening, and the sick person may be unpredictable and pose a danger to themselves or their surroundings. It's worth remembering that alcoholic psychosis often means advanced addiction. This is a signal that waiting it out on one's own is usually not enough and professional treatment and further addiction therapy are needed to maintain abstinence and reduce relapse risk.:::cta Need help fighting addiction? Our specialists are ready to help you. Call or schedule an online consultation. Call: 880 808 880 | Schedule appointment :::
