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Delirium Tremens – What Are The Symptoms?

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Alcohol addiction can be difficult for everybody involved – not just the person with the addiction. However, it can also be difficult to break the addiction to alcohol and control your alcohol intake – partly due to the withdrawal symptoms.

In most cases, withdrawal symptoms are considered manageable. Some people may experience alcohol cravings and flu-like symptoms when they first undergo an alcohol detox, but it usually doesn’t get much more serious than that.

However, alcohol withdrawal can sometimes be severe. Delirium tremens (known as DTs or alcohol withdrawal delirium/ AWD) are a severe form of alcohol withdrawal and can have some dangerous and even life-threatening symptoms.

But what exactly is delirium tremens – and more importantly, what are the symptoms of delirium tremens? That is what we are going to explore on this page. Read on to learn more about alcohol withdrawal, the detox process, and delirium tremens.

What Is Alcohol Addiction?

Alcohol addiction is a form of alcohol use disorder – also known as AUD. Medical professionals have begun to avoid using the terms ‘alcoholic’, ‘alcohol addiction’ and even ‘alcohol dependence’ – instead using the terms ‘alcohol use disorder’ and ‘alcohol use disorders’ to describe problems with alcohol and excessive alcohol consumption.

Alcohol use disorder can vary in severity, ranging from mild to moderate to severe. Alcohol addiction or alcohol dependence is the most severe form of alcohol addiction.

It can impact all aspects of your life and wellbeing – for example, your relationships, family, finances, career, and of course, your physical health and your mental health.

If you are addicted to alcohol, you’ll find it hard to control your alcohol use. Even if you have the desire to stop drinking alcohol, it can be physically and mentally difficult to do so – and often, professional help is needed (for example, alcohol rehab).

Alcohol addiction affects thousands of people in the UK. In fact, in England alone, there are over 600,000 people dependent on alcohol – but only 18% of these people receive treatment for their addiction.

It’s important to receive addiction treatment. If you fail to get the help you need for your addiction, alcohol can end up taking over your life. It can impact your health, weakening your immune system.

Alcohol abuse can also increase the risk of developing certain types of cancer – as recorded in the National Toxicology Program’s Report on Carcinogens. Alcohol can affect your physical health in many ways, whether it be organ damage or alcohol-related dementia/ ARBD.

If you’re noticing the negative effects of alcohol but you continue drinking, then you likely have an alcohol problem. Likewise, if you wish to quit drinking, but struggle to or end up relapsing, you may be dependent on alcohol.

AUD is characterised by the urge to drink alcohol – even when the negative effects start to present. Essentially, alcohol addiction encompasses the lack of control over drinking.

This means that you may have a lack of control over what you drink, how much alcohol you drink, how often you drink, when you start drinking, when you stop drinking, and much more. It is a chronic and relapsing disease and brain disorder that involves excessive drinking.

If you think you have a problem with alcohol, it’s important to get help, whether you contact a local alcohol rehab clinic, or a medical professional/ GP. At Help4Addiction, we can find the right place for you to receive addiction treatment.

Withdrawing from alcohol alone can be tough, so it’s important that you have the right support around you. Read on to learn more about alcohol withdrawal and alcohol withdrawal symptoms.

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Alcohol Withdrawal Explained

Alcohol withdrawal can affect anybody who drinks an excessive amount of alcohol, or drinks a lot of alcohol regularly.

Typically, alcohol withdrawal symptoms begin to appear within a couple of days of stopping drinking/ after your last drink – however, if you have a severe alcohol addiction, then you may begin to exhibit symptoms of alcohol withdrawal within just a few hours of your last drink.

Why exactly do you experience withdrawal symptoms after stopping drinking? Well, this could be because of the GABA effects.

Alcohol affects your central nervous system. It has a suppressing effect on your brain and your central nervous system, ultimately affecting how your brain works over time if you drink heavily.

Drinking alcohol raises the levels of GABA, a neurotransmitter, in your body. This can lead to feelings of calmness and sometimes even euphoria. As well as raising GABA levels, alcohol lowers your glutamate levels – essentially decreasing excitability levels.

If you drink excessive amounts of alcohol or drink alcohol regularly, then your body may get used to these changes and find it hard to increase the GABA effects and decrease glutamate levels over time.

When you stop drinking, the GABA receptors in your brain remain less responsive – which causes an imbalance – which is worsened by the increase in glutamate – an excitatory transmitter.

Ultimately, this leads to you feeling negative effects after your last drink, when you stop drinking suddenly. You may feel anxious, hyper, shaky, and restless.

The symptoms tend to be more severe depending on the severity of your addiction – for example, if you previously drank heavily, then you may feel these effects more strongly than others – and experience severe symptoms.

Alcohol Withdrawal Syndrome – Withdrawal Symptoms

Alcohol withdrawal can affect you both mentally and physically, often varying in severity. Psychological withdrawal symptoms and physical withdrawal symptoms can range from mild to moderate to severe – however, in most cases, alcohol withdrawal isn’t life-threatening.

The signs and symptoms of alcohol withdrawal syndrome (often referred to as simply AWS) can appear as quickly as a few hours after your last drink, or as long as a few days after stopping drinking.

The symptoms often peak around the third day – However, milder alcohol withdrawal symptoms may persist for longer in some people. Severe alcohol withdrawal syndrome generally lasts longer.

No person’s experience is the same when it comes to alcohol withdrawal – factors such as height, weight, medical history, and of course, alcohol addiction history can all impact how you and your body experience alcohol withdrawal.

Some physical withdrawal symptoms that you may experience after heavy drinking in the long-term, or being dependent on alcohol, include headaches, sweating, pale skin, dilated pupils, and shakiness.

You may also feel fatigued – wiped out and tired. Some recovering alcoholics experience nausea during alcohol withdrawal, and may also vomit. This may contribute to another alcohol withdrawal symptom – loss of appetite. Tremors are also common – as is a faster heart rate.

Alcohol withdrawal can also take its toll on you psychologically, affecting your mood and a general sense of wellbeing. While detoxing from alcohol, you may feel depressed or irritable. Mood swings are also a common symptom of alcohol withdrawal. It’s important to have a support network around you, whether you’re in a rehab clinic or detoxing at home.

Your sleep may be impacted when you’re withdrawing from alcohol – which can cause further issues with your mood. You may have trouble falling to sleep, or staying in a deep sleep, and some people have trouble with nightmares.

A common symptom of alcohol withdrawal is the inability to think clearly – for example, you may have scattered thoughts.

These symptoms are common and aren’t typically considered dangerous. However, alcohol withdrawal can be dangerous – not everybody has a safe experience when withdrawing from alcohol.

Some people experience severe withdrawal symptoms and delirium tremens. Read on to learn more about severe alcohol withdrawal syndrome – more specifically, delirium tremens (DTs). 

Severe Alcohol Withdrawal/ Delirium Tremens

Delirium tremens, known as DTs, are the most severe form of alcohol withdrawal. It is characterised by an altered mental state and hyperactivity, also known as global confusion and autonomic hyperactivity.

Symptoms are categorised into either minor symptoms or major symptoms. Symptoms of minor alcohol withdrawal include nausea, vomiting, anxiety, tremors, and insomnia. Major alcohol withdrawal symptoms can include hallucinations (both auditory hallucinations and visual hallucinations), whole body tremors, hypertension (high blood pressure), vomiting, and diaphoresis (excessive sweating).

Delirium tremens is the most severe alcohol withdrawal – and often, people with acute alcohol withdrawal symptoms will need to be hospitalised and receive medical treatment.

It can be fatal if not managed correctly. However, it is not very common – even in those with alcohol use disorder/ alcohol dependence.

Risk Factors for Severe Alcohol Withdrawal

Some risk factors for severe alcohol withdrawal and delirium tremens include the number of times you’ve gone through alcohol withdrawal, and your previous experiences with alcohol withdrawal symptoms (for example, alcohol withdrawal seizures or delirium tremens).

Having underlying health issues can also put you at an increased risk of developing DTs – for example, traumatic brain injuries or other major injuries, or liver or heart disease. You may also have a higher chance of having a more severe withdrawal if you’re older.

If you have existing mental health issues or a psychiatric disorder/ mental disorder, you may also be at a higher risk of having a more severe withdrawal process. The same applies if you’re taking other medications.

However, arguably the biggest risk factor for delirium tremens is the amount of alcohol you previously consumed before going through alcohol withdrawal syndrome.

Excessive alcohol use increases the risk of acute alcohol withdrawal symptoms. If you had a severe or chronic alcohol addiction and consumed excessive amounts of alcohol, you’re more likely to experience severe alcohol withdrawal symptoms.

How Is Delirium Tremens Diagnosed?

In order to be given a delirium tremens diagnosis, you need to be assessed by a medical professional. A doctor or specialist will look out for two distinct aspects – delirium and severe alcohol withdrawal.

According to the DSM – diagnostic and statistical manual – the criteria are delirium and alcohol withdrawal. You won’t have a physical exam – instead, a medical professional will assess your mental state and ask questions.

In terms of delirium tremens, delirium is classed as a rapid onset of disturbed consciousness, sleep, psychomotor ability, and cognition. There are many causes of delirium; alcohol withdrawal syndrome is just one.

For example, delirium can be caused by infections, drugs, head injuries, and many more. In many cases, a multitude of factors contributes to the onset of delirium.

The presence of at least three symptoms (e.g hand tremors, nausea, and hyperactivity) after stopping drinking suddenly indicates alcohol withdrawal. However, DT is a clinical condition that comprises symptoms of both alcohol withdrawal and delirium.

Delirium may not be solely caused by alcohol withdrawal – it is associated with other risk factors as mentioned above (e.g head injury).

Delirium Tremens Symptoms

Do you think you’re showing signs of delirium tremens? Delirium tremens symptoms are considered severe and can impact your day-to-day functioning.

If you have delirium tremens, you may experience a fever, seizures, extreme agitation and confusion, hallucinations, and dangerously high blood pressure.

The hallucinations associated with delirium tremens can vary – you may experience either visual hallucinations, tactile hallucinations, or auditory hallucinations. Some people may experience a combination of these.

Severe autonomic hyperactivity is a major symptom of delirium tremens. This can include sweating, nausea, vomiting, tachycardia, and trembling. In some cases, this is a medical emergency and should be treated as such.

Typically, delirium tremens symptoms won’t appear suddenly – they’ll progress from early withdrawal symptoms. If you have delirium tremens, you may notice that the symptoms you experience change throughout the day or week. Read on to learn how to treat delirium tremens, alcohol withdrawal, and alcohol addiction in general.

Treatment For Severe Alcohol Addiction and Withdrawal

Chronic alcohol use can be extremely damaging – not only to you but to your relationships and family. This is just one of the reasons why it’s so important to seek help for your addiction.

Some people can deal with alcohol withdrawal alone – but with more severe addictions, it’s best to undergo alcohol detox at an inpatient facility in the form of a medical detox with medical supervision.

At Help4Addiction, we can help you to find the right place for you to receive treatment for alcohol addiction. Having the right care is sure to streamline the process from start to finish.

Some people prefer to undergo rehab as an outpatient – this is known as outpatient rehab. However, others feel better receiving treatment as an inpatient, at an inpatient rehab centre/ residential rehab facility. This is where you temporarily reside in a rehab centre – the same place you’re receiving treatment.

Treatment of alcohol withdrawal varies from case to case. Oral medications such as Naltrexone or Acamprosate can be effective in relieving the unpleasant symptoms of alcohol withdrawal.

Alcohol Detox

Hospitals and rehab clinics/ detox centres have staff with the right experience to deal with patients experiencing severe alcohol withdrawal and can provide the appropriate treatment. During detox, experiencing symptoms of withdrawal is common.

The detox stage of the rehab process can be difficult at the best of times, but it’s a lot more difficult when you have delirium tremens. Whether you choose to undergo alcohol detox at an NHS rehab or private rehab, it’s important to receive the right support.

If you have a severe alcohol addiction or delirium tremens, you may be given detox medication – however, detox medication should only be managed by medical professionals.

This is because one size does not fit all with detox medication – what works for your situation may not work for somebody else’s.

Likewise, some detox medicine can pose risks – and react if you’re on other medications. Avoid self-medicating while detoxing from alcohol – prescription drugs alone do not solve addiction. They are not a cure; they can simply make the process easier for you.

Alcohol Addiction Therapy

Once your withdrawal symptoms are under control, you may wish to receive therapy. This can help to deal with the psychological, behavioural, and social aspects of addiction.

Addiction therapy aims at not only building your confidence and teaching you coping mechanisms but improving your mental health and general wellbeing. Through therapy, you may learn more about yourself and your addiction; for example, the root causes of your addiction, or your addiction triggers.

Some common addiction therapies include CBT (cognitive behavioural therapy), group therapy, interpersonal therapy, family therapy, DBT (dialectical behavioural therapy), and combination. Often, a combination of therapies works best.

Secondary Care

Your support doesn’t have to end once you leave the rehab clinic – you can continue receiving support as an outpatient in the form of aftercare or secondary treatment. This can include group therapy, counselling, or support groups such as Alcoholics Anonymous.

The key aim of aftercare is relapse prevention. Secondary treatment can ease the transition from rehab to your everyday life, providing you with the support you need to stay sober.

At Help4Addiction, we can help you get control of your addiction by finding the right substance abuse treatment for you.

About Author

Nicholas Conn

Nicholas Conn

Nicholas Conn is a leading industry addiction expert who runs the UK’s largest addiction advisory service and is regularly featured in the national press, radio and TV. He is the founder and CEO of a drug and alcohol rehab center called Help4addiction, which was founded in 2015. He has been clean himself since 2009 and has worked in the Addiction and Rehab Industry for over a decade. Nick is dedicated to helping others recover and get treatment for drug and alcohol abuse. In 2013, he released a book ‘The Thin White’ line that is available on Amazon.

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