White fever or in other words “squirrel” or “squirrel”, and in more scientific language “delirium delirium” or “alcoholic psychosis” is a state of delirium with sudden withdrawal of alcohol. Most often it occurs not during the period of intoxication itself, but 3-5 days after stopping alcohol consumption, against the background of withdrawal syndrome. At the psychopathic level, the disorder is accompanied by hallucinosis of various anamnesis, including tactile, visual and auditory hallucinations of a not very pleasant nature. From a somatic point of view, the patient may experience tremors of the limbs, fever and increased body temperature. It is worth noting that the disorder most often occurs in binge alcoholics with more than 5 years of experience.
Symptoms of the disease
The general symptoms of alcoholic delirium are characterized by a large number of vivid illusions and hallucinations in the patient, as well as problems with orientation in time and space. Hallucinosis, as noted above, is quite unpleasant and sometimes frightening visions: the patient may see devils, snakes, spiders, monsters and other creatures that do not exist in reality. Illusions are geometric or color changes in visible objects, such as fancy designs and patterns arising from ordinary objects.
Hallucinations are divided into visual, auditory and tactile, most of which are visual hallucinosis. The patient sees small unpleasant animals or reptiles, as well as devils or little green men. It is this fact that determines the common phrases: “drink yourself to hell” or “green snake.” Sometimes large animals may appear to the patient, but also not of the most friendly appearance and attitude: wolves, angry dogs, bears.
As for the symptoms of auditory hallucinosis, most often it is the hum of voices heard from all sides. The voices in most cases are addressed to the patient himself, scolding and condemning him or ordering him to do something.
Kinesthetic hallucinations are characterized by absolutely real sensations. The patient may feel as if spiders are crawling on his body or there are foreign objects, such as threads or hair, in his mouth.
In this aspect, there is the concept of mixed complex hallucinosis, when illusions and hallucinations are combined at all levels.
The general condition is accompanied by severe neurosis and deep depression, as well as sudden mood swings: from unbridled anger to spontaneous euphoria. The patient may experience severe fear. Oppressive melancholy, in general, a feeling of total hopelessness. In this condition, cases of suicide are not uncommon, occurring against the background of unbearable melancholy or motor psychomotor activity. This means that in the process of fighting non-existent subjects, the patient may harm himself or jump out of the window.
Physiological symptoms
At the somatic level, delirium tremens is accompanied by the following symptoms: Tremor and fever, muscle spasms, high temperature and blood pressure, cyanosis or erythema of the skin, disorder or inflammation of the gastrointestinal tract, cirrhosis of the liver, blood dysfunction.
Female symptoms
By and large, women's symptoms are not much different from men's, and the main danger is that a person, no matter whether a man or a woman, is unable to distinguish reality from nonsense.
However, some differences based on gender do exist, including the severity of symptoms. For example, women are characterized by a state of depression that overtakes them even before the onset of psychosis. Sleep disorders, neurosis-like states, aggression, and other manifestations of negativism can also be observed in women not during delirium itself, but before its onset. In men, as a rule, there are no warning signs of delirium tremens.
Development of withdrawal syndrome
Withdrawal syndrome may appear within a few hours after the last drink. The main stages and possible complications are listed below. Please keep in mind that these are general cases and there may be exceptions.
Withdrawal symptoms can be deadly.
The first stage of withdrawal involves the onset of minor symptoms, usually subsiding in less than 12 hours after the last drink. These include anxiety, insomnia, nausea, headaches, loss of appetite, sweating, and fast or irregular heartbeat.
12 to 24 hours
During this period of time, tactile, auditory, or visual hallucinations may occur . Visual hallucinations are the most common. For example, a person may see something dangerous outside the window, break the glass and cut himself. The patient may experience a burning sensation, itching or numbness that has no physical cause.
24 to 48 hours
Severe withdrawal attacks most often occur during this period. This can be very dangerous as life-threatening complications can occur. Typically, most symptoms resolve within a maximum of five days , but full recovery may take weeks.
Consequences and prognosis
“Delicate tremens” is a fatally dangerous alcoholic psychosis, in which the alcoholic becomes dangerous not only to himself, but also to others. If the patient’s symptoms of the disorder do not go away and treatment is not provided on time, then hallucinations can become exaggerated and drive the patient to madness or suicide. Drug treatment is a mandatory and necessary measure to neutralize this condition; in its absence, sudden death can occur not only due to mechanical reasons, but also on its own, for example, from cardiac arrest or other concomitant diseases. However, it is quite difficult to say how long a patient will live after an attack of delirium tremens.
The consequences of alcoholic psychosis depend on many combined factors that should be considered together, for example, taking into account: how quickly professional help was provided, and how qualified and relevant it was to the specific case, the presence of other diagnoses in the patient and, of course, his lifestyle after therapy. According to statistics, delirium delirium does not have a very good prognosis. The mortality rate is about 10%, and can occur from a variety of causes. Often this disorder leads to alcoholic dementia and other forms of dementia that cannot be completely cured. On the other hand, the prognosis largely depends on the patient himself.
With proper treatment of mild to moderate disease and the patient’s compliance with recommendations, his life is not in danger.
Content:
- Causes of delirium
- How delirium tremens manifests itself 2.1. First stage 2.2. Second stage 2.3. Third stage
- Consequences
- Treatment
Alcohol psychosis is one of the most common, severe and dangerous complications of advanced stages of alcoholism. Most often, narcologists deal with delirium tremens , which has an outdated but persistent name - delirium tremens. Despite the success of therapy, this delirious state worsens the quality of life of patients and is the cause of death. Relatives of alcoholics also suffer from it. At the first suspicion of the development of this pathology, the patient should be hospitalized immediately. Early treatment allows you to achieve better results and minimize time and financial costs.
Forms and classification
Due to the fact that every alcoholic “drinks differently,” the forms and manifestations of the disease can vary significantly. Symptomatic manifestations and the onset of one or another stage depend on parameters such as the patient’s age, the presence of other diseases, the frequency, quantity and type of alcoholic beverages he drinks.
- The most common type of alcoholic delirium is classic . It is characterized by the entire set of previously described symptoms. It is important to note that this form develops quite gradually, and before acute psychosis the patient can drink alcohol for a long period of time.
- The lucid form develops very quickly, almost suddenly, and there is no hallucinosis and symptoms of delirium, but acute hypochondriacal neurosis, insurmountable fear and somatic disorders expressed in impaired coordination are present.
- In the abortive form, delusions and hallucinations are observed, but they are not pronounced. But anxiety and depression are strongly manifested.
- The professional form demonstrates amnesia; the patient may forget events not only that happened recently, but also significant moments of the past. Motor stereotypy is also present - the patient is unable to perform complex actions. This form has similar symptoms to dementia.
- Mussitating is a certain kind of continuation of the professional form. In addition to problems with the perception of reality and the ability to perform normal activities, the patient develops serious diseases of the internal organs.
- Atypical - unlike professional, it has symptoms similar to schizophrenic disorder. There is vivid delirium, persecutory delusions, very acute hallucinations and somatic disorders. Amnesia may also occur.
Risk factors
Chronic alcoholics tend to suffer from certain diseases and infections, such as hepatitis or pancreatitis. These diseases can aggravate the symptoms of delirium tremens or make them more difficult to relieve.
List of diseases caused by alcohol addiction:
- Cirrhosis of the liver, also called alcoholic liver disease. The disease can manifest itself after many years of heavy alcoholism.
- Alcoholic cardiomyopathy. Long-term alcohol abuse can lead to heart problems. If cardiomyopathy, often called alcoholic heart disease, is left untreated, serious complications such as heart failure can occur.
- Alcoholic polyneuropathy occurs as a result of nerve damage from excessive alcohol consumption. Symptoms may include tingling in the arms and legs, numbness, pain, cramps and other muscle problems.
These co-occurring disorders can increase symptoms such as fear and anxiety, and also cause aggressive behavior in the patient. For example, alcohol and panic attacks are a very bad combination. Additionally, older people face a higher risk of experiencing delirium tremens, and their symptoms tend to be more severe.
Three stages of delirium tremens
Classic delirium tremens includes three stages.
At the first stage , also called “Korsakov psychosis,” you can notice a sinusoidal hysterical mood of the patient; attacks of anxiety, fear and anger can be replaced by euphoria. Another symptom of the initial stage is excessive talkativeness of the patient, who may chatter incessantly, talking about his experiences, or remembering the past.
Hallucinosis usually occurs in the second stage of the disease. Especially at night. Since the patient’s sleep is very superficial, the visions are mixed with dreams seen by a person in a state of drowsiness, after which he can confuse the events of the dream with reality. Hallucinations are usually terrifying in nature.
At the third stage, visions and illusions become extremely clear. A person no longer just hears and sees strange creatures, but can also feel them physically, as mentioned earlier.
Literature:
- Delirium tremens: (Clinic and some issues of pathogenesis) / M. G. Gulyamov, I. R. Khasanov, V. F. Kolomiets; Ed. and with a preface. G. V. Morozova. – 2nd revision and additional ed. – Dushanbe: Irfon, 1982. – 175 p.
- Emergency diagnosis and methods of relieving alcoholic delirium, withdrawal syndrome and convulsive paroxysms: Method. recommendations / Kharkiv. Research Institute of Neurology and Psychiatry; [N. I. Protasevich and others]. – Kharkov: B. i., 1988. – 13 p.
- Alcoholic delirium and delirious-oneiric psychoses of complex structure / K.G. Danielyan. – Yerevan: Hayastan, 1977. – 132 p.
Treatment and prevention of delirium tremens at home
Manifestations of alcoholic delirium can be accompanied by quite dangerous consequences. What to do if you have delirium tremens?
First of all, in a state of violent insanity, it is necessary to put the patient in bed and monitor him until the ambulance arrives. In folk medicine, it is recommended to apply ice (or something cold) to the forehead and follow a drinking regime. The more liquid, the better. Also, one of the fundamental symptoms of delirium is a sleep disorder, which it is advisable to normalize with the help of sedatives and hypnotics. And the most basic advice is to control the patient’s behavior and actions. In a state of hallucinosis and mental confusion, a person can jump out of a window. Fleeing from an illusory danger or start waving heavy objects at hand, which is dangerous not only for himself, but also for those around him.
As for prevention, the only method is a healthy lifestyle and careful attention to your body and psyche. It is known that withdrawal syndrome does not occur in the early stages of alcoholism, so the only recommendation is not to start drinking, or better yet, not to start drinking at all.
Is it possible to cure a sick person at home?
The only thing loved ones can do to help a person with delirium tremens is to call a doctor as quickly as possible. Suggestion and folk methods will not help in this case. You cannot disturb the patient or slap him in the face so that he comes to his senses. You shouldn't shout and prove to him that he has schizophrenia. At best, the patient will not perceive the information.
It is advisable not to let the patient go outside and constantly monitor his behavior until the doctors arrive. In this state, he can harm himself, get lost or freeze. Self-medication can be dangerous if you give drugs to a patient without consulting a doctor. An overdose of sleeping pills or sedatives will only worsen the situation. If you do give a patient a sedative, read the instructions carefully first and do not exceed the recommended dosage.
Despite the fact that delirium occurs against the background of withdrawal syndrome, the patient should not be given alcohol. This will not help return him to a normal state, but will only complicate the detoxification procedure for doctors, since the IV is placed on the condition that there is no alcohol in the stomach.
Giving water to a person with delirium is also useless. You can give him something to drink to reduce the effects of dehydration, but in small portions. Large amounts of water will cause vomiting.
Herbal decoctions will calm you down a little, but will not solve the problem completely. You can give an infusion of yarrow, wormwood, but not alcohol tinctures. First you need to make sure that the patient does not have an allergic reaction to these herbs.
Treatment of alcoholic delirium
Delirium tremens is a kind of “breakdown” of several resource systems of the body: somatic, psychopathic and mental. The condition is actually extremely dangerous and it is impossible to cure it completely, as well as neutralize the consequences, without medical intervention. Whatever the severity, it is advisable to refer the patient to a psychiatric clinic. Attempts to recover at home often lead to an unfavorable outcome. Delirium tremens itself usually lasts from 2 to 8 days, the symptoms of which usually worsen at night, and this is the most dangerous period. Drug treatment, as such, includes the use of a complex of sedatives and psychotropic drugs, as well as drugs that replenish water-salt resources in the body and improve metabolism. Great attention should be paid to normalizing the functions of the respiratory and cardiovascular systems, and this is only possible under the supervision of specialists. Antipsychotic medications are also prescribed to treat hallucinosis. The rehabilitation period should also take place under professional medical supervision, since the patient’s complete or partial recovery depends on it. During the recovery phase, alcohol is limited to the point of complete exclusion.
Mandatory procedures
In most cases, patients with delirium tremens are taken to a psychiatric hospital, where special treatment is provided. This is also necessary so that he cannot harm himself (if the cloudiness occurs, a person may even jump out of the window) or other people. In order for the symptoms to completely subside, careful treatment under constant supervision is required.
First of all, patients are given drugs that stop attacks (sibazon solution, sodium hydroxybutyrate, etc.). Then the body is detoxified, the remaining alcohol is removed from the blood, breathing is stabilized and, with the help of special tranquilizers, drugs and vitamins, the water-electrolyte balance is normalized and metabolism is restored.
The main task of doctors is to suppress psychotropic disorder and restore normal sleep in the patient.
Memoirs of survivors of delirium delirium
The most interesting thing about this diagnosis is that any patient clearly remembers everything that happened to him during the attack. Terrible visions that appear to a person during psychosis often continue to haunt him for the rest of his life. Devils, ghosts, terrifying illusions are etched into the memory for a long time. And it’s good if alcoholic delirium ended at the stage of hallucinations, and the patient did not have time to injure himself or his loved ones. In most cases, acute alcoholic psychosis is the fundamental reason why an alcoholic is cured of his illness. Many patients believe that what is happening to them is some definite sign from above, informing them that they have reached the final stage in their bad habit. Patients especially vividly remember deceased relatives who appeared to them, scolded, shamed them and called on them to return to normal life.
Social consequences of alcoholic psychosis.
It's no secret that an incorrect, antisocial lifestyle leaves its mark on areas of human development. Long-term alcohol consumption not only undermines health, but also affects an individual’s social position. Disturbances in the functioning of the nervous system, manifested in the form of depression or sudden mood swings, in any case remain even in a completely cured person and negatively affect the quality of his life: ability to work, communication with others and the ability to achieve his goals. On the other hand, it is often the very point of crisis that sometimes serves as a springboard that gives the starting impetus to positive changes. It is not for nothing that psychologists say that a crisis is given to a person as a chance to change something for the better. But from a medical and general social point of view, it is better not to reach crises expressed by deviant symptoms. In order to minimize negative consequences at the rehabilitation stage, the patient is recommended to undergo a course of group or individual psychotherapy.
Where do monsters come from?
Alcoholic hallucinosis appeared a long time ago, when there were no works of popular fiction, cinema and television. Then the sources of images were the Holy Scripture and other religious literature, which describes hell and the creatures inhabiting it.
Today's patients have watched horror films and anime, played computer games, so images appear in their heads that Murakami is resting. Stories heard long ago remain in the subconscious and remind of themselves when delirium sets in.
One man said that devils smell like dogs - such vivid hallucinations haunted him. The other not only saw the snakes, but also clearly heard their hissing.
There is a controversial scientific theory that links the emergence of religions to people being in altered states. For example, South American Indians used mescaline and saw, say, a familiar image of a bear, but with two heads or an unusual green color, it could speak in the voice of a familiar person or fly in the sky. If such visions were observed by a shaman, they were perceived categorically, without criticism, and thus, according to some researchers, legends were born and the foundations of religious teachings were laid.
Ethnomycologists Robert Gordon Wasson and his wife Valentina Pavlovna Wasson studied the influence of entheogens, including psilocybin, on the culture of indigenous peoples of America. The couple combined data on mycology with data from other sciences - history, linguistics, mythology, comparative religion. They called the new discipline ethnomycology
.
In a state of altered consciousness, people today often see evil spirits, ideas about which exist in their religions or in folk mythology, and here the ethnic and religious diversity of our country is manifested.
Sometimes those who observe such images consider this to be a manifestation of some kind of chosenness. As a rule, such an experience is associated with drug intoxication, when hallucinations can be of a loyal or even benevolent nature towards the patient. But in the case of alcoholic delirium, the monsters behave aggressively: they threaten, give chase, and try to kill. Here the opposite idea of self-abasement, fair persecution arises: “I did something for which all these monsters were sent to me as punishment.” No matter how uneducated the patients are, no matter how low their intellectual level, sooner or later the moment of criticism comes: they understand that the condition they are experiencing is associated with alcohol consumption. But this awareness rarely becomes a reason to quit drinking.
Breakthrough of devils through the ethereal field
In the 1990s, when Russia was experiencing a renaissance of occultism in all its diversity, Chelyabinsk psychiatrist Nikolai Pravdin spoke at a medical conference in Yekaterinburg with a report on delirium, the essence of which boiled down to the following: strong alcohol, with its powerful negative energy, thins the human etheric field and also changes the frequency of electrical impulses in nerve cells, so the human eye receives additional perceptual capabilities. As a result, alcoholics begin to see otherworldly entities, and those, taking advantage of their weakness, surround them, like vampires creeping up on a potential victim - this is “delirium tremens.”
