Alcohol Psychosis, Symptoms, Causes & Treatment

Alcohol-induced psychosis as a result of excessive drinking should always be treated seriously. It can manifest as alcoholic hallucinosis or other forms of delirium tremens and timely diagnosis and appropriate treatment is essential.

Alcohol-related psychosis is considered a medical emergency as it causes symptoms of alcoholic paranoia that are alarming to the person affected and to anyone observing them.

Delirium Tremens especially, a severe form of alcohol withdrawal that can include alcoholic hallucinosis, can be life-threatening and requires emergency medical care.

Treatment typically involves providing a safe and supportive environment and administering medications to manage symptoms and reduce the risk of complications.

Conditions classified as Alcohol Psychosis cover a range of disorders and symptoms that are directly linked to alcohol abuse or alcohol withdrawal. These conditions can vary in severity and presentation.

These alcohol-induced psychoses often overlap, and a person may experience more than one type simultaneously. Here are the main types:

  • Alcohol Hallucinosis: Symptoms include predominantly auditory hallucinations, which can be distressing and may involve critical or persecutory content. Visual and tactile hallucinations can also be experienced.
  • Alcohol-induced Delirium Tremens (commonly called DTs): psychotic symptoms include confusion, agitation, severe hallucinations, tremors, rapid heartbeat, and sometimes seizures.
  • Alcohol-Induced Persisting Amnestic Disorder: people with this condition experience memory impairment and difficulty in forming new memories, which can be permanent. This tends to be a result of chronic alcohol use disorder including excessive consumption.
  • Alcohol-Induced Psychotic Disorder: this condition includes a wide range of psychotic symptoms, such as hallucinations, delusions, disorganised thinking, and mood disturbances. Psychosis may occur during a binge-drinking episode or emerge during alcohol withdrawal.
  • These alcohol-induced psychoses often be experienced simultaneously.

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Can Alcohol Make You Paranoid?

Excessive drinking that produces acute intoxication has the potential to induce alcohol paranoia.

Alcohol affects the central nervous system, leading to changes in perception and behaviour. In moderate amounts, it can lower inhibitions and induce relaxation, making people feel more sociable.

Heavy alcohol consumption can disrupt the balance of neurotransmitters in the brain, such as serotonin and dopamine, which play a role in regulating mood and perception. This imbalance can contribute to heightened anxiety, irrational fears, and a distorted sense of reality, contributing to feelings of paranoia.

People under the influence of alcohol may become excessively suspicious of others, convinced that they are being watched or judged.

Acute intoxication can impair cognitive functions, making it difficult to accurately interpret social cues or situations. This can lead to misinterpretations of others’ intentions, fuelling paranoid feelings and false beliefs.

By no means everyone who consumes alcohol will experience paranoia, as individual reactions vary. Nonetheless, excessive drinking and the risk of mental health problems should be taken seriously.

Any small evidence of paranoia or other negative psychological effects when consuming alcohol are warning signs not to be ignored. They indicate at least a review of one’s alcohol consumption or a decision to seek professional advice and quit drinking.

Can Alcohol Cause Psychosis?

Chronic alcoholism can lead to damage to brain regions responsible for memory and cognition.

Excessive alcohol consumption and a history of severe alcohol intoxication through heavy, prolonged drinking followed by acute alcohol withdrawal can damage neurotransmitter balance and brain function generally.

Problems That Can Lead To Developing Alcohol-Induced Psychosis Include:

Is Alcohol-Induced Psychosis Dangerous?

When alcohol abuse triggers symptoms of psychosis, such as hallucinations, delusions, and impaired insight into one’s behaviour, dangerous situations arise such as:

  • Risk of Harm to Self and Others: psychotic delusions or hallucinations can put the sufferer and others at risk of harm through actions such as self-injury, suicide attempts or aggressive behaviour towards others.
  • Impaired Judgment: alcohol impairs judgment, decision-making and cognition generally. When combined with psychosis symptoms, people may engage in risky behaviours or make irrational choices leading to accidental harm. Drunk driving is an obvious example.
  • Reduced Awareness: people in an alcohol-induced psychotic state have a diminished awareness of reality. They may not recognise the severity of their condition or the consequences of their actions, which can delay seeking help.
  • Increased Vulnerability: psychotic individuals are vulnerable to injuries from others and exploitation generally. They may be unable to protect themselves from physical harm or make sound decisions about their safety.
  • Potential for Long-Term Consequences: repeated episodes of alcohol-induced psychosis can lead to long-term cognitive and psychological damage and the development of other mental health conditions.
  • Distinguishing alcohol-induced psychosis from primary disorders like schizophrenia can be challenging, which may delay appropriate treatment. However, addressing the underlying alcohol abuse is a crucial part of treatment to prevent future episodes.

If someone is experiencing symptoms of alcohol-induced psychosis or if you suspect that someone you know is in this state, it is essential to seek immediate medical attention.

alcohol psychosis

Alcohol Psychosis Symptoms

Alcohol-induced psychosis, also known as alcohol withdrawal delirium or alcohol hallucinosis, refers to a number of alcohol-related conditions that can manifest with a range of distressing behaviours and other psychotic symptoms. These typically occur during or shortly after a period of heavy alcohol dependence, when a person suddenly reduces their intake or attempts to quit drinking altogether.

Alcoholic psychosis is distinct both from primary psychotic disorders like schizophrenia and conditions such as alcohol poisoning which can produce physical consequences such as liver disease.

Here are some common symptoms of alcohol-induced psychosis:

  • Hallucinations: vivid and often terrifying hallucinations often occur. These can be auditory (hearing sounds, voices, or noises that are not real) or visual (seeing things, people, or objects that do not exist). They can contribute to intense anxiety and confusion.
  • Delusions: false and irrational beliefs are formed that are resistant to reason or contrary evidence. During alcohol-induced psychosis, people may hold paranoid delusions, believing that others are plotting against them or that they are in imminent danger.
  • Disorientation: a pronounced sense of disorientation and confusion is common. Those affected may not know where they are, and what day it is, or have difficulty recognising familiar people.
  • Agitation: restlessness and agitation are common. A person may become highly anxious, and fidgety, and may engage in purposeless or erratic movements.
  • Mood Swings: mood swings can be extreme, with displays of intense fear, anger, or sadness within a short period. These mood fluctuations can be unpredictable.
  • Impaired Memory and Attention: significant cognitive impairments, including memory deficits and difficulty focusing on tasks or conversations, are often observed.
  • Physical Symptoms: in addition to psychological symptoms, physical changes occur, producing for example rapid heart rate, sweating, tremors, and elevated blood pressure.
  • Sleep Disturbances: insomnia and disturbed sleep patterns are common, contributing to further confusion and exhaustion.

It’s crucial to seek immediate medical attention when these symptoms arise. Delirium tremens, a severe form of alcohol withdrawal, can be life-threatening and requires emergency medical care.

Treatment typically involves providing a safe and supportive environment, administering medications to manage symptoms and reduce the risk of complications, and addressing underlying alcohol abuse through rehabilitation and counselling.

Early intervention is essential for a better prognosis and a reduced risk of recurrence.

Get Help With Ending Alcohol Abuse Before Psychotic Symptoms Appear

Any kind of substance abuse, especially chronic alcohol abuse, can lead eventually to mental illness such as alcohol-induced psychosis.

People suffering from substance use disorders (especially alcoholic beverages) can experience psychosis at any time, though family history and other factors may play a part. Lasting damage to physical health as well as a variety of mental health problems often result.

Getting help earlier rather than later is likely to result in fewer health problems. The impact on public health in the general population will consequently be less too.

Alcohol Psychosis vs Schizophrenia

Distinguishing alcohol-induced psychosis from primary psychotic disorders like schizophrenia can be challenging and may delay appropriate treatment. However, addressing the underlying alcohol abuse is a crucial part of treatment to prevent future episodes.

If someone is experiencing symptoms of alcohol-induced psychosis or if you suspect that someone you know is in this state, it is essential to seek immediate medical attention.

Treatment typically involves stabilising the individual, addressing any immediate safety concerns, and providing therapy and support to address both the psychosis and alcohol abuse. Early intervention can significantly reduce the risks associated with alcohol-induced psychosis and improve long-term outcomes

What Qualifies As Alcohol-Induced Mental Illness?

“Alcohol-induced mental illness” constitutes the development of mental health disorders or exacerbation of pre-existing mental health conditions as a direct result of alcohol use or withdrawal. It thus covers a range of mental health issues associated with alcohol consumption of which the following are the main ones

  • Mood Disorders: these include conditions such as alcohol-induced depressive disorder or alcohol-induced bipolar disorder, where alcohol use directly contributes to the development or worsening of mood-related symptoms. For instance, persistent heavy drinking can lead to feelings of sadness and hopelessness, mimicking depression.
  • Anxiety Disorders: anxiety disorders, for example, generalised anxiety disorder or panic disorder can be negatively affected or triggered by alcohol use. Heightened anxiety and panic attacks during or after drinking are examples.
  • Psychotic Disorders: alcohol can induce psychotic symptoms such as hallucinations and delusions. These are typically a direct result of alcohol intoxication or withdrawal symptoms.
  • Sleep Disorders: chronic alcoholism can disrupt sleep patterns, leading to alcohol-induced insomnia. Sleep disturbances, in turn, can contribute to mood and anxiety disorders.
  • Neurological Disorders: abusing alcohol long-term can lead to disorders affecting memory, attention, and other cognitive functions.
  • Conditions such as Wernicke-Korsakoff syndrome, characterised by severe memory impairment, confusion, and hallucinations due to thiamine (vitamin B1) deficiency, are common.
  • Sexual Disorders: alcohol misuse may lead to sexual dysfunction, such as erectile dysfunction or reduced libido, due to its impact on the nervous system and hormonal balance.
  • Personality Disorders: changes in behaviour, impulsivity, and personality traits when under the influence of alcohol may occur, which may not necessarily meet the criteria for a formal personality disorder but are nonetheless influenced by alcohol use.

It’s important to note that while alcohol can exacerbate or trigger these mental health conditions, it may not be the sole cause. Genetic predisposition, environmental factors, and co-occurring substance use can also play significant roles in the development of these disorders.

The distinction between primary disorders and those exacerbated by alcohol can be complex, making a comprehensive assessment by a health professional crucial for accurate diagnosis and effective treatment.

Treating both the alcohol use disorder and the associated mental health issues is typically necessary for a successful recovery.

Women’s Unique Health Risks: researchers began to uncover the specific health risks associated with alcohol addiction in women, including a higher susceptibility to alcohol-related liver disease and breast cancer.

Women also tend to develop alcohol-related problems such as alcohol-induced psychosis, more rapidly than men, at lower levels of consumption.

Rise in Female Alcoholism: as women gained more freedom and entered traditionally male-dominated spaces, consumption among women increased. By the mid-20th century, there was growing recognition of alcohol addiction as a significant health issue for women.

Current Challenges: today, alcohol remains a significant women’s health issue, with ongoing concerns about the health risks, gender-specific treatment approaches, and societal attitudes toward women’s alcohol use.

Issues such as binge drinking, underage drinking, and alcohol-related violence continue to be of concern.

Treatment and Support: the recognition of alcoholism as a health concern led to the development of gender-specific addiction treatment programmes and support groups, acknowledging the unique needs of women in recovery.

At Castle Craig Hospital we have run an alcohol treatment programme for women over many years as part of our overall substance abuse treatment approach.

Safe Detox in Comfort

Castle Craig has a dedicated detoxification centre and 24/7 supervision by doctors and nurses to ensure the utmost patient safety.

Alcohol-Induced Psychosis Treatment

Alcohol-induced psychosis treatment is an essential consideration in the treatment plan of any person wishing to address a heavy drinking problem.

Where withdrawal symptoms are severe perhaps leading to alcohol withdrawal psychosis or secondary psychosis, then admission to a general hospital emergency department may be needed.

Treatment typically involves stabilising the individual, addressing any immediate safety concerns, and providing therapy and support to address both the alcohol-induced psychosis and the alcohol abuse itself. Early intervention can significantly reduce the risks associated with alcohol-induced psychosis and improve long-term outcomes.

Inpatient Alcohol Rehab

Any form of mental illness that includes acute psychosis such as evidenced by visual hallucinations or other severe withdrawal symptoms, should be thoroughly investigated and treated.

There are likely to be fewer negative consequences when this is addressed at a treatment centre where inpatient rehab is available. Any form of alcohol-induced psychosis needs skilled diagnosis and careful treatment planning.

Treatment for Alcohol-Induced Psychosis at Castle Craig Hospital

At Castle Craig, we have over 35 years experience of in treating alcohol-induced psychosis including alcohol withdrawal psychosis, alongside other mental disorders related to addiction.

Personalised Treatment Plans:

Our therapists create personalised treatment plans catering to the individual needs of the patient, taking into consideration the severity of the psychosis and addiction.

Medical Detox

We provide 24/7 medical supervision to ensure the safety and well-being of the patient during detoxification and recovery.


At Castle Craig, we offer various therapies, including cognitive behavioural therapy (CBT), individual counselling, group therapy, and complementary therapies, which can be essential in treating underlying mental health issues.

Family Support:

They might also involve the family in the recovery process to ensure that the patient has a supportive environment to return to post-treatment.

Continuing Care:

The provision of aftercare to prevent relapse and support long-term recovery is often an integral part of the treatment process.

If you are concerned about your own or a loved one’s addiction or if you suspect any form of psychosis related to addiction, please don’t hesitate to call us for a confidential discussion on your best options.

Take the First Step Toward Recovery Today

At Castle Craig, we understand the challenges that you and your loved ones face when dealing with alcohol addiction. Our treatment centre offers a restful environment, where comprehensive care meets compassionate support. 

With our medical detox process, you’ll have the support you need as your body adjusts to an alcohol-free life, and our experienced medical team ensures your comfort and safety throughout. 



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