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  • Alcohol Withdrawal Symptoms: Getting Through Quitting

    Quitting alcohol is never easy. Yes, you read that right.
    Psychologically, it’s difficult to give up something that you have come to associate with pleasure and relaxation.
    Alcohol Withdrawal - Getting through Quitting

    You drank to numb an emotional hurt. You drank to de-stress and to forget your worries. And you drank because you couldn’t imagine living without alcohol.

    But the most challenging part of giving up alcohol is managing the symptoms of withdrawal. Alcohol withdrawal symptoms range in severity from simply uncomfortable to potentially life-threatening, and it’s not just the grave symptoms that you need to watch out for. Withdrawal symptoms can be so unpleasant and painful that you simply return to drinking, relapsing instead of recovering.

    Managing alcohol withdrawal symptoms effectively and safely is critical to relapse prevention. Learn more about what to expect during the alcohol withdrawal period.

    What Are the Symptoms of Alcohol Withdrawal?

    • Shaking hands and feet
    • Sweating
    • Nausea and vomiting
    • Diarrhea
    • Elevated blood pressure
    • Tightness in the chest
    • Rapid heartbeat
    • Irregular heart rhythms
    • Increased body temperature
    • Headache
    • Abdominal pain
    • Insomnia
    • Low-grade fever
    • Seizures

    Symptoms like headaches and abdominal pain are uncomfortable and painful, but you don’t need to be concerned about those; some people find relief simply through over-the-counter pain medication.

    Likewise, symptoms like vomiting are simple to manage. Just make sure that you are drinking plenty of fluids—ideally an electrolyte solution—to replenish the water and salts lost, especially if you experience severe bouts of vomiting.

    Symptoms such as elevated blood pressure and rapid or irregular heartbeat, however, need to be addressed immediately at a medical facility.

    If not managed promptly, these may aggravate and trigger strokes, heart attacks, or cardiac arrest.

    It is also best that you seek medical help if you experience seizures during alcohol withdrawal. While in some cases the seizures may be temporary and resolve on their own, they may also indicate the onset of delirium tremens (DTs), a particularly dangerous symptom with a high mortality rate.

    What Are the Mental Signs of Alcohol Withdrawal?

    • Confusion and disorientation
    • Irritability and agitation that can progress to violent aggression
    • Anxiety that can range from mild to severe
    • Mood disturbances
    • Depression
    • Hallucinations (visual, tactile, or auditory)

    Often the mental symptoms of alcohol withdrawal get laughed off or dismissed as “typical” drunken behavior.

    While some symptoms may subside on their own, the risk of a person injuring him- or herself or a bystander is always a real threat.

    In a confused or disoriented state, someone undergoing withdrawal may experience a fall. Fuzzy thinking, a tendency to act out on one’s hallucinations, and a heightened state of irritability can also make the person lash out at, hit, and injure someone else.

    The danger of a relapse during withdrawal is quite high for someone trying to quit alcohol. Being unable to cope with the anxiety and dark moods that may prevail during the phase of alcohol withdrawal can also make a person reach for a drink.

    Severe Complications of Alcohol Withdrawal

    As detailed in a paper published by the National Institute on Alcohol Abuse and Alcoholism, acute alcohol withdrawal can trigger severe complications such as:

    Wernicke-Korsakoff Syndrome

    Though Wernicke’s encephalopathy and Korsakoff syndrome are caused by nutritional deficiencies, their symptoms usually manifest during the alcohol withdrawal period. They are both disorders of the nervous system and have to be treated promptly because the symptoms can aggravate and cause permanent cognitive damage, coma, and death.

    The classic symptoms of Wernicke’s encephalopathy are:

    • Paralysis of eye muscles
    • Abnormal gait
    • Delirium
    • Profound disorientation
    • Severe agitation
    • Cognitive impairment
    • Altered consciousness

    If left untreated, the person may even develop a permanent memory disorder or Korsakoff syndrome. In worse cases, depressed consciousness can lead to stupor, coma, and death. About 80% of those who develop Wernicke’s encephalopathy go on to manifest the symptoms of Korsakoff syndrome, which are:

    • Severe retrograde amnesia (inability to remember past events)
    • Anterograde amnesia (inability to form memories of current experiences)
    • Learning disabilities that follow from memory loss
    • Confabulation (narrating imaginary stories to fill in gaps in memory)

    Wernicke-Korsakoff syndrome can rob a person of the ability to succeed in school or at work. In worst cases, the person may be unable to live and function independently.

    Acute Depression

    Psychiatric symptoms are common during the alcohol withdrawal phase. Depression may develop during the withdrawal period when the levels of alcohol in the blood decrease and the initial “high” of intoxication gives way to feelings of low. Depression in alcoholics who are abstaining is marked by:

    • Anxiety
    • Feelings of alienation
    • Social isolation
    • Aggression
    • Emotional instability

    What is disconcerting is that about 15 percent of alcoholics are at risk of committing suicide during one of these depressive moods. Depression can also aggravate any other mental disorder that the person may suffer from. Again, the presence of a co-occurring psychiatric disorder, like schizophrenia or a mood disorder, can intensify the symptoms of depression.

    Delirium Tremens (DTs)

    According to the National Institutes of Health, delirium tremens (DTs) is a severe form of alcohol withdrawal symptom. It is potentially fatal and therefore, a medical emergency.

    Delirium Tremens

    What are the symptoms of delirium tremens?

    • Excessive sweating
    • High blood pressure
    • Elevated and irregular heartbeat
    • Low-grade fever
    • Severe and uncontrollable tremors
    • Severe anxiety
    • Confusion and disorientation
    • Hallucinations (usually visual that the person mistakes for real)
    • Grand mal seizure

    The mortality rate amongst people who exhibit DTs symptoms is between 5% and 25%.

    The chances of survival increase if the person receives medical treatment promptly.

    Alcohol Withdrawal Timeline

    The alcohol withdrawal timeline usually begins within 6-24 hours the last drink, according to the American Academy of Family Physicians. Mild symptoms like anxiety, insomnia, and nausea begin after 8 hours. Moderate symptoms, including blood pressure and elevated body temperature may develop during the next 1-3 days. Most withdrawal symptoms will subside after a week.

    Some people may develop more severe symptoms like hallucinations, seizures, irritability, and low-grade fever during this time. Still other chronic abusers of alcohol or alcoholics go on to develop protracted withdrawal syndrome (PWS),i which is a cluster of acute withdrawal symptoms that persist beyond the typical timeline. PWS can occur if acute withdrawal symptoms are not managed. But it may also point to the fact the brain takes

    But it may also point to the fact the brain takes time to recover from the cell damage caused by chronic alcohol abuse.

    What are the Symptoms of Protracted Withdrawal Syndrome?

    • Sleep difficulties (insomnia or disrupted sleep)
    • Tremors
    • Anxiety
    • Depression
    • Rapid heartbeat
    • Elevated blood pressure
    • Lethargy and reduced energy level
    • Slow metabolism

    The symptoms of PWS may persist for up to two years after giving up alcohol. The danger of a relapse is always present during this time. Some people experiencing PWS decide that their attempts to quit alcohol have failed and go back to their old drinking habits after losing motivation. Some others stop investing time and effort into their recovery and develop dry drunk syndrome; they too often relapse.

    However, alcohol withdrawal prognosis improves with prompt treatment.

    Who Is at Risk of Developing Severe Alcohol Withdrawal Symptoms?

    Not all people who drink alcohol will develop intense withdrawal symptoms. The signs of alcohol withdrawal are most severe if a person:

    A person experiencing alcohol withdrawal symptoms may not always be physically fit or mentally alert enough to call for medical help if symptoms worsen. If you are planning to quit alcohol and any of the instances mentioned above apply to you, consider being admitted to an inpatient alcohol rehab facility for medically-assisted detoxification.

    The mild signs of alcohol withdrawal can be uncomfortable and may disrupt your ability to get through your daily life. Symptoms like diarrhea and vomiting can cause dehydration and other issues at a life-threatening level of severity. Uncontrolled high blood pressure and rapid heartbeat can lead to heart attacks and strokes. Even mild to moderate alcohol withdrawal symptoms risk developing into more severe issues.

    Some people try to bear the pain and discomfort of the symptoms by drinking alcohol; some, unfortunately, do not get the chance. Do not ignore the signs of alcohol withdrawal!