Imagine that you're walking along a city sidewalk. You round a corner and suddenly—there in front of you—is a giant grizzly bear. What happens next? You get an adrenaline rush, your heart races, your blood pressure shoots up, you shake like a leaf, your pupils get large as saucers, your hairs stand on end, you break into a sweat, and you run like heck. Do you have a strong mental picture of this? Good. Hold that thought; we'll come back to it.Delirium tremens, also known as
DTs, is most serious of several syndromes that can occur when someone who is physically dependent on alcohol stops drinking. By serious, I mean that people with this condition can die. Even with hospital treatment death rate can be 1-5%, but without treatment it could be 20%. Even convulsive seizures—another alcohol withdrawal syndrome—are less likely to be lethal than DTs.
Symptoms of DTs typically start 2-4 days after last drink in someone with prior heavy and prolonged consumption of alcohol. Earliest signs of DTs can be three T's—temperature elevation, tremor and tachycardia (rapid heartbeat). The affected individual can experience anxiety, restlessness, nausea, and impaired sleep. By time delirium tremens becomes fully developed, it includes entire battery of "grizzly bear" symptoms mentioned above. These occur because a portion of nervous system responsible for regulating basic bodily processes, sympathetic system, jumps into overdrive.
But DTs involve much, much more. The parts of brain responsible for perception and thought go haywire. Ordinary lights and sounds seem excessively harsh. The afflicted individual becomes confused, agitated, and even psychotic. He or she might even fail to identify family members. There is constant and sometimes incoherent talk. Ordinary components of environment, like patterns on wallpaper, can be perceived as frightful threats, like spiders or snakes.
Moreover, hallucinations can occur. These can include terrifying sights, sounds or smells that others in room can't detect. In addition, there can be distressing sensations as if skin is being touched by insects or other unseen intruders.
At first, person in DTs might have lucid intervals in which he or she makes appropriate conversation, but then becomes more continuously inaccessible to questions. Subsequently, symptoms subside usually in a matter of days and recovery can even be sudden.
What makes these terrible things occur? The evidence to date suggests that in people with heavy and prolonged drinking, brain gets used to alcohol's constant presence, and normal chatter among brain cells no longer gets toned down by alcohol like it does in brains of occasional drinkers. The brains of heavy drinkers probably accomplish this by reducing number of locations on brain cells where natural inhibitory chemical, GABA (gamma-amino-butyric acid), can act to slow things down.
