What is delirium tremens?

What is delirium tremens Delirium tremens means “trembling delirium” and is part of the confessional disorders of consciousness. These disorders are characterized by two fixed elements: a variable degree of numbness (involving a decrease in the level of alertness and less clarity of consciousness), and disordered mental activity, fantastic or limited.

Delirium is the confusing state par excellence, which on many occasions includes visions of objects, animals or people. They can be of many types, some of them especially grotesque and unpleasant.

What is delirium tremens

The visions appear in a confused way, with little clarity of the images and intermixed with the reality; or manifest clearly, governing the mental state of the patient in full.

In this second case, the person is completely immersed in the visions, considering them real, and responding to their contents, fostering a state of general agitation in the individual.

The physical state of a patient with delirium is usually highly disturbed. They present fever, dehydration, fatigue, intestinal disorders, tachycardia and arterial hypotension, among others. The evolution of physical and psychological symptoms may be toward complete recovery or death.

In the event that the disorder ends with the recovery of the patient, only vague memories fragmented and confused of what happened.

Relation to withdrawal syndrome

The withdrawal syndrome is the set of symptoms that people with substance addiction after a while without ingesting the drug.

In the case of drinkers, the withdrawal syndrome appears between 12 and 24 hours after stopping alcohol, and presents with the following symptoms: tremors, weakness, chills, headaches, dehydration and nausea.

When the withdrawal syndrome is remarkably severe and acute, then we speak of delirium tremens.

Symptoms of delirium tremens

Delirium tremens is an acute confessional picture caused by alcohol deprivation when a person is heavily dependent on alcohol, caused by the ingestion of large amounts of alcohol over a long period of time.

A simpler way to understand the definition of delirium tremens would be to consider it as the ultimate expression of withdrawal syndrome.

The symptoms of this type of delirium are:

  • Nervousness
  • Physical and emotional instability
  • Anxiety
  • Extreme fatigue
  • Headache
  • Excessive sweating
  • Total loss of appetite
  • Irritability
  • Extreme Excitation
  • Nightmares
  • Visions
  • Hallucinations
  • Tremors
  • Shaking and convulsions, the patient may even reach death


When considering the diagnostic criteria for delirium tremens, it is important to know that the diagnosis should only be made when the symptoms exceed those of a withdrawal syndrome, with the severity enough to be withdrawn from this syndrome.

These diagnostic criteria would be:

  1. Altered consciousness (egg, decreased ability to pay attention to the environment) with reduced ability to focus, maintain or direct attention.
  2. Change in cognitive functions (such as memory impairment, disorientation, language impairment) or presence of a perceptual disturbance that is not explained by previous or developing dementia.
  3. The alteration occurs in a short period of time (usually in him or days) and tends to fluctuate throughout the day.
  4. Demonstration, through history, of physical examination and laboratory tests, that the symptoms of Criteria A and B occur during shortly after a withdrawal syndrome.

Some tips for families of people with alcohol addiction

Be aware of the problem

The patient will tend to conceal his problem or to minimize it by saying that “one only takes x beers …” Sometimes the family itself tries to protect the patient because he sees it suffer, but this only hinders the recovery process.

Find reasons to change

Not only will the patient have to change his behavior and make a great effort for his recovery, since the family will also have to change behavior patterns that lead to recovery. Among all must look for the reasons that make the change at personal and family level is necessary.

The supports

Addicted people are sick and need the help of specialists, relatives and close friends. They tend to relapse, and it is common for families to lose confidence in the addicted person. You have to be patient.

Working trust

As we have said, the loss of confidence on the part of the families is more than common, caused by the continuous promises of change on the part of the addict patient.

When they do not trust one, self-esteem suffers, and the feeling of loneliness grows, strengthening addictive behaviors as a means of evasion. Confidence can be worked:

  1. Developing communication within the family.
  2. Facilitating moments to request help within the family.
  3. Looking for alternatives to alcohol in difficult times together.
  4. The family knows the short-term goals of the patient, to help them meet them.
  5. Developing a plan for achieving goals, also known by the family.
  6. Working respect among the members of the family, especially in the sick-family and sick-family.

Re-establish responsibilities

It is possible that over time family members have taken on more responsibilities than would be expected in a normal situation.

Responsibilities must be reorganized and shared among all. Family members should not prevent the person with alcohol addiction from taking over their responsibilities (taking care of their children, for example).

Take advantage of free time

Empty times do not help in times of alcohol withdrawal, and can be really hard.

Doing truly entertaining and entertaining activities will help improve the person with addiction. It is good to share activities with the family.

Positive reinforcement

It is no secret that people function best when we feel valued and loved.

It is important to let the person with addiction know the things he does well, what he is competent and useful, and show affection to make him feel loved. Samples of love are always useful, no problem whatever.

Pay attention to changes

Any small step towards improvement is a great step for the alcoholic person, as there is a great effort behind to achieve that little achievement.

The family also makes a great effort to help their sick family member. The idea is to keep these changes in mind, so that they serve as motivation to continue the treatment.

The addictions

Drug addiction is a chronic, recurrent disorder in which compulsive drug-seeking behavior occurs, and consumption is maintained despite the negative physical, psychological, and social consequences of drug addiction.

The World Health Organization and the American Psychological Association use the term “substance addiction” rather than “drug addiction.” People with addictions show a tolerance to the drug (that is, it has less and less effect), and they begin to manifest symptoms that show their physical dependence on the substance.

As the body of these people each time presents greater tolerance to the substance, they need to consume a greater quantity of drug to be able to obtain the same effects that at the beginning of its consumption. This causes a vicious circle, as the amounts of consumption are becoming greater, and with it, the addiction is increasing.

According to the DSM-IV, there must be a maladaptive pattern of consumption of the substance in question, meeting at least 4 of the following 7 criteria:

  1. Tolerance, defined by: (a) a need for markedly increasing amounts of the substance to achieve intoxication or the desired effect (b) the effect of the same amounts of substance clearly decreases with its continued consumption.
  2. Abstinence, defined by (a) the withdrawal syndrome characteristic of the substance or (b) the same (or very similar) substance is taken to alleviate or avoid withdrawal symptoms.
  3. The substance is often taken in increasing amounts or for a longer period than originally intended.
  4. There is a persistent desire or unsuccessful efforts to control or discontinue the use of the substance.
  5. A lot of time is spent on activities related to obtaining the substance (egg visiting various doctors or moving long distances), substance use (egg smoking one cigarette after another) or recovery of the effects of the substance.
  6. Reduction of important social, labor or recreational activities due to substance use.
  7. The substance is continued to be taken despite being aware of relapsing or persistent psychological or physical problems that appear to be caused or exacerbated by substance use (egg, cocaine use despite knowing that it causes depression, or continued alcohol intake even though an ulcer worsens).

Factors influencing substance dependence

  1. The chemical properties of the substance. In the case of alcohol, it is a psychoactive drug that at first causes euphoria, disinhibition, loquacity and impulsivity.
  2. Psychiatric and personality disorders. These factors are the main ones that condition the onset of substance abuse to dependence. Traits such as the search for risk or novelty favor the consumption of addictive substances. Psychiatric illnesses related to a higher incidence of addictions are schizophrenia, ADHD, bipolar disorder and depression.
  3. Genetic factors. Men with alcoholic relatives are more prone to alcoholism, even when they have been adopted and reared by parents unrelated to alcoholism. In addition, by birth, they are less sensitive to alcohol, which only increases the chances of alcohol addiction.
  4. Social factors. Although it is a fact that addictions occur in people of any socioeconomic level, the fact is that people in disadvantaged situations and at risk of social exclusion are at greater risk of addiction.
  5. Social acceptance. Alcohol is a highly socially accepted drug, contributing to the integration of people into social situations. Their acceptance makes access to the substance very simple and recurrent.

Alcohol addiction

When the consumption of ethanol (alcohol) is in low doses or at the onset of acute intoxication by ethanol, it produces stimulant effects due to the suppression of the central inhibitory systems. However, when levels of ethanol in the blood are increasing, there is sedation, difficulties or disappearance of coordination, ataxia and poor psych0m0tor performance.

Also Read: Chronic Alcoholism: Symptoms, Consequences and Treatments

Alcohol addiction is related to dopamine and to the modification of the activity of the serotonin receptors.

Alcohol has numerous side effects in the human body, among which we can highlight the following:

  • Affection of the brain and nervous system. Every time the brain functions are affected. First, these changes are manifested in behavior, with continuous abrupt mood swings on the part of the alcoholic, but later thoughts and judgment will be affected.
  • Periods of amnesia, profound alterations in memory and awareness of different duration.
  • It increases cardiac activity, causing hypertension, weakness of the cardiac muscles, and peripheral vasodilatation.
  • It increases the production of gastric acid, which in the long term leads to ulcers and hemorrhages.
  • It can cause esophagi is, pancreatitis, type II diabetes, peritonitis, jaundice, kidney problems, among other diseases of the digestive system.
  • Alcohol gives the human body large amounts of calories, but with little nutritional value. This causes you to lose your appetite, and long-term malnutrition.
  • It inhibits the production of red and white blood cells in the blood, which can result in megaloblastic anemia.
  • The lack of white blood cells weakens the immune system, causing viral and bacterial diseases.
  • It significantly decreases libido, and sexual activity, in addition to causing erectile dysfunction and infertility.
  • During pregnancy, it can cause fetal alcohol syndrome, characterized by generalized growth retardation, facial features alteration, cardiac malformations and cerebral malformation.