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Delirium Tremens: How to Help Your Close Person?

28.08.2019 Author: psiholog pavel horoshutin

“I started drinking at 15. Alcohol solved many of my personal problems – fears and complexes disappeared. Then it seemed to me that it was wonderful. My school days consisted of constant parties with booze. Then there was a professional college with the same drinking parties.

At the age of 25 I realized that I had become an alcoholic. I was unable to stop and overcome the dependence. We drank with my friends till vomiting, we were drinking for many days without stops. I had little money, because I constantly changed my job. Of course we drank not the best quality alcohol.

I do not know how much my drunkenness would continue, if I did not catch jimjams at the age of 30. During a binge I just thought for how many days I have been already drinking. I found it difficult and it turned out that about 3 weeks. There was no money for the next bottle, so I decided to give up for a couple of days. It was really difficult. On the first day, I had such a terrible hangover, which I have never experienced. I felt hot and cold, thirst tortured me, stomach and head were paining so much. The next day it became a little easier physically. But by the evening, jimjams began. I hardly remember those days – everything was like in the fog. There was a colored carrousel and strange sounds in front of my eyes, though I was alone at home. For some reason it seemed that someone was watching me, so I was running convulsively around the house and hiding in the corners. My hearing has become more acute, like I began to hear what the neighbors say. And, they talked about me – they were blaming such a drunkard. I really believed in my hallucinations, did not understand that I had jimjams. I lost in time – I slept, then again hid in the corners from the “enemies”. I don’t know what would have happened to me if I had not come out into the street on the 4th day of my clanks. And I came out to deal with my “chasers”. As doctors told me later, I fell down on the street, and someone called an ambulance. The doctors came and immediately took me to the narcological dispensary. I don’t remember the next couple of days – I was on a drip, all the time I was sleeping. I was brought to life and the treatment started. When I was completely sober, I became scared – what have I become? Jimjams could kill me. This was a turning point – I realized that I needed to stop.

I have not been drinking for 3 years already. Now I realize that the happiest period of my life is just the time when I didn’t drink. The most difficult was to start alcohol therapy, when it was necessary to admit to myself the existing problem”.

– Igor, 33

It seems, the most terrible thing, where alcoholism can lead, is chronic diseases of internal organs. But there is another thing, which brings no less dangerous consequence of the excessive use of alcohol – jimjams. Unfortunately, doctors do not always give a positive prognosis for the recovery of patients who come to hospital in this condition. In the article we will talk about what are jimjams. What symptoms do they have? What can be done if there are jimjams of your close one?

Contents:

What are jimjams or delirium tremens

The state of a person, which is popularly called jimjams or clanks is designated as delirium tremens (alcoholic delirium) in official medicine. It is a sharp psychosis occurring against the background of withdrawal syndrome after abandoning alcohol. [1]

Jimjams are often confused with a state in which a strongly drunk person is. In general, symptoms can be similar – visual and auditory hallucinations, confused consciousness, difficult speech, elevated body temperature. But in fact, jimjams develop after a period of 5 days to 2-3 months, when the consumption of alcohol is sharply limited. The complete abolition of alcohol leads to a real withdrawal, which provokes disorders in the work of the brain and internal organs.

Delirium is the most often diagnosed type of alcoholic psychosis, which occurs at the 2nd and 3rd stages of alcoholism. According to statistics, jimjams in 64% of cases develop in patients aged 40-50 years, in 22% of cases – up to 40 years. [2]

Reasons of the formation of delirium tremens

alcoholic

Alcoholic delirium, as a rule, develops at a chronic stage of alcoholism after 5-7 years of constant drinking. But in a number of cases, if the state of an addict is complicated by some mental illness, the symptoms of jimjams can come at the 1st and 2nd stages of alcoholism. [2]

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The mechanism for the development of the disease is not fully established, but some experts believe that violations of metabolic processes in the brain tissues caused by long-term drinking, play an important role in its development. When an addict abruptly stops drinking alcohol, the withdrawal syndrome increases in time, accompanied by severe symptoms of jimjams, the consequences of which can bring serious harm to health.

People who are at risk:

  • who previously had traumatic brain injury,
  • who constantly consume surrogate alcoholic drinks,
  • who have suffered severe psychological trauma,
  • who practice non-trusted homemade ways of alcohol abruption

Experts believe that bad heredity also increases the risks of jimjams development. [2]

Signs of jimjams

how to stop drinking

Alcoholic delirium fully shows itself on the 2nd – 4th day after a sharp abruption of alcohol. The beginning of jimjams is preceded by typical symptoms of acute withdrawal syndrome:

  • sleep disorders,
  • a sense of anxiety,
  • disturbance,
  • vomiting and diarrhea,
  • lack of appetite,
  • limb cramps,
  • headache. [3]

The state of a person with the development of delirium tremens quickly becomes worse. Jimjams are characterized with the following signs:

  • auditory and visual hallucinations,
  • confused consciousness,
  • temporary loss of consciousness,
  • broken speech,
  • hand tremor,
  • skin redness,
  • yellowing of whites of eyes,
  • high blood pressure,
  • fast heart rate,
  • increased sweating,
  • epileptic seizures. [3]

Stages of the disease

Jimjams last on average for 3-5 days. There are 3 stages of the disease in narcology. [3]

1st  stage (threatening delirium) Hallucinations begin to appear mostly in the evening.  At first, these are not clear visual illusions and high anxiety, which further enhance the patient’s sensitivity to external irritants.A person is anxious, practically does not sleep, does not eat at all, talks with himself/herself. There is a slight increase in body temperature and sweating.If an addict at the initial stage of delirium begins to drink again, then all symptoms gradually go away.
2nd  stage (accomplished delirium)    Hallucinations become increasingly vivid. The stories of patients who had jimjams prove that illusions can be various – dead relatives, movie characters, friends, mythical creatures, animals. Hallucinations become so realistic that a person can completely lose connection with reality.The body temperature becomes higher, heart rate increases to critical values. The patient can become aggressive, because hallucinations frighten him/her.Alcoholic delirium at the 2nd stage can’t be cured by itself. Immediate medical treatment by doctors is required.
3rd stage (life threatening delirium)The patient’s nervous excitation decreases. Jimjams during this period are shown by a completely incoherent speech. Severe seizures may occasionally occur.Hallucinations continue, accompanied by simple stereotypical actions – sighs of limbs, turns of the head, moving lips. A person ceases to understand who and where he/she is. He/she may not recognize relatives, fall into epileptic seizures.The depressed state of a patient progresses. It can develop into brain edema, which is fraught with coma and further death.

Features of delirium tremens in men and women

According to the statistics of narcologists, there are more men with symptoms of jimjams, who entered the hospital, than women – about 90% of all reported cases. There is no specific explanation for this “exacerbation” of withdrawal syndrome. Some doctors believe that men, unlike women, often go into long periods of drinking, which exactly causes the development of jimjams.

Alcoholic delirium in women can occur even after 3-4 years of continuous drinking. This is due to physiological features – in a woman’s body there are fewer enzymes that split ethanol, and therefore alcohol intoxication with the constant use of alcohol-containing drinks occurs earlier. [2]

In general, the symptoms of jimjams in men and women are similar. But women are more likely to have an abortive type of hallucinations. This state is characterized by a smaller disturbance of consciousness, illusions do not cause a loss of orientation in time. This condition worsens for 2-3 hours, then everything becomes normal again. [2]

Medical practice has established that jimjams in women are more pronounced. Women (with the same period of alcoholism) tolerate deterioration of physical condition much worse than men, which complicates and delays the treatment process. The period of rehabilitation after detoxification of the organism is difficult. There is a depressed emotional state after treatment of psychosis in women, which comes more often than in men,. [2]

What should be done if a person started to have jimjams

Treatment of alcoholic delirium at home can be dangerous for a person!

Patients with jimjams often are unable to take care of themselves – deterioration of physical condition and constant hallucinations confuse the consciousness. A person often does not understand what happens to him/her, and cannot do the simplest action – call an ambulance. Therefore, the responsibility falls more on the family.

Have you noticed that when a person suddenly stops taking alcohol, he/she has symptoms, which are not typical of normal alcohol withdrawal? If there is especially an epileptic attack, then almost certainly in the evening jimjams will begin. Therefore, call an ambulance immediately. Any of your actions aimed at home treatment of jimjams can have negative consequences for the health of the addict. This is especially true for antibiotics that you want to give a person to relieve the condition during jimjams. The addict needs immediate assistance from specialists.

All what is recommended to do if a person has jimjams, put him/her on bed and wait for the arrival of an ambulance. If a patient became aggressive, bind him/her without blocking the respiratory tract. [4]

Treatment of delirium tremens

alcoholism treatment

Jimjams are treated in a narcological dispensary. The scheme of therapy includes intensive detoxification of the body from the products of the decay of ethanol. Drug therapy is aimed at eliminating psychotic phenomena, normalizing metabolism, restoring the functions of organs, as well as preventing the development of persistent cognitive disorders.

In the process of detoxification, a patient is given intravenous administration of salt solutions and vitamins. A patient is prescribed nootropes to prevent the occurrence of disorders in the work of the brain. 

The period of jimjams treatment depends on the stage of the disease and the presence of other pathologies in a patient. But in any case, the term of stay in the narcological department of the hospital will be at least 2 weeks.

An addict is discharged from the hospital when his/her physical condition is restored. If a patient wishes to fight the addiction, he/she will be given a long psychotherapy. Relatives should make every effort to convince an addict to fight alcoholism. Otherwise, during next drinking there is a risk of being in a hospital with a diagnosed alcoholic delirium.

Possible complications and consequences of jimjams

support of loved ones

There are 3 possible outcomes of  jimjams:

  1. Full recovery

Full recovery of a patient without any deviations in health is possible only with a minimal “drinking period” of alcoholism, absence of chronic diseases in the history and timely treatment by the doctor at manifestations of the first symptoms of jimjams. But such cases are rare. As a rule, delirium develops after long years of drinking, when health is already undermined.

  1. Recovery with deterioration of health

Complications after jimjams more often occur at the 2nd and 3rd stages of the disease. These include:

  • chronic psychosis;
  • temporary amnesia;
  • heart, lung, liver and kidney diseases. [2]
In a patient who has suffered jimjams, after drinking even a small amount of alcohol, alcohol psychosis develops much more easily, which can lead to death.
  1. Fatal outcome

Deaths of patients with acute alcoholic psychosis are reported to be about 3% of the total number of those seeking medical care. A person dies from pathologies that worsened against the background of jimjams. As a rule, these are heart diseases, hepatitis, pancreatitis. [5]

The chance to cope with delirium is to consult a doctor in time. If treatment is started at the first or second stages of the disease, a patient significantly improves the chances of survival.

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The best prevention of jimjams is the treatment of alcoholism

A person can hide his/her addiction from others for a long time. But by the moment when there is a danger of the development of alcoholic delirium, it is no longer possible to “veil” the existing problem with excess drinking of alcohol. And if an addict is not fully aware of the risks, being under the influence over a long time already by this dangerous habit, his/her close ones should not give up. It is important to convince a person that he/she needs treatment. How to do it better –  read this article. Getting rid of dependence is the best way to avoid jimjams.

Healing is impossible without psychotherapy, because emotional attachment to alcohol even after intensive detoxification in the dispensary remains for a long time. A person can no longer say “no” to the harmful habit at a difficult stage of the disease.

One of the new psychological methods of treating alcoholism is the 7Spsy behavior modification technique. This is a patented course based on the theories of I.P Pavlov, B. F. Skinner, A. A. Ukhtomsky.

The training will help an addict, who has recognized the problem, master a healthy behavior model. For many, alcohol is a means for relieving stress and relaxation. Over time, this is becoming a serious dependency. By changing negative settings, one learns to find more rational ways to get rid of fears and depression. This is the best prevention of long-term binges, and accordingly, of a development of alcohol delirium.

The 7Spsy behavior modification technique course is designed for up to 6 weeks. The training is conducted in strict confidentiality – if an addict finds it difficult to tell his/her family about the existing problem, he/she may not do it. A psychologist gives all necessary consultations in convenient remote mode – by e-mail, in chat and by phone.

Don’t miss the moment when alcoholism will lead to the development of jimjams. This is a serious dependency that requires immediate treatment.

References:

  1. «Hronicheskaya alkogol’naya intoksikaciya», 2007 g., A. YA. Grinenko, V. V Afanas’ev i dr.
  2. «Obshchaya i chastnaya narkologiya: Rukovodstvo dlya vrachej», 2008 g., I. N. Pyatnickaya.
  3. «Neotlozhnye sostoyaniya v narkologii. Uchebnoe posobie», 2013 g., O. Syropyatov, N. Dzeruzhinskaya i dr.
  4. «Rukovodstvo po skoroj medicinskoj pomoshchi», 2006 g., S. F. Bagnenko.
  5. «Smertnost’ bol’nyh ostrymi alkogol’nymi psihozami v narkologicheskom stacionare» (zhurnal «Voprosy narkologii», 2002 g., № 3), A. V Karpec.