During prolonged alcohol abuse, particularly among daily heavy drinkers, the brain is forced into hyperactivity to compensate for the depressant effects of alcohol. When an alcoholic suddenly stops drinking, this hyperactivity continues leading to symptoms such as tremors, vomiting, increased heart rate, hallucinations, high blood pressure and increased heart rate and delirium tremens, or acute loss of mental function. Generally, the symptoms last for five to seven days with the most severe manifestations coming in the first two days. There are some lingering effects in some patients, however, leading to Protracted Withdrawal Syndrome or PWS.
Depression
Depression from PWS is difficult to diagnose due to the number of factors that contribute to clinical depression. For alcoholics, depression is often marked by a decreased sexual appetite in the absence of alcohol, the inability to cope with the feelings of loss associated with cessation and difficulty engaging with others. Sufferers may have trouble sleeping, which is also due, in part, to the continuing effect of autonomic nervous system irregularities, according to Dr. N.G. Desal, et al., in a paper published in the Indian Journal of Psychiatry.
Autonomic Hyperactivity
Among the more dangerous symptoms of acute withdrawal is a disruption of the body's autonomic processes. In the first few days of withdrawal, symptoms include high blood pressure, rapid pulse, sweating and elevated body temperature. During the detoxification period, these symptoms are most pronounced during the second, third and fourth days, but they can continue for up to a year, according to the National Institute of Alcohol Abuse and Alcoholism. A pharmacological regimen is required, particularly to deal with the lingering high blood pressure.
Protracted Delerium
In the acute stage of withdrawal, delirium tremens results in aural and visual hallucinations, memory loss, confusion and difficulty concentrating. It is possible that some of these symptoms continue long after the acute stage is complete, perhaps as long as a year. Impaired executive level function disrupting the patient's ability to function in work and social environments may be the result of a slower than normal repair of the reversible nerve damage associated with chronic alcohol abuse, acording to the NIAAA.
Cravings
In the alcoholic, drinking is often considered a symptom of a myriad of other issues. Alcohol becomes the crutch with which an alcoholic is able to limp through daily life. There is a strong emotional bond created, and this bond leads to cravings, particularly in situations the patient associates strongly with alcohol. They may be brought on by moments of stress or joy, or they may consume the recovering alcoholic at seemingly random times. The cravings diminish over time as the alcoholic begins to build a new life without alcohol, but that sense of longing can persist in some form for a lifetime.
