Health sites like this list similar symptoms for Alcohol Withdrawal Syndrome (as opposed to Delerium Tremens) thus:
But none explain the mechanics of what is happening to the brain. Anyone know?
I am far from an expert on this but …
It is my understanding that alcohol has two main neurological effects. There is a strong and rapid but relatively short term sedative effect. And there is a weaker but persistent agitation of the nervous system that lasts far longer than the sedation.
Long time and regular consumption of alcohol masks the agitation with the sedation. When the alcohol intake stops, the agitation comes to the forefront.
At least it is plausible.
PS. I think that the shakiness and sweats are mild DT’s. And DT’s by the way are not funny but rather are considered a life-threatening condition.
If you want to be specific, alcohol works by modifying GABA A subtype A receptors so that the gates are more open. GABA is one of the primary inhibitory neurotransmitters in the brain so this tends to slow the rate of fire for neurons in many different parts of the brain. This is a large reason why alcohol is a depressant. It has a sedative effect on the CNS via this mechansim.
When alcohol is removed from someone that has become dependent on it, the inhibitory mechanism is taken away. Many different CNS systems have become so dependent on having an inhibitory mechanism acting on them that the neurons have compensated by becoming more excitatory, or easier to fire than they normally would. When GABA A subtype A channels are no longer in hyperdrive because of alcohol exposure, they become hyperexcitable.
This leads to the stimulatory effects that you see in withdrawal. Nervousness, and sweating are caused by overarousal of the symathetic nervous system. Other parts of the brain become so excitable that they can lead to DT and death in some cases.
I have a friend who NEEDS to read this. Thank you very much, Shagneasty.
Hmm, extra letters. What is that a sign of? :o
From a functional standpoint, think of it this way: alcohol is a general depressant to brain tissue. When faced with chronic alcohol intake, the brain adjusts to the presence of the alcohol by ratcheting up its general excitation level to compensate. When you suddenly stop drinking, the brain remains in a state of hyperexcitation for a few days or so, because it takes some time to return to its pre-alcohol level of normal activity. This hyperexcitation manifests itself with varying degrees of nervousness/anxiety, sleeplessness, rapid heart rate, high blood pressure, et cetera. This may progress to seizures, circulatory collapse, and death in cases of severe alcohol dependency. This state of severe alcohol withdrawal is called delerium tremens. Few people die this way these days because alcohol withdrawal withdrawal is 100% treatable in the hospital, and DTs can be abolished with adequate levels of intravenous sedation.