There is a close connection between the use of alcohol and the development of mental illnesses that cause delusions, even of a temporary nature. But it is also the case that those who are prone to these mental diseases are also those prone to abuse alcohol, hence exacerbating their symptoms, even when drinking only in moderation.

A delusion is a frame of mind that has little if any connection to the world of reality. It can take many forms. It can produce hallucinations. It can confabulate thinking, so false memories and false beliefs about the immediate environment are created. Imagination is substituted for memory. Delusions also can take the form of grossly distorted body images and interpretations of the intentions of others. Delusions can also create feelings of distress and senses of power and personal ability far beyond reality.

David Cooper, an internationally recognized specialist in substance abuse, holds that delusions are most closely associated with alcohol use when the patient is already prone to mental illness. Even more, mental illness is often a trigger for alcohol abuse. Those victims, such as people suffering from schizophrenia or bipolar disorder, are far more likely to develop temporary or even persistent delusions with alcohol use even over the short term.

The basic causes of delusional thoughts or behaviors concerning alcohol can be reduced to two. The first, that alcohol causes brain damage, that can, in turn, create mental illness.  Secondly, the withdrawal symptoms from alcohol can create delusions, especially of extreme anxiety and feelings of persecution and depression.

Interactions with antidepressants and antipsychotics are a serious problem for those seeking treatment for mental illness. These interactions can both increase the sedation effect of the drugs, which itself can possibly cause delusions. These interactions can also cause serious liver damage. The effect of drugs designed to treat mental disorders often lose their effectiveness when interacting with alcohol and even work against their original purpose.  

The basic effects of delusions derived from alcohol are suicidal thoughts and hallucinations. However, more practically, alcohol use among the mentally ill is often associated with resistance to treatment. Similarly, those who abuse alcohol without being mentally ill and who develop delusive behavior might also resist treatment due to the delusions. For example, instead of seeing potential caregivers as being friends, the delusional alcoholic might see them as persecutors out to humiliate them.



Cooper, David (2000). Alcohol Use. Radcliffe Medical Press.

“Delusional Disorder.” The Charming Health Therapy Consultation Center. (

“Alcohol-Induced Psychotic and Mood Disorders.” St. Louis Psychologists and Counseling Information and Referral Network. (