I’ve reached a similar conclusion with my brother. I’d found it puzzling his psychosis comes and goes often with drink in the picture. It’s very different than my experience with psychosis, but I drink very little. Lately it’s been happening seemingly in mid telephone conversation or voicemail message. In the space of a two minute message or phone call he can go from conciliatory and apologetic to raving and angrily threatening, punctuated with a hang up. And he’ll repeat this cycle over and over again, all through the night and into the morning. It’s so disruptive I’ve set up his number as a do-not-disturb between 10 pm and 7 am without remorse.
In reading up on later stage alcoholism many of his symptoms which he attributes to allergies, his “exceptional” version of bipolar disorder and “tiger blood”, align better with cirrhosis. He’s developed recurrent nosebleeds, insomnia, amnesia, “allergy attacks” resembling panic attacks, bizarre delusions seeking to explain these symptoms like extreme ragweed allergies in the dead of winter, Toluene poisoning from a printing factory, allergies to ingredients from a candle factory many miles away, etc etc.
Apparently as the liver begins failing, ammonia starts building up in the blood triggering brain disfunction, B-1 deficiencies interfere with brain function triggering Wernicke’s encephalopathy which brings temporary confusion, vision and movement issues and later memory issues of Korsakoff Syndrome. Together the Thiamine deficiency syndromes are called WKS, otherwise known as “wet brain”. All well and good to know all this, but the practical understanding we’ve gained is his answer to all his symptoms is to drink more, leading him to talk batshit crazy (to use my other brother’s technical term) with no end in sight, beyond seemingly death.