Does this sound like psychosis, mania, or an extreme alcohol blackout?
My friend had a really weird and honestly scary episode a few nights ago and I'm trying to understand what could have caused it.
For some background, she has a history of substance abuse and has been through a lot of stress over the last few years. She's seen a psychiatrist before and has taken medication to help with alcohol cravings. The thing is, this doesn't happen every time she drinks. She drinks pretty often and most of the time she's completely normal. But every once in a while something switches and she becomes a completely different person.
A few nights ago she was on vacation in my town with her boyfriend. Earlier that evening she seemed super happy and was having a great time. Then she called me sounding extremely drunk and saying she needed to see me immediately. When I got there she was acting completely unlike herself. She was really loud, emotional, and her mood was changing rapidly. One minute she was happy, the next she was angry. Her pupils seemed unusually large and she had this distant, almost vacant stare that was really unsettling.
At a restaurant she became furious because our food was taking a while and started arguing with a waitress. This is very unlike her because she's normally polite to service workers and has worked as a waitress herself. The situation escalated to the point where the chef threatened to call the police, and my friend even ran into the kitchen.
After we left, I basically had to babysit her because she kept trying to run off and at one point was trying to jump in front of cars. She also lost a €500 bag and initially didn't care at all.
I eventually got her to my apartment for a bit before we planned to get her back to her hotel. While waiting for a taxi, another friend called to check on her and she got so angry that she threw her phone onto the pavement. Later, when her boyfriend mentioned her missing bag, she suddenly became obsessed with finding it, ran off, and disappeared. She was missing for about two hours with no phone. The next day she said the only thing she remembered was smoking weed with some tourists and kissing a random guy for a cigarette. She barely remembers the entire night and doesn't even remember me being there.
This isn't the first time something like this has happened. There have been previous incidents where she ended up lying in a puddle or dancing on top of a rental car while yelling at strangers.
One thing I've noticed is that these episodes always seem to start when she's in an unusually good mood. She's happy, energetic, social, and excited. Then she starts drinking and, occasionally, things go completely off the rails. I've never seen it happen when she's sad, depressed, or already upset.
Has anyone seen anything like this before? Does this sound more like an extreme alcohol blackout, substance-related issue, psychosis, mania, or something else? I'm just trying to understand what could cause someone to act so drastically different and then remember almost none of it afterward.