Alcohol and Depression: Understanding the Connection

Alcohol use can worsen symptoms of depression, mania, or hypomania if you have bipolar disorder. Understanding what alcohol does to your condition and discussing it with your doctor can help you maintain better health and well-being. However, taking the first step toward getting help can make bipolar disorder and alcohol a huge difference. There are effective treatments and resources available that focus on managing both conditions together.

• Patients who are fully manic often require hospitalization to decrease the risk of harming themselves or others.
• As a result, a person with bipolar disorder may not get the correct treatment that can relieve their symptoms.
• Prolonged alcohol consumption increases the risk of liver disease, cardiovascular problems and a weakened immune system.
• The AUDIT is also recommended to screen comorbid individuals by several evidence- based guidelines, e.g., the German S3-Guidelines on AUD (49, 53).
• The successful treatment of people diagnosed with bipolar disorder who also struggle from alcoholism requires an integrative approach to both disorders.

Treatment for bipolar disorder and alcohol use disorder

Symptoms of AUD and SUD may often obscure an underlying diagnosis of BD, and frequently result in a long delay before a BD diagnosis has been established by careful clinical observation. Brown et al. reported rates of SUDs in patients with BD ranging from 14 to 65% in treatment settings (48) but only a minority has received a correct diagnosis so far. Given the high incidence of psychiatric comorbidities in AUD, the German S3 Guideline recommend in every patient with AUD to carefully screen for psychiatric comorbidities after completing treatment of acute intoxication or withdrawal (49). Whereas, the incidence of BD across countries and cultures is within a similar range, reported rates for AUD differ considerably due to cultural and religious diversity. For example, a representative household survey in Iran found a 12-month prevalence of alcohol use disorders of 1% according to DSM-IV criteria and 1.3% according to DSM-5, with higher prevalence rates in urban vs. rural areas (8).

Drinking alcohol on bipolar medication

Having either depression or alcohol use disorder increases your risk of developing the other condition. Studies have consistently demonstrated a higher prevalence of alcohol use disorders among individuals with bipolar disorder compared to the general population. Research estimates suggest that approximately 30% to 60% of individuals with bipolar disorder also experience alcohol use disorders at some point in their lives.

These factors can lead to a cycle of worsening symptoms and decreased treatment efficacy, making it more challenging for individuals with bipolar disorder to achieve and maintain stability. Specialized dual diagnosis or co-occurring disorder programs address both bipolar disorder and alcohol use together. These programs often provide a multidisciplinary team — including psychiatrists, therapists, and addiction specialists — to ensure all aspects of the person’s well-being are addressed. Cyclothymia, or cyclothymic disorder, involves chronic fluctuations between milder depressive symptoms and hypomanic symptoms for at least two years (one year in children and adolescents). While these shifts may not meet the full criteria for mania or major depression, the pattern still disrupts daily life and can lead to emotional instability.

The Role of Alcohol in Triggering Bipolar Episodes

Alcohol consumption can lead to feelings of depression due to chemical reactions. In the short term, drinking alcohol can make you feel good, sociable, and even euphoric. If you have bipolar II, it’s essential to make careful decisions about drinking and to keep an open dialogue about use with a healthcare provider. Bipolar disorder and AUD share several symptoms, and if you’re living with both conditions, they often overlap. This can exacerbate your symptoms to a much greater extent than they would be if you had only one condition. BD is a highly genetic disorder, with a family history in about 80% of patients.

Depressive symptoms and alcohol

This chapter deals with the intermediate and long-term treatment of comorbid BD and AUD. We do not recap acute treatments for detoxification or delirium on one side, and mania or severe depression on the other side. These acute treatments are symptom-orientated, rarely different in comorbid vs. non-comorbid patients and depend on the predominant symptomatology (affective vs. addictive) that needs attention first. For intermediate and long-term treatment, the dogma persisted for a long time that AUD needs to be treated first and sufficiently before attention should be paid to the mental health disorder. Today, strategies that promote concomitant therapy of dual disorders are the established treatment of choice (80) and recommended in major guidelines (81). However, treatment adherence and compliance remain a challenge in this special group, since medications are often not taken as prescribed (61) and psychotherapy appointments are often missed.

• Relying on these support structures and actively working to overcome challenges in recovery helped John W.
• If you’re supporting someone, remember to educate yourself, encourage them to get help, and be there to listen without judgment.
• It affects millions of people worldwide, causing disruptions in daily life, relationships, and overall functioning.
• The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose.

We’ll examine the research findings and potential reasons behind this comorbidity. Additionally, we’ll explore how alcohol interacts with medications used to manage bipolar disorder, and the potential implications for treatment. Yes, alcohol can trigger episodes of bipolar disorder by disrupting neurotransmitter balance and mood regulation, increasing the risk of manic or depressive episodes. Dual diagnosis requires appropriate assessment to differentiate between primary bipolar symptoms and substance-induced mood disorders. Chronic alcohol consumption exacerbates depressive episodes by increasing withdrawal, the tendency to self-harm and suicidal thoughts. It may also deepen depressive phases, potentially resulting in a presentation similar to alcohol induced bipolar disorder ICD 10.

However no difference in prognosis was found when subjects were divided by which disorder came first (Farren et al., 2011). The relationship between alcohol and bipolar mania is particularly concerning. Alcohol can trigger manic episodes in individuals with bipolar disorder, leading to increased risk-taking behavior, impulsivity, and poor decision-making. During manic episodes, individuals may be more likely to engage in excessive drinking, creating a dangerous cycle of escalating symptoms and substance abuse. Multiple explanations for the relationship between these conditions have been proposed, but this relationship remains poorly understood. Alcohol use may worsen the clinical course of bipolar disorder, making it harder to treat.

Will the Online Safety Act protect young people’s mental health?

In conclusion, it appears that alcoholism may adversely affect the course and prognosis of bipolar disorder, leading to more frequent hospitalizations. In addition, patients with more treatment-resistant symptoms (i.e., rapid cycling, mixed mania) are more likely to have comorbid alcoholism than patients with less severe bipolar symptoms. If left untreated, alcohol dependence and withdrawal are likely to worsen mood symptoms, thereby forming a vicious cycle of alcohol use and mood instability. However, some data indicate that with effective treatment of mood symptoms, patients with bipolar disorder can have remission of their alcoholism.

If you have bipolar disorder, AUD, or both, talk to your doctor about treatment options that will work for you. You also must have experienced one or more hypomanic episodes lasting for at least 4 days. Table 1 supplies an overview of double-blind, randomized pharmacological studies for comorbid bipolar affective and AUDs, based on a systematic PubMed search. Overall, the mix of alcohol and bipolar disorder can create a dangerous cycle of instability.

In neuroimaging studies, there are a number of areas of interest in BD and indeed in AUD that have emerged in different studies in different populations. Have identified areas including the pre-frontal cortex, the corpus striatum and the amygdala as being abnormal in early BD, potentially predating illness (Chang et al., 2004, Strakowski et al., 2005b). Abnormalities in the cerebellar vermis, lateral ventricles, and some prefrontal areas may develop with repeated affective episodes, and may represent the effects of illness progression (Strakowski et al., 2005b).

Some people use alcohol as a way to cope with the symptoms of depressive episodes, while others may misuse alcohol during manic periods when they have less impulse control. The interplay between alcohol consumption and BD is complex and unique to each person. Alcohol misuse can significantly worsen symptoms of bipolar disorder and potentially cause the development of additional mental health disorders. In conclusion, the combination of bipolar disorder and alcohol use presents significant challenges, but with proper understanding, treatment, and support, these challenges can be overcome. By recognizing the risks, seeking help when needed, and committing to a healthy lifestyle, individuals with bipolar disorder can navigate the complex landscape of mental health and substance use, working towards a more stable and fulfilling life.

A second key concept underlying IGT is a focus on common features in the recovery and relapse process in the two disorders. Patients are told that the same kinds of thoughts and behaviors that will facilitate their recovery from one disorder will also aid in the recovery process from their other disorder. Conversely, thoughts and behaviors that may increase the risk of relapse to one disorder will similarly elevate their chances of relapse to the other disorder.