Bipolar disorder and alcoholism: Are they related?

Both conditions are harmful on their own, but when they happen together, the problems can be even worse. In someone who has bipolar disorder, drinking can increase symptoms of mood shifts. However, it may also be difficult to control the impulse to drink during shifts in mood. There isn’t much research that describes how to best combine treatment for bipolar disorder and AUD, but emerging recommendations from studies are available.

• 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.
• Similar rates of SUD were also reported in the Systematic Treatment Enhancement Program Bipolar Disorders (STEP BD) study including 3,750 Bipolar I or II patients (30).
• O’Sullivan and colleagues (1988) found that alcoholics with bipolar disorder functioned better during a 2-year followup period than did primary alcoholics (i.e., those without comorbid mood disorders) or alcoholics with unipolar depression.

Chronic alcohol consumption over a long period of time impairs the brain’s ability to control emotions well. bipolar disorder and alcohol Long-term alcohol abuse has a negative impact on cognitive performance, memory and decision-making. In people with bipolar disorder, this contributes to impaired mood regulation and recovery processes. The high prevalence of co-occurrence of bipolar disorder and alcoholism emphasises the underlying links. In bipolar and alcoholism, several factors explain this association, including self-medication, genetic influences and environmental stressors. Understanding this relationship is crucial for both individuals with bipolar disorder and their loved ones.

Challenges to Effective Treatment of Bipolar Disorder and Alcoholism

We’ll work as a team, empowering you to develop the skills to get a handle on your bipolar symptoms and manage your AUD. Despite the considerable public health significance of co-occurring BD and alcohol dependence, there are few effective pharmacotherapeutic interventions. Pharmacotherapy clinical trials for BD and those for alcohol dependence have often excluded co-occurring disorders in an attempt to reduce confounding variables.

With proper treatment, support, and commitment to self-care, individuals with bipolar disorder can successfully manage their condition and achieve lasting sobriety. The journey may be challenging, but the rewards of improved mental health and overall well-being are immeasurable. Alcohol consumption can disrupt the delicate balance of neurotransmitters in the brain, potentially triggering or intensifying mood episodes. For individuals with bipolar disorder, this can mean more frequent, severe, or prolonged manic or depressive episodes.

Prevalence of Co-occurrence

The unpredictability of the effects of alcohol complicates treatment strategies. The researchers found that patients in the complicated group had a significantly earlier age of onset of bipolar disorder than the other groups. They also found that the complicated and secondary groups had higher rates of suicide attempts than did the primary group. Preisig and colleagues (2001) also reported that the onset of bipolar disorder tended to precede that of alcoholism. They concluded that this finding is in accordance with results of clinical studies that suggest alcoholism is often a complication of bipolar disorder rather than a risk factor for it.

In younger patients, it appears that alcohol use and bipolar symptoms are more likely to increase or decrease in unison (64). An exploratory sub-analysis (65) examined the impact of depressive symptoms on craving and drinking behavior in 30 comorbid patients participating in a 8-week, placebo-controlled relapse prevention study (acamprosate vs. placebo). The analyzed subgroup of bipolar patients was well-stabilized on different mood stabilizers (antipsychotics, antiepileptics, or lithium). Severity of depression correlated significantly with craving and drinking behavior 1 week later. Supporting someone with alcohol abuse and bipolar disorder requires patience, empathy, and understanding. Understanding their symptoms and how they interact helps you offer informed support.

What is depression?

One of the most alarming consequences of alcohol use in bipolar disorder is the increased risk of suicide and self-harm. Alcohol can impair judgment, increase impulsivity, and exacerbate depressive symptoms, all of which contribute to a higher risk of suicidal thoughts and behaviors. Studies have shown that individuals with bipolar disorder who also struggle with alcohol use are at significantly higher risk for suicide attempts compared to those who do not use alcohol. The latter appears to be mainly driven by illicit drugs (OR 7.46 in BD-I and 3.30 in BD-II) (28). For AUD, however, a recent meta-analysis of 22 studies showed no difference between BD-I (OR 3.78) and BD-II (OR 3.81) (28). A recent catchment area study in Northeast England found a 40% lifetime comorbidity between BD II and AUD, surprisingly with little difference between female (38%) and male (43%) subjects (36).

Medications and alcohol

Furthermore, alcohol can interfere with the effectiveness of mood stabilizing medications, rendering them less effective in managing bipolar symptoms. Alcohol is a commonly consumed substance that can have significant effects on mental health. Understanding how alcohol impacts the brain and emotions is essential in comprehending its relationship with bipolar disorder. 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.

Of the 228 Bipolar probands, 75.4% (74% in bipolar I patients and 77% in bipolar II patients) fulfilled criteria for DSM-IV life time alcohol dependence. Bipolar disorder and alcoholism are complex conditions that often go hand in hand, making it difficult for those affected to find balance. However, with the right support, treatment, and understanding, recovery is possible.

Prevalence of Comorbidity

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. These programs often include a combination of medical management, psychotherapy, support groups, and holistic approaches to recovery. They may also offer family therapy and education, recognizing the impact that living with a bipolar spouse or family member can have on loved ones.

Alcohol can lead to substance use disorder

• For AUD, however, a recent meta-analysis of 22 studies showed no difference between BD-I (OR 3.78) and BD-II (OR 3.81) (28).
• It can trigger manic or depressive episodes, making it harder to stabilize mood.
• If alcohol consumption exacerbates bipolar symptoms or interferes with daily functioning, professional help is essential.
• It is important to recognize that addressing one condition in isolation may not lead to successful outcomes if the other condition remains untreated.
• Addictive behavior and alcohol and substance abuse are common among people with bipolar disorder.

The following obstacles can make successful treatment more difficult and require a personalised approach for addressing bipolar alcoholic traits, which is essential for lasting recovery. Cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT) teach you how to deal with mood swings, how to manage them and how to resist drinking. Long-term alcohol abuse accelerates cognitive decline and leads to memory impairment, reduced problem-solving ability and a poor ability to control emotions. Alcohol dependence and bipolar disorder create a cycle of addiction in which it is very difficult for those affected to maintain stability.

She advises patients to maintain consistency in their alcohol consumption, as well as in sleep, medication, and eating habits. This approach could help individuals resist pressures to drink excessively in social situations and focus instead on harm-reduction strategies. As a general rule, it seems appropriate to diagnose bipolar disorder if the symptoms clearly occur before the onset of the alcoholism or if they persist during periods of sustained abstinence. The adequate amount of abstinence for diagnostic purposes has not been clearly defined. Family history and severity of symptoms should also factor into diagnostic considerations. Given that bipolar disorder and substance abuse co-occur so frequently, it also makes sense to screen for substance abuse in people seeking treatment for bipolar disorder.