Bipolar Disorder and Alcohol: Effects, Risks, Management

This article explains the relationship between bipolar disorder and alcohol and discusses treatment strategies. Providers may treat bipolar disorder and alcohol use disorder sequentially (one before the other), independently (by themselves), or using an integrative approach (together). Proposed treatment and support algorithm for patients with comorbid AUD and BD. People who suffer from bipolar disorder often feel out of control or out of touch with their life. Unsure of what to do or how to feel when an episode occurs make turning to alcohol a very appealing solution in relieving these mind-numbing symptoms. Both bipolar disorder and alcohol consumption cause changes in a person’s brain.

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. Like a volatile cocktail, the combination of bipolar disorder and alcohol consumption creates a dangerous mixture that can amplify symptoms, complicate treatment, and lead to dire consequences for those affected.

Bipolar 2 Disorder

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2. Severity of depression correlated significantly with craving and drinking behavior 1 week later.
3. Patients who are fully manic often require hospitalization to decrease the risk of harming themselves or others.
4. All condition, treatment and wellness content is medically reviewed by at least one medical professional ensuring the most accurate information possible.
5. There is also evidence to suggest that these subtypes of bipolar disorder have different responses to medications (Prien et al. 1988), which would help provide a rationale for the choice of agents in the alcoholic bipolar patient.

A controlled study suggested a reduction of alcohol consumption with ondansetron (126). The use or digital media and “blended care” is likely to increase in the future across treatment settings and will facilitate diagnosis and treatment of mental disorders including comorbid conditions. It’s usefulness in BD patients comorbid with AUD, however, still needs to be further investigated. Are you or a loved one struggling with addiction to alcohol and bipolar disorder?

Understanding bipolar disorder

BD and SUD are afflicted with high rates of suicide attempts and suicide that are even topped in case of coexistence of both disorders (24). A Brazilian study reports of at least one suicide attempt in 68% of BD patients with AUD compared to 35% in BD without AUD, with virtually no difference between BD patients with DSM-IV alcohol abuse and dependence (23). It’s important to note that can alcohol cause bipolar disorder is a question that often arises. While alcohol abuse doesn’t directly cause bipolar disorder, it can trigger the onset of symptoms in individuals with a genetic predisposition to the condition. Additionally, chronic alcohol use can lead to changes in brain chemistry that may increase vulnerability to mood disorders.

Fortunately, treatment for co-occurring bipolar disorder and AUD is available. If you or someone you know is struggling with either condition, seek professional help immediately. Also known long covid alcohol intolerance as alcoholism, AUD occurs when alcohol consumption becomes a problem.

What Is the Connection Between Bipolar Disorder and Alcohol Use Disorder?

It can be difficult to get the medication right with bipolar disorder because each person is different and may respond differently to medications. People with bipolar disorder often use medications to stabilize their symptoms. Bipolar disorder is already difficult to diagnose, as it can share symptoms with other conditions, including attention-deficit hyperactivity disorder (ADHD), schizophrenia, and depression. This may cause alcohol misuse and bipolar disorder each to trigger symptoms of the other condition. The effects of bipolar disorder vary between individuals and also according to the phase of the disorder that the person is experiencing.

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Bipolar 1 is characterized by at least one episode of mania that lasts at least one week, or by manic symptoms that require hospitalization. Alcohol use disorder (AUD) and bipolar disorder often occur together, and when they do, they can exacerbate each other. Table 1 supplies an overview of double-blind, randomized pharmacological studies for comorbid bipolar affective and AUDs, based on a systematic PubMed search. A controlled study with topiramate in BD + AUD failed due to slow recruitment (114). If you or a loved one is ready to overcome an alcohol addiction, reach out today. Treatment providers can connect you with programs that provide the tools to help you get and stay sober.

The NIH estimates that about 42% of people how to quid salvia with bipolar disorder also have an alcohol use disorder. Living with bipolar disorder may increase the risk of having an alcohol use disorder. Also, if you have bipolar disorder, alcohol use of any amount may affect your health. There is also a greater risk of suicide in individuals who have bipolar disorder and alcohol use disorder.

Except from few specialized long-term inpatient settings for comorbid patients (89) the emphasis of all treatment concepts is on outpatient settings as behavioral changes and building up resilience is a long process in both disorders. The German S3 Guidelines for AUD recommend that both disorders, BD and AUD, should be treated in one setting and by the same therapeutic team (49, 81). If not feasible, a close coordination of therapies, e.g., by means of a case manager, should be established. Many of those suffering from bipolar disorder turn to alcohol to suppress the symptoms the disorder comes with. Medicine can be prescribed to reduce the uncontrollable state experienced, reducing the motivation to drink alcohol as a coping mechanism. Additionally, many bipolar medications react very negatively with alcohol, causing effects such as intense hangovers and vomiting.

Side effects, including lethargy, weight gain, and tremors, were listed as the main reason for non-compliance with lithium (Weiss et al. 1998). steve harwell liver disease However, it is also important to note that prescription bottles for lithium usually have a warning label on them not to drink alcohol while taking the medication. Thus, if an alcoholic has the choice between taking lithium or drinking alcohol, it is very likely the alcoholic will not be compliant with lithium.

Other guidelines, e.g., the Canadian Network for Mood and Anxiety Treatments (CANMAT) do not recommend CBT but rather the integrated group therapy (IGT) developed by Weiss and colleagues which includes CBT and psychoeducation components. IGT has been studied in a pilot study (92) and 2 separate RCTs (93, 94) comparing it with either group drug counseling or no treatment. This manualized program with 20 weekly group sessions demonstrated effectiveness both for the prevention of alcohol and bipolar relapses (93) even at 8-month follow-up. A slimmed version with twelve sessions, developed by the same group, also demonstrated effectiveness (94).

Alcohol use disorder and bipolarity significantly influence each other’s severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity. The role of genetic factors in psychiatric disorders has received much attention recently.

If you have bipolar disorder and alcohol use disorder or another addiction, you have what’s known as a dual diagnosis. You may need to see a mental health professional who is an expert in treating both disorders. Bipolar disorder and alcohol use disorder (AUD) often co-occur, making it challenging to manage both conditions. Alcohol can worsen bipolar symptoms and reduce the effectiveness of medications. Only a few mental health disorders are as closely linked to alcohol abuse as bipolar disorder.

Among mental health disorders, BD has probably the highest risk of having a second, comorbid DSM -IV axis I disorder (26). The already cited WHO census across 11 countries showed a mean SUD life time comorbidity with BD of 36.6% with a large variation between countries (2). A meta-analysis including nine national surveys conducted between 1990 and 2015 revealed a mean prevalence of 24% for AUD and of 33% for any SUD except nicotine (28). Analyzing SUD and bipolar comorbidity in clinical settings, the same group reports the highest prevalence for AUD (42%) followed by cannabis use (20%) and any other illicit drug use (17%) (21).