Bipolar Disorder and Alcohol: Effects, Risks, Management

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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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).

The Relationship Between Alcohol And Bipolar Disorder

The AUDIT is also recommended to screen comorbid individuals by several evidence- based guidelines, e.g., the German S3-Guidelines on AUD (49, 53). Because of this, people with both conditions may not get the full treatment they need at first. Even when researchers study bipolar disorder or AUD, they tend to look at just one condition at a time.

1. 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.
2. However, it is almost always better to treat the dual diagnosis at the same time rather than have the untreated illness bring back symptoms of the one that received treatment.
3. Hopelessness or feeling lost can occur, fluctuating to intense feelings of happiness, or numbness.
4. Manifestation of BD in children and adolescents is not as infrequent as previously assumed, with rates of bipolar spectrum disorder reaching an estimated 4%, especially in US samples (10).
5. The higher the high alcohol would bring, the lower the low a bipolar individuals mood would project onto daily life, yet for some it is all worth it.

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 what is salvia trip 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.

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.

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 na vs aa alcohol abuse as bipolar disorder.

Managing Alcohol Use with Bipolar Disorder: Strategies for Success

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Bipolar 2 disorder

Pediatric onset BD rarely occurs in the absence of comorbid conditions, and the co-occurrence of additional disorders complicates both the accurate diagnosis of BD and its treatment. Manifestation of BD in children and adolescents is not as infrequent as previously assumed, with rates of bipolar spectrum disorder reaching an estimated 4%, especially in US samples (10). Both bipolar affective disorder (BD) and substance use disorder (SUD) are wide-spread in the general population. Most epidemiological and treatment studies were conducted according to DSM-IV or ICD-10 criteria that distinguishes between substance abuse and dependence as diagnostic entities on its own. Depending on the diagnostic system (ICD or DSM) used and subject sample studied, bipolar affective disorder (BD) in the general population has a lifetime prevalence between 1.3 and 4.5% (1). The World Health Organization World Mental Health Survey Initiative (2) conducted across eleven countries reported a 4.8% lifetime prevalence of all manifestations of bipolarity, including subthreshold and spectrum disorder.

Side effects, including lethargy, weight gain, and tremors, were listed as the main reason for non-compliance with lithium (Weiss et al. 1998). 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.

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.

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.

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.

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 what is central nervous system depression group reports the highest prevalence for AUD (42%) followed by cannabis use (20%) and any other illicit drug use (17%) (21).

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.

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 as alcoholism, AUD occurs when alcohol consumption becomes a problem.