Author: James Anderson

Bipolar Disorder and Alcohol

By fostering understanding, empathy, and awareness, we can create a supportive environment for individuals living with bipolar disorder and alcohol concerns. It is essential to offer appropriate resources, combat stigma, and advocate for comprehensive care that addresses the unique challenges posed by this dual diagnosis. Alcohol dependence is also highly genetic (Mayfield et al., 2008), and a wide range of studies confirm that association (Kendler et al., 2009). Bipolar disorder (BD) and alcohol use disorder (AUD) are independently a common cause of significant psychopathology in the general population.

The causes of alcohol-induced bipolar disorder are not well understood, but it is believed that alcohol’s impact on neurotransmitters in the brain, particularly dopamine and serotonin, plays a significant role. Alcohol-induced bipolar disorder can be challenging to diagnose accurately, as it requires observing the individual’s symptoms in the absence of alcohol use. Alcohol, when introduced into the life of an individual with bipolar disorder, can have a profound impact on the course and severity of the illness. Let’s explore the various ways in which alcohol can interact with bipolar disorder. In summary, only few psychotherapeutic interventions have been studied in a randomized study design and mostly only by one research group.

Alcohol and symptoms of bipolar disorder

One of the benefits of residential treatment is that the program will evaluate you thoroughly, so that all issues are diagnosed. You can then work with the facility’s staff of experts to manage bipolar disorder and your drinking, as well as any other issues. An outpatient program doesn’t necessarily have the resources or experts to address all of your needs.

Let’s explore some strategies and resources that can help individuals with bipolar disorder and alcohol concerns navigate this complex relationship. Understanding the link between alcohol abuse and bipolar symptoms is crucial in highlighting the importance of addressing both issues concurrently. Treating bipolar disorder without addressing alcohol abuse leaves a significant gap in the recovery process, potentially compromising the individual’s overall well-being and stability. The FIRESIDE Principles for an integrated treatment of bipolar disorder and alcohol use disorder.

Also, having both conditions makes mood swings, depression, violence and suicide more likely. If you or someone you care about has bipolar disorder and is struggling with drinking, take steps to get help as soon as possible. Even if you don’t think you have an alcohol use disorder, drinking while living with this condition is risky. Seek treatment for bipolar disorder and talk to your doctor or therapist about drinking and how to stop.

Understanding Bipolar Disorder

Additionally, alcohol can interact negatively with specific medications, intensifying their sedative properties or increasing the risk of liver toxicity. 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). Carbamazepine has been traditionally used in acute alcohol withdrawal to reduce the risk of seizures and ameliorate physical symptoms. However, there are no reliable data whether it is of any usefulness in the long-term treatment of BD + AUD.

The coexistence of alcohol and bipolar disorder comes with a myriad of risks and consequences that can have a significant impact on an individual’s mental and physical well-being. Let’s explore these risks and shed light on the potential dangers that arise when alcohol and bipolar disorder intersect. Additionally, alcohol consumption during a manic episode can disrupt sleep patterns, aggravate irritability, and exacerbate feelings of restlessness and agitation. The combination of alcohol and bipolar mania creates a volatile mix that can result in emotional volatility and unpredictable behavior. If the AUD commences before the BD, then one hypothesis for the comorbidity would be that the AUD activates a predisposition towards BD in that subgroup; although there is no genetic or familial evidence for this (Maier and Merikangas, 1996). The other hypothesis, namely that patients with BD use alcohol to self-medicate their mood symptoms, or drink a result of their tendency towards impulsive behaviours, may also apply (Swann et al., 2003).

1. With the right support, resources, and treatment tailored to address both bipolar disorder and alcohol use, individuals can navigate this delicate balance and work towards stability, improved mental health, and an enhanced quality of life.
2. A person who consumes alcohol during a manic phase has a higher risk of engaging in impulsive behavior because alcohol reduces a person’s inhibitions.
3. Through professional guidance, therapy, medication management, support systems, and self-care practices, individuals can forge a path towards recovery.
4. There are many reasons to avoid drinking if you have bipolar disorder, including the potential interactions with medications.

We will also examine how alcohol can worsen bipolar disorder and even induce alcohol-induced bipolar disorder. Acamprosate has also been evaluated in an open-label trial and a randomized controlled trial. No statistically significant treatment differences were detected in drinking or mood outcomes. Post-hoc analysis showed that acamprosate treatment resulted in lower Clinical Global Impression scores of substance abuse severity in the last two weeks of the trial (Tolliver et al., 2012).

Medications for anxiety, antidepressants, anticonvulsants used as mood stabilizers, mood stabilizers, and antipsychotics may interact with alcohol. Alcohol use disorder (AUD) and bipolar disorder often occur together, and when they do, they can exacerbate each other. BD is a highly genetic disorder, with a family history in about 80% of patients. Researchers haven’t identified a clear link between bipolar disorder and AUD, but there are a few possibilities. Impulsivity (not thinking before acting) and engaging in risky situations that may lead to painful consequences can accompany mania.

Comorbidity of Bipolar Affective Disorders in Alcohol Use Disorder Patients

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). In the meantime, DSM-5 (11) abolished the distinction between substance use, abuse and dependency by defining threshold numbers of criteria for different grades of severity of substance use. Of the 11 criteria, 2–3 should be fulfilled to diagnose mild alcohol use disorder (AUD) (12). Also, BD criteria experienced some adaptions with yet speculative consequences for epidemiological figures.

As a result of this process, a number of evidence-based psychotherapies have been developed for BD and for alcohol dependence. Similarly, motivational enhancement therapy, twelve-step facilitation therapy, and cognitive-behavioral relapse prevention therapy have all been shown to be effective in the treatment of alcohol dependence (Project MATCH Research Group, 1997). As a result, little psychotherapy research has focused on patients with co-occurring BD and alcohol dependence. Gender differences have a significant influence on treatment outcomes in BD (58) but not as much on outcomes in alcohol dependence (59).

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). Bipolar disorder is defined by mood episodes that fluctuate between highs and lows. When coupled with alcohol use disorder, symptoms of either condition may worsen. There are a variety of treatment options, including talk therapy and medication, to treat these conditions separately or as they co-occur. Although not a formal diagnosis, during a manic episode, people with bipolar disorder can have a “bipolar blackout,” which means they have trouble remembering their actions. During a bipolar blackout, a person may engage in behavior that is impulsive or risky.