Bipolar Disorder and Alcohol Use Disorder: A Connection?

All that’s needed for a diagnosis of bipolar I disorder is the development of a manic episode. These episodes may be so severe that they require hospitalization in order to stabilize. To receive a diagnosis of bipolar 1 disorder, you must have experienced at least one episode of mania. This episode may precede or follow an episode of depression, but isn’t necessary. On the other hand, people who receive a diagnosis of bipolar disorder first are more likely to have difficulty with the symptoms of AUD.

Alcohol and mood stabilizers, for instance, can lead to increased sedation, impaired cognitive function, and reduced effectiveness of the medication. 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.

Grasping the nuances of the types of bipolar disorder — and how alcohol can distinctly impact each — is crucial in making informed decisions. Bipolar disorder, formerly known as manic depression, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These episodes can significantly impact a person’s ability to function, think, and relate, leading to other serious health concerns. Persistent neurocognitive deficits (Balanzá-Martínez et al., 2005) likely result from the combination of genetic and environmental risk factors, as well as neurodevelopmental and neuroprogressive processes (Goodwin et al., 2008). Subsyndromal depressive symptoms, comorbidites and side effects of medications may compound and further worsen these deficits yet cannot fully explain them (Balanzá-Martínez et al., 2010). Thus, there is growing evidence that the presence of a concomitant alcohol use disorder may adversely affect the course of bipolar disorder, and the order of onset of the two disorders has prognostic implications.

Neuroscience of Alcohol

A growing number of studies have shown that substance abuse, including alcoholism, may worsen the clinical course of bipolar disorder. Sonne and colleagues (1994) evaluated the course and features of bipolar disorder in patients with and without a lifetime substance use disorder. Although this association does not necessarily indicate that alcoholism worsens bipolar symptoms, it does point out the relationship between them. Although researchers have proposed explanations for the strong association between alcoholism and bipolar disorder, the exact relationship between these disorders is not well understood. One proposed explanation is that certain psychiatric disorders (such as bipolar disorder) may be risk factors for substance use.

If you have any symptoms of depression or mania, see your healthcare or mental health professional. A mental health professional with experience in bipolar disorder can help you get your symptoms under control. People who have a diagnosis of both bipolar disorder and alcohol dependence will need a special treatment plan. In the past, researchers have noted that symptoms of bipolar disorder appear as a person withdraws from alcohol dependence. Some scientists have suggested that alcohol use or withdrawal and bipolar disorder affect the same brain chemicals, or neurotransmitters. Addictive behavior and alcohol and substance abuse are common among people with bipolar disorder.

Alcohol and symptoms of bipolar disorder

Bipolar disorder and substance abuse can create a feedback loop, each condition exacerbating the other and making treatment more challenging. Children and teens may have distinct major depressive or manic or hypomanic episodes. Another study by the same research group focused on cognition during the course of early remission from a severe mood episode (Levy et al., 2012). This 3-month, follow-up study compared 21 BD patients with AUDs in the previous year and 34 BD patients without a history of SUDs. Dually diagnosed patients performed worse on measures of verbal memory, visual memory, and executive functioning on both assessments and showed a poorer neurocognitive recovery relative to those without SUDs. These findings underscore the special needs of BD-AUD patients in terms of intensive treatment and support aimed to achieve early recovery after relapses.

There is a lot that we still need to understand about the link between alcohol and depression, and this is an emerging area of research. Existing research indicates that depression can cause alcohol overuse, and alcohol overuse can cause depression. On the other hand, both conditions also share certain risk factors, such as genetics and social isolation. Having either depression or alcohol use disorder increases your risk of developing the other condition. This study was limited by several aspects of the PLS-BD protocol and overall participant demographic makeup. First, this study was naturalistic in design, and therefore it is unclear whether specific types and timing of treatment (eg, medication changes and therapy) changed the longitudinal dynamics of alcohol use, mood, and functioning.

When you stop using drugs and alcohol your body and mind go into withdrawal. Since the brain does not have normal levels of dopamine you may experience manic episodes or depression. If this is left untreated and substance abuse continues you can develop bipolar disorder. Individuals with BDII exhibited higher autocorrelation in AUDIT scores, indicating that greater alcohol use in this group was more likely to persist over time.

Bipolar disorder and alcoholism: Are they related?

1. Treating both bipolar disorder and substance use disorder could help relieve or reverse some detrimental side effects.
2. Please list any fees and grants from, employment by, consultancy for, shared ownership in or any close relationship with, at any time over the preceding 36 months, any organisation whose interests may be affected by the publication of the response.
3. A bipolar diagnosis is described as type 1 or 2, depending on the severity of symptoms.
4. However, this self-medication approach often backfires, leading to a vicious cycle of worsening symptoms and increased alcohol dependence.

The journey may be challenging, but the rewards of improved mental recovery games for groups health and overall well-being are immeasurable. Moreover, alcohol use can make it difficult for healthcare providers to accurately diagnose and treat bipolar disorder. The symptoms of alcohol abuse and withdrawal can closely mimic those of bipolar disorder, potentially leading to misdiagnosis. In some cases, alcoholism may be misdiagnosed as bipolar disorder, or vice versa, complicating treatment efforts and delaying appropriate care. One of the most significant risks is the effect of alcohol on bipolar medication. Many medications used to treat bipolar disorder, including mood stabilizers and antidepressants, can interact dangerously with alcohol.

“The reasons behind our findings likely have more to do with what alcohol and social situations involving alcohol do to a person’s circadian rhythms and brain-based reward circuits, not just the action of the substance in the brain,” said Sperry. The findings were seen even in people who were not engaging in binge drinking, drinking with high intensity or frequency, or experiencing impairment related to their alcohol use. 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.

Major depressive episode

According to these authors, clinical staging may provide a more holistic approach to dual BD patient’s problematic areas, including neurocognitive dysfunctions. Here we suggest that BD-AUD may similarly benefit from the application of another holistic perspective—systems biology. 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.