Author: Gary Jackson

Bipolar Disorder and Alcohol

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. Increased medication compliance with valproate may be an important factor in selecting a mood stabilizer for alcoholic bipolar patients. The treatment plan may also include regular monitoring of medication effectiveness and potential interactions with alcohol.

Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization. Although bipolar disorder can occur at any age, typically it’s diagnosed in the teenage years or early 20s. This may cause alcohol misuse and bipolar disorder each to trigger symptoms of the other condition.

Risk factors

IGT (Weiss & Connery, 2011), based primarily on cognitive-behavioral therapy principles, is designed to serve as an adjunct to BD pharmacotherapy by focusing on the two disorders simultaneously, with a particular emphasis on their relationship. The first is the “single-disorder paradigm,” in which patients are encouraged to think of themselves as having a single disorder, i.e., “bipolar substance abuse,” rather than trying to tackle two discrete disorders at once. Thinking of themselves as having a single disorder aids in the process of acceptance. 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. Research indicates a person will experience a decrease in functioning, an exacerbation (worsening) of manic or depressive symptoms, and a higher risk of suicide when these conditions co-occur.

• Let’s explore the relationship between alcohol and mental health in the next section.
• Understanding the impact of alcohol on bipolar disorder is crucial for individuals and their support systems.
• When coupled with alcohol use disorder, symptoms of either condition may worsen.
• This makes it challenging to achieve stability and effectively manage bipolar disorder symptoms.

The medications most frequently used for treating bipolar disorder are the mood stabilizers lithium and valproate. As stated previously, preliminary evidence suggests that alcoholic bipolar patients may have more rapid cycling and more mixed mania than other bipolar patients. 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. Available research on the use of lithium, valproate, and naltrexone for comorbid patients is reviewed below. Because evidence suggests that active drinking may worsen bipolar symptoms, it makes sense that medications designed to decrease alcohol consumption may be useful in bipolar alcoholics. Naltrexone (ReVia™) is an FDA-approved medication designed to decrease cravings for alcohol.

Managing Alcohol Use and Bipolar Disorder

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. Alternatively, symptoms of bipolar disorder may emerge during the course of chronic alcohol intoxication or withdrawal. Still other studies have suggested that people with bipolar disorder may use alcohol during manic episodes in an attempt at self-medication, either to prolong their pleasurable state or to sedate the agitation of mania. Finally, other researchers have suggested that alcohol use and withdrawal may affect the same brain chemicals (i.e., neurotransmitters) involved in bipolar illness, thereby allowing one disorder to change the clinical course of the other.

• The authors concluded that naltrexone was useful in treating patients with comorbid psychiatric and alcohol problems.
• Stay with us to gain a comprehensive view of the risks and consequences that alcohol poses for individuals with bipolar disorder.
• In conclusion, it appears that alcoholism may adversely affect the course and prognosis of bipolar disorder, leading to more frequent hospitalizations.
• BD is a highly genetic disorder, with a family history in about 80% of patients.
• Moreover, substance abuse, including alcohol misuse, can complicate the treatment process.

Some evidence is available to support the possibility of familial transmission of both bipolar disorder and alcoholism (Merikangas and Gelernter 1990; Berrettini et al. 1997). Common genetic factors may play a role in the development of this comorbidity, but this relationship is complex (Tohen et al. 1998). Preisig and colleagues (2001) conducted a family study of mood disorders and alcoholism by evaluating 226 people with alcoholism with and without a mood disorder as well as family members of those people.

Research on Integrated Group Therapy

Combining alcohol with psychosis increases the risk of mental and physical complications. The person may experience hallucinations, or they may believe that they are very important, that they are above the law, or that no harm can come to them, whatever they do. Consuming alcohol during a depressive phase can increase the risk of lethargy and can further reduce inhibitions.

• It can be difficult to get the medication right with bipolar disorder because each person is different and may respond differently to medications.
• In 2011, researchers noted that alcohol misuse can result in a misdiagnosis of bipolar disorder.
• Alcohol abuse can have a detrimental effect on treatment outcomes for bipolar disorder.

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. Both tend to occur more frequently in people who have a family member with the condition. Alcohol use disorder (AUD) and bipolar disorder often occur together, and when they do, they can exacerbate each other.

Treatment of Comorbid Bipolar Disorder and Alcoholism

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.

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. As a result, there is a limited literature that clinicians can draw upon when treating patients with co-occurring BD and alcohol dependence. Weiss et al. (2007) then conducted a randomized controlled study in which IGT was compared to an active control condition, Group Drug Counseling (GDC) (Daley et al., 2002).