Alcohol Use Linked to Increased Bipolar Disorder Symptoms

People who struggle with any substance use disorder and have bipolar are less likely to stick with their treatment. It’s important to be aware of this connection if you struggle with bipolar disorder. It may be tempting to drink in order to manage symptoms and mood changes, but the risks are high.

Depression and Bipolar Disorders in Patients With Alcohol Use Disorders

Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40–70%, both for Bipolar I and II disorder, and with male preponderance. 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 weed and ecstasy these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability.

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

Neuroscience News is an online science magazine offering free to read research articles about neuroscience, neurology, psychology, artificial intelligence, neurotechnology, robotics, deep learning, neurosurgery, mental health and more. For instance, patients who see alcohol as a tool to get to sleep or calm anxiety may be best off focusing on keeping their alcohol use low and stable, and avoid bingeing. Others may see the new findings as important for resisting peer pressure central nervous system (cns) depressants to binge drink during social situations. Findings may aid patients and their clinicians to have conversations about abstaining from alcohol vs. engaging in harm reduction strategies, Sperry notes. People with an SUD may go through periods when they don’t feel or seem like themselves. In addition to behavioral changes from the effects of the substance, psychological and physical dependence on a substance can impair someone’s judgment and decision making skills.

Consequences of Comorbidity

This is one good reason to consider residential care for comorbid substance abuse and bipolar disorder. A residence provides a safe place to stabilize on the appropriate medications. There are many reasons to avoid drinking if you have bipolar disorder, including the potential interactions with medications. Therapy and other treatment strategies are important in managing bipolar disorder, but so is medication. Antidepressants, mood stabilizers, antipsychotics, and other drugs help manage symptoms and reduce the frequency and severity of mood cycles. Because of this, people with both conditions may not get the full treatment they need at first.

1. All of them complete measures of mood symptoms, life functioning, alcohol use and more every 2 months throughout their involvement in the study.
2. Table 1 supplies an overview of double-blind, randomized pharmacological studies for comorbid bipolar affective and AUDs, based on a systematic PubMed search.
3. A controlled study suggested a reduction of alcohol consumption with ondansetron (126).
4. They hijack the brain’s ability to modify connections in the mind and reroute those connections to home in on the pleasurable effects of a drug at the expense of all other functions.

Caffeine is an underappreciated bipolar trigger and can also impair sleep, he says, which can be particularly problematic because sleep deprivation is a notorious trigger for bipolar mood swings and mania. Alcohol has frightening effects on bipolar depression and bipolar depression medication. When you choose not to use alcohol, you improve your experience with bipolar depression, and you help your medications work.

Diagnosing Bipolar Disorder and Alcohol Addiction

The evidence base for suitable psychotherapies in comorbid BD and AUD remains poor. The German S3 Guidelines for AUD (49) recommends cognitive behavioral therapy (CBT) as the best evidenced modality whereas there is no recommendation for other psychotherapies due to insufficient data. You may be more likely to experience manic symptoms when you’re actively using a stimulating substance or engaging in prescription medication misuse. You may find yourself needing less sleep, becoming easily distracted, or even acting out in ways that can have social, work, relationship, sexual, or legal consequences. Incidentally, dopamine is one of three main messengers (neurotransmitters) that research links to bipolar disorder as well. These neurotransmitters carry messages to nerve cells, help regulate behaviors and mood, and keep brain function smooth.

That’s particularly important for people with bipolar, because the disorder can increase your risk of obesity and heart and vascular disease, according to the National Institute of Mental Health. Eating a diet high in refined sugar can make it harder to control weight and obesity — and related belly fat — and make some bipolar disorder drug treatments less effective, according to the results of a multicenter study from 2016. Patients with citalopram-treated MDD and alcohol or drug abuse responded about as well as those without an SUD. However, those with alcohol and/or drug abuse had reduced rates of remission, and their remission was delayed, as compared with those without alcohol or drug abuse. There were more suicide attempts and psychiatric hospitalizations among the cohort with drug abuse.

Therefore, in the treatment of patients hospitalized for alcohol detoxification, it is common to observe them for 1 month before considering antidepressant medication. Alcohol dependence poses a major depression risk that contributes to higher rates of alcohol use. In people with ethanol dependence, the prevalence of major depressive disorder (MDD) is 21%.4 People who are alcohol dependent are 4 times more likely than are nondependents to have MDD. Forty-one percent of people who seek treatment for current alcohol abuse have a mood disorder.

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. Second, the PLS-BD cohort lacks racial diversity; most participants are White individuals. Although this demographic makeup mirrors that of the PLS-BD recruitment catchment area, it does not reflect the demographic characteristics of the US as a whole and therefore may limit the findings’ generalizability. Still, alcoholic patients going through alcohol withdrawal may appear to have depression.

However, improvement of mood was not confirmed in a double-blind study with naltrexone add-on to cognitive behavioral therapy, and there was only a trend toward less alcohol consumption (121). Similar disappointing results have mirtazapine with alcohol been reported from a controlled study with acamprosate in BD + AUD (122). You might want to consider going to the doctor so that they can screen your symptoms since bipolar and substance abuse symptoms can overlap at times.

These findings also suggest that future neurocognitive studies of BD should take into account the potential confounding effects of comorbid AUDs, including past exposures to psychoactive substances (Savitz et al., 2005). In our opinion, two additional implications for research merit further discussion. Cosci and Fava (2011) have recently proposed an alternative strategy to examine dual diagnosis based on clinimetric methods, helped by staging and evaluation of subclinical symptoms. 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.

People with bipolar II disorder often enjoy being hypomanic (due to elevated mood and inflated self-esteem) and are more likely to seek treatment during a depressive episode than a manic episode. Cyclothymia is a disorder in the bipolar spectrum that is characterized by frequent low-level mood fluctuations that range from hypomania to low-level depression, with symptoms existing for at least 2 years (American Psychiatric Association [APA] 1994). Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally.