It causes manic moods and depression, both of which can be debilitating and dangerous. Alcohol use disorder commonly co-occurs with bipolar disorder, and it increases the risk for complications, worsens symptoms, and makes treatment more difficult. It is important to understand the risks, to know the facts, and to be cautious about drinking when living with bipolar disorder. 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.
Addiction helplines, like the one owned and operated by American Addiction Centers, are available to answer questions about co-occurring bipolar and alcohol use disorder and can help you understand the treatment process. Please call to speak to a caring admissions navigator who can help connect you to treatment centers that may be appropriate for your needs. Other therapeutic interventions, such as integrated group therapy, Alcoholics Anonymous, and cognitive behavioral therapy have also proven effective at treating both sides of the co-occurring disorder, although only if attendance was regular. Withbipolar II, depressive episodes still occur, but mania is replaced with hypomania, a condition nearly identical to mania, except for the fact that hypomania does not last as long or require hospitalization. Among these participants, 445 (76.2%) had a diagnosis of BDI and 139 (23.8%) had BDII (eFigure 1 in Supplement 1).
- Some children may have periods without mood symptoms between episodes.
- However, it’s important to be aware of the ways you may be uniquely vulnerable so you can take preventive measures.
- Substance-induced depression is different from major depressive disorder and, by definition, should improve once a person stops consuming substances (such as 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.
How these disorders are diagnosed
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. In the United States, about 4.4 percent of adults will experience bipolar disorder at some point in their lives, according Acute and Chronic Effects of Cocaine on Cardiovascular Health PMC to the National Institute of Mental Health. A bipolar diagnosis is described as type 1 or 2, depending on the severity of symptoms. Some theorize that when AUD appears first, it can trigger bipolar disorder. Others have suggested that bipolar and AUD may share genetic risk factors.
Analyzing the SFBN sample of the two German centers revealed a life-time prevalence of 17.8% for AUD only—compared to 33% in the whole SFBN which included four US and three European centers (two in Germany, one in the Netherlands). The transatlantic difference for illicit drug use might be even higher, as SUD other than AUD was only present in 8.5% of the German SFBN sample (37). The higher SUD comorbidity rates in the US might directly relate to the poorer prognosis and higher treatment resistance in the SFBN US compared to the European sample (38). Depending on which drugs you take for bipolar disorder, alcohol may interfere with their ability to work correctly. If you take lithium for mood stabilization, there is a risk of developing toxic levels of the drug in your body.
Mayo Clinic Press
The lack of efficacy of quetiapine against AUD was also confirmed in another placebo- controlled study (120). No controlled data for other aAP or antidepressants have, so far, been generated (see Table 1). The OR for developing a SUD has been estimated 1.8 in patients with a lifetime MDD and 6.9 for those with a lifetime BD-I, compared with the general population (34), and prevalence rates for SUD are ~25–50% higher in BD-I than BD-II patients (26, 35). The latter appears to be mainly driven by illicit drugs (OR 7.46 in BD-I and 3.30 in BD-II) (28). 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).
This section examines some of the issues to consider in treating comorbid patients, and a subsequent section reviews pharmacologic and psychotherapeutic treatment approaches. If you have depression and drink too much alcohol, then you may be wondering if there are any treatments or lifestyle changes for someone in your situation. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), if depression symptoms persist after one month without consuming alcohol, then a different depressive disorder diagnosis would apply. One study of people with both AUD and depression undergoing treatment for both conditions found that the majority of symptom improvement for both conditions happened during the first three weeks of treatment.
How do bipolar disorder and alcoholism interact?
Both valproate and alcohol consumption are known to cause temporary elevations in liver function tests, and in rare cases, fatal liver failure (Sussman and McLain 1979; Lieber and Leo 1992). Therefore, the safety of valproate in the alcoholic population has been questioned because of the potential for hepatotoxicity in patients who are already at risk for this complication. However, recent preliminary evidence suggests that liver enzymes do not dramatically increase in alcoholic patients who are receiving valproate, even if they are actively drinking (Sonne and Brady 1999a). Thus, valproate appears to be a safe and effective medication for alcoholic bipolar patients. However, manic depression (commonly known as bipolar disorder) is a much different animal.
Several Factors Explain the Link Between Bipolar Disorder and Alcohol Misuse.
It becomes a vicious cycle of wrestling with bipolar depression and drinking alcohol in which each worsens the symptoms of the other. Limited data exist on the effect of anti-craving medication in AUD with comorbid BD. Results of an open study suggested a reduction of both craving and stabilization of mood with naltrexone in patients with BD + AUD (125). 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).