Heading Off Alcohol Use Disorder
If you are only treated for bipolar disorder and continue to drink, not only can your substance use disorder become more severe, it can trigger recurrences of mental health symptoms. Likewise, if you are only treated for addiction, the symptoms of bipolar disorder will likely trigger you to relapse and drink again, even after a successful period of sobriety. Co-occurrence of depression and substance abuse often poses diagnostic and therapeutic sun rocks weed challenges. This article reviews the prevalence, clinical considerations, and treatment of depression coexisting with alcohol use disorders (AUDs). The potential relevance of systems medicine for AUD (Spanagel et al., 2013; Gorini et al., 2014) and BD (Frangou, 2014; McIntyre et al., 2014) has been recently proposed. We agree with McIntyre et al. (2014) that this approach may be particularly relevant for BD with comorbid conditions.
Possible Explanations for Comorbidity
A person with bipolar disorder can usually remain healthy if they take their medication as a prescribed, and if they avoid alcohol. As a result, a person with bipolar disorder may not get the correct treatment that can relieve their symptoms. In 2006, a study of 148 people concluded that a person with bipolar disorder does not need to drink excessive amounts of alcohol to have a negative reaction. Read on to find out more about the links between bipolar disorder and alcohol consumption. For AUD, a healthcare provider will monitor the administration of medications to reduce alcohol cravings and reduce recovery.
Bipolar Disorder & Alcohol Use Disorder (AUD)
- Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.
- One common myth is that alcohol can help stabilize mood swings in bipolar disorder.
- Additionally, chronic alcohol use can lead to changes in brain chemistry that may increase vulnerability to mood disorders.
- Even though mood swings aren’t as extreme as the other bipolar disorders, they’re still impactful and drinking alcohol can complicate things.
- 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).
When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mixing suboxone with alcohol mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. The severity of symptoms could differ, as each individual may react differently and a variety of factors could affect alcohol’s impact.
Understanding the Effects of Alcohol on Bipolar Disorder
Two studies indicated trends of reduced drinking with use of prescribed alcohol-deterrent drugs. Depression linked to recent alcohol abuse may not respond well to an antidepressant drug beyond what is achieved with ethanol abstinence. In one study, depressive symptoms were assessed over the course of alcohol-related hospitalizations.6 drinker nose Depression was evident in 42% of patients 48 hours after admission, but only 6% remained clinically depressed by week 4 of hospitalization. Therefore, in the treatment of patients hospitalized for alcohol detoxification, it is common to observe them for 1 month before considering antidepressant medication.
The Relationship between Bipolar Disorder and Alcohol: Exploring the Effects and Risks
If commonalities in the recovery and relapse process in the two disorders can be seen as parallels between the two disorders, the focus on the relationship between the two disorders can be viewed as the intersection between BD and alcohol dependence. Thus, patients are told that drinking will negatively affect the course of their BD, and that non-adherence to their BD medication will increase their risk of relapse to drinking. Again, the focus on the intersection between the two disorders is consistent with the single-disorder paradigm. Bipolar disorder (BD) and alcohol use disorder (AUD) are independently a common cause of significant psychopathology in the general population. BD can affect up to 3% of the population in some countries; with the increasing awareness of the bipolar spectrum of disorders, this figure could increase over time. The co-morbidity of AUD in BD can reach 45% (Kessler et al., 1997; Cardoso et al., 2008), and the odds ratio for AUD in bipolar I disorder is higher than for bipolar II disorder, ( 3.5 and 2.6 respectively) (Hasin et al., 2007).
Alcohol can worsen bipolar symptoms and reduce the effectiveness of medications. For people with bipolar disorder, caution is warranted even with moderate alcohol consumption. Alcohol is a depressant that disrupts chemical messengers in the brain, which may lead to worsened depressive symptoms or trigger hypomania or mania. 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. Bipolar disorder is a mood disorder characterized by distinct high and low mood episodes.
In the programmatic level, as exemplified by the work of Farren et al. (Farren and McElroy, 2008, 2010; Farren et al., 2010), patients enter a comprehensive integrated treatment programme that focuses on both psychiatric illness and substance use disorders. This series of studies on bipolar subjects with alcohol dependence examined the response to an inpatient integrated four-week psychoeducational programme with appropriate individualised pharmacotherapy. The programme consisted of specifically developed relapse prevention group therapy, individualised interpersonal therapy, with psychoeducational video and group sessions, together with self-help groups including Alcoholics Anonymous, and Dual Recovery Anonymous.
Of the 228 Bipolar probands, 75.4% (74% in bipolar I patients and 77% in bipolar II patients) fulfilled criteria for DSM-IV life time alcohol dependence. At the clinical level, dual diagnosis seems to be mutually detrimental since addiction worsens the clinical presentation, course, prognosis and treatment of BD, and vice versa (Salloum and Thase, 2000). Comorbid addictions worsen functioning in BD, sometimes to that of SZ patients (Jaworski et al., 2011). Clearly, dual BD represents a prevalent, severe and difficult to treat subgroup of BD, but, surprisingly, little is known about its neurobiological and neurocognitive correlates (Nery et al., 2011). Alcohol can trigger manic episodes in individuals with bipolar disorder, leading to increased risk-taking behavior, impulsivity, and poor decision-making. During manic episodes, individuals may be more likely to engage in excessive drinking, creating a dangerous cycle of escalating symptoms and substance abuse.
In addition, bipolar disorder can have a long-term negative impact on a person’s relationships, work, and social life. When problems occur, the person may use alcohol in an attempt to alter their mood in response to these negative feelings. Alcohol can affect a person with bipolar disorder differently, compared with someone who does not have it. A person with bipolar disorder can also be more likely than others to misuse alcohol.
Positive effects of lithium on SUD apart from indirect effects via mood stabilization could not be substantiated so far (109). 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.