Alcohol & Health
Treatment
Helping Alcoholics
Medically Reviewed by Dr P. E. Pancoast, MD
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Only a few mental health disorders are as closely linked to alcohol abuse as bipolar disorder. That’s because alcohol intensifies the symptoms of bipolar disorder through its depressive effects.
While alcohol use disorder (AUD) is common among those with mental illness, it's highest among those with bipolar disorder. Over 46 percent of those with bipolar I have AUD, while those with bipolar II are at 40 percent.8
Many people with bipolar disorder turn to alcohol to self-medicate and reduce symptoms. While they may find temporary relief, alcohol increases the severity of symptoms over time.
Because the symptoms of the two conditions are similar, proper diagnosis and treatment of bipolar disorder are often delayed.
While doctors do not fully understand the connection between the two conditions, genetics also play a role. Both AUD and bipolar disorder are inheritable conditions.4
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A 2006 study found a direct link between alcohol consumption and rates of depressive or manic episodes in people with bipolar disorder.9
Alcohol amplifies bipolar symptoms:
Bipolar disorder is a mental health condition classified by extreme mood swings. These mood disorders include emotional highs (mania or hypomania) and extreme lows (depression).1
When a person experiences mania, they may feel energetic or even irritable. Manic depression causes sadness and loss of interest in most activities.
These extreme mood changes can affect:
The two main types of bipolar disorders are bipolar I and II. While bipolar disorder can occur at any age, diagnosis typically occurs in the teenage years to the early 20s.
Bipolar I disorder is the only one that includes manic episodes. It's more severe, with manic episodes lasting for at least a week and depressive episodes lasting for at least two.
It's also possible to experience episodes of depression with manic symptoms simultaneously.
Bipolar II disorder has episodes of depression and hypomanic episodes but no mania. A person is more likely to seek treatment during a depressive episode than a manic episode.
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Bipolar disorder symptoms vary depending on whether it’s during a mania, hypomania, or depressive episode.
Mania and hypomania share the same symptoms but are different. Mania is more severe and can trigger a break from reality or psychosis.
Mania and hypomania symptoms include:
Depression symptoms include:
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For many with bipolar disorder, regular drinking as a form of self-medication dramatically increases the risk of AUD.
This is because alcohol alters brain chemistry. It can cause a rapid shift from depression to mania.
Also known as alcoholism, AUD occurs when alcohol consumption becomes a problem. You can no longer control your drinking, which affects your daily life. You also keep drinking despite experiencing negative consequences and unsuccessful efforts to control or stop drinking.
Common symptoms of AUD (or alcoholism) include:
A dual diagnosis is when someone is diagnosed with a substance use disorder (SUD) and mental health disorder.
Since alcohol can alter or enhance bipolar symptoms, treatment typically begins with detox. This allows medical providers to manage care during withdrawal, evaluate bipolar symptoms, and begin treatment.
Treatment options for both disorders include:
Medication-assisted treatment can help manage symptoms of bipolar disorder and AUD.
For bipolar disorder, medical professionals may prescribe:
For AUD, a healthcare provider will monitor the administration of medications to reduce alcohol cravings and reduce recovery. These medications include naltrexone or acamprosate.
Behavioral therapies such as cognitive behavioral therapy (CBT) can help treat both conditions. During CBT, you learn to recognize triggers that lead to drinking. They also learn to manage symptoms and develop healthier coping skills.
Inpatient and outpatient programs provide intensive treatment for those with bipolar disorder and AUD. Treatment focuses on stabilizing bipolar symptoms, managing cravings, and teaching coping skills.
Bipolar support groups and 12-step programs provide a much-needed social network. They also offer guidance and accountability during recovery.
Bipolar disorder and alcohol use disorder (AUD) often co-occur, making it challenging to manage both conditions. Alcohol can worsen bipolar symptoms and reduce the effectiveness of medications.
Fortunately, treatment for co-occurring bipolar disorder and AUD is available. If you or someone you know is struggling with either condition, seek professional help immediately.
Treatment can help manage the symptoms of both conditions and improve quality of life. A requirement for successful treatment for AUD is a firm and ongoing commitment to abstinence.
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