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Updated on July 31, 2023
5 min read

Understanding the Effects of Alcohol on Bipolar Disorder

Vince Ayaga
Dr P. E. Pancoast, MD
Written by 
9 Sources Cited
Vince Ayaga
Written by 
9 Sources Cited

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.

Link Between Bipolar Disorder & Alcohol

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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Can Alcohol Cause Bipolar Disorder?

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:

  • Alcohol’s depressant effects can make depression worse for those with bipolar disorder
  • In small doses, alcohol has stimulant-like qualities that can lead to mania
  • Alcohol also reduces medications’ effectiveness and can increase side effects like dizziness and nausea

What is Bipolar Disorder?

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:

  • Energy levels
  • Sleep patterns
  • Cognition
  • Behavior

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

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

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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Symptoms of Bipolar Disorder

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:

  • Abnormally upbeat or wired and jumpy
  • Increased energy levels
  • Increased irritation and agitation
  • High level of self-confidence
  • High level of euphoria
  • Decreased need for sleep
  • Racing thoughts and easily distracted
  • Unusually talkative
  • Poor decision making
  • Increased appetite

Depression symptoms include:

  • Feelings of sadness and hopelessness
  • Loss of interest
  • Decreased appetite and weight loss
  • Changes in sleep – insomnia or sleeping too much
  • Fatigue
  • Feelings of worthlessness
  • Reduced ability to think and concentrate
  • Thoughts of death or suicide

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Bipolar Disorder & Alcohol Use Disorder (AUD)

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.

What Is AUD?

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:

  • Spending a lot of time drinking or recovering from alcohol consumption
  • Unable to limit the amount of alcohol you drink
  • Extreme cravings for alcohol
  • Developing a tolerance that requires more alcohol to achieve the desired results
  • Unable to meet work or school obligations
  • Losing interest in favorite activities or social gatherings
  • Continuing to drink even when it causes physical, social, or emotional problems
  • Experiencing withdrawal symptoms when alcohol is not available

Treating Co-Occurring Bipolar Disorder & AUD

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:

  • Mood stabilizers
  • Antidepressants
  • Antipsychotics 

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

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.

Support Groups 

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.

Updated on July 31, 2023
9 sources cited
Updated on July 31, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Bipolar Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services.

  2. Pary R, Patel M, Lippmann S. "Depression and Bipolar Disorders in Patients With Alcohol Use Disorders." Fed Pract, 2017.

  3. Bipolar Disorder and Alcoholism.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services.

  4. Carmiol et al. "Shared genetic factors influence risk for bipolar disorder and alcohol use disorders." Eur Psychiatry, 2014.

  5. Strakowski SM. “Effects of Co-Occurring Alcohol Abuse on the Course of Bipolar Disorder Following a First Hospitalization for Mania.” Archives of General Psychiatry, American Medical Association, 2005.

  6. Yasgur BS. “Managing Comorbid Bipolar Disorder and Alcohol Use Disorder: Clinical Challenges and Conundrums.” Psychiatry Advisor, 2018.

  7. Brunette et al. “A Review of Research on Residential Programs for People with Severe Mental Illness and Co-Occurring Substance Use Disorders.” Drug and Alcohol Review, 2004.

  8. Cerullo MA, and Strakowski SM. “The prevalence and significance of substance use disorders in bipolar type I and II disorder.” Substance abuse treatment, prevention, and policy, 2007.

  9. Goldstein BI. “The Association between Moderate Alcohol Use and Illness Severity in Bipolar Disorder.” The Journal of Clinical Psychiatry, 2006.

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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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