As we explore this subject, we’ll uncover the potential risks, effects, and management strategies that individuals with bipolar disorder should consider when it comes to alcohol use. Unfortunately, the field is marred by a paucity of well-conceived, conducted, and published studies informing the clinician about how to manage a comorbidly diagnosed patient. Despite some ongoing studies, the research field still reflects the current therapeutic field; namely there are few integrated treatment programmes in existence, and even fewer leading to therapeutic guidelines.
Treating Co-Occurring Bipolar Disorder & AUD
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). This recommendation is, by large, based on the CBT studies conducted by Farren et al. In a prospective cohort study, 232 comorbid patients with alcohol dependence and an affective disorder (among whom 102 were individuals with BDs), received inpatient treatment with cognitive behavioral therapy for 4 weeks (90). At 6-month follow-up both groups (depressive and bipolar patients) showed a significant reduction of alcohol consumption, but no difference was found between patients with unipolar and bipolar disorder. At 5-year follow-up, there was still a significant long-term benefit, particularly in those who engaged in post-discharge supportive therapy.
- The AUDIT score range is from 0 to 40, with 8 or higher indicating AUD is highly probable; 8 to 14 indicating hazardous or harmful drinking; and 15 to 40 indicating severe drinking or dependence.
- These substances provide temporary relief of the mood swings and allow you to feel normal while your mind is altered.
- Bipolar disorder affects around 4.4 percent of people in the United States at some time in their lives.
- Family-focused treatment (FFT) with psychoeducation is recommended and effective (99).
- The authors concluded that naltrexone was useful in treating patients with comorbid psychiatric and alcohol problems.
Managing Alcohol Use and Bipolar Disorder
These statistics are troubling and there needs to be more education on the correlation between substance abuse and bipolar disorder. Aripiprazole is an antipsychotic that partially agonizes dopamine receptors. Aripiprazole was used as an adjunctive intervention in a randomized trial of 35 patients with comorbid alcohol dependence and depression.37 There was less depression in both the aripiprazole plus escitalopram group and the escitalopram group.
Alcohol’s Impact on Bipolar Disorder
Another reason is that people with bipolar disorder often self-medicate to manage their mental health condition. People with bipolar disorder have a 21.7% to 59% increased chance an honest drug guide for raves festivals and clubs clubnight of being diagnosed with substance use disorder at least once in their life, per SAMHSA. Alcohol misuse appears to be most common among people with bipolar disorder.
It is characterized by alternating episodes of mania (or hypomania) and depression, with periods of relative stability in between. If you’ve lost control over your drinking or you misuse drugs, get help before your problems get worse and are harder to treat. Seeing a mental health professional right away is very important if you also have symptoms of bipolar disorder or another mental health condition.
Despite the mood extremes, people with bipolar disorder often don’t recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don’t get the treatment they need. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life. Because the symptoms of the two conditions are similar, proper diagnosis and treatment of bipolar disorder are often delayed. Participants selected for the present study were those with a diagnosis of BD type I (BDI) or type II (BDII) who had been in the study for at least 5 years. Data used were extracted from February 2006 to April 2022, and follow-up ranged from 5 to 16 years. For now, the key message about alcohol use for people with bipolar disorder seems to be to keep things consistent over time – – just like clinicians advise them to do with sleep schedules, medication schedules, and eating patterns.
A person may need to work with their doctor for some time before they find a suitable medication and dose. On the other hand, the person may decide to skip their medication in order to drink more “safely.” However, not taking the medication can cause symptoms to return. If a person uses valproic acid with alcohol, this may put extra strain on the liver, increasing the risk of liver disease.
They also found that the complicated and secondary groups had higher rates of suicide attempts than did the primary group. Preisig and colleagues (2001) also reported that the onset of bipolar disorder tended to precede that of alcoholism. They concluded that this finding is in accordance with results of clinical studies that suggest alcoholism is often a complication of bipolar disorder rather than a risk factor for it. The AUDIT is also recommended to screen comorbid individuals by several evidence- based guidelines, e.g., the German S3-Guidelines on AUD (49, 53). A third feature of IGT is a discussion of the relationship between the two disorders.
The NESARC survey revealed strong associations between depression, substance use, and other psychopathologies. 5 Compared with MDD alone, SUD combined with MDD conferred high vulnerability to additional https://sober-home.org/ketamine-abuse-addiction-effects-and-treatment/ psychopathology, depressive episodes that were more severe and greater in number, and more suicide attempts. Suicidal thoughts and behavior are common among people with bipolar disorder.
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 these disorders using an integrated therapy approach where both disorders are tackled in the same alcohol withdrawal symptoms, treatment and timeline 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.
