Bipolar Disorder and Alcohol Misuse

Last Updated on June 8, 2021

Bipolar disorder is a challenging condition that, if left untreated, can have serious life consequences. When it overlaps with alcohol misuse, it can become even more devastating. Fortunately, with medication and other support, many people can successfully live with bipolar disorder, while also recovering from alcohol abuse problems.

Many people wonder how alcohol affects bipolar disorder, and if someone with the disorder is more likely to have drinking issues. Here’s a look at what bipolar disorder is, how it relates to alcohol misuse, and what you can do if you have it.

What Is Bipolar Disorder?

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Photo by Susan Q Yin on Unsplash

In general, bipolar disorder refers to a set of symptoms that involve more intense mood shifts than normal, typically fluctuating between high (manic) and low (depressive) moods. While everyone may experience mood changes, bipolar individuals experience these at a level that interferes with everyday life. These shifts may make it difficult to maintain jobs and relationships, and can lead to life-threatening behaviors.

Types of Bipolar Disorder

There are three types of bipolar disorder, and each presents differently1. Here’s a look at each:

Bipolar I

Bipolar I is the disorder people are most familiar with. This presents more clearly, with longer manic episodes. During manic episodes the individual may have extremely high energy, talk quickly with few pauses, and may or may not experience paranoia or psychosis. There are typically episodes of depression in between manic stages. In some cases, someone may also experience episodes of paranoia or delusions, or have increased anger or aggression.

Bipolar II

With this second type of bipolar, individuals have “hypomanic,” or less extreme, episodes. However, specialists have begun to recognize that bipolar II may be more than just a milder bipolar I. Those with bipolar II may experience major mood changes more frequently, and deal with depressive episodes in particular over longer periods of time.

Related Disorders

When individuals don’t meet the full diagnostic criteria for bipolar I or II, they may be diagnosed with cyclothymic disorder. Other variations of depression and manic or hypomanic mood shifts may be diagnosed as “bipolar not otherwise specified.”

It’s helpful to note that the depression symptoms that occur with bipolar disorder are different from those of major depression disorder (MDD). In fact, medications commonly used to treat MDD can actually make bipolar symptoms worse2. This is why it’s important to see an experienced mental health professional to determine the right diagnosis.

Diagnosing Bipolar Disorder and Alcohol Misuse

In the case of each diagnosis, bipolar disorder would be ruled out if the symptoms are entirely caused by alcohol abuse. For example, if someone experiences mood shifts, depression, or episodes of high energy only while drinking or withdrawal, this would not be considered bipolar disorder. Instead, the diagnosis would be alcohol misuse disorder.

The difficulty of sorting out which problem came first is a challenge for mental health professionals. When it’s determined that someone has both a mental health condition and an alcohol or substance abuse problem, it’s called a dual diagnosis.

Does Bipolar Disorder Lead to Alcohol Problems?

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Photo by Iheb AB on Unsplash

There’s certainly a connection between having bipolar disorder and abusing alcohol. One major study found a 46 percent occurrence of alcohol use disorder in people with bipolar I, and a 39 percent occurrence in people with bipolar II3. When combined with the use of other substances, the rates are even higher.

Researchers aren’t sure why the co-occurrence is so high, but it’s possible some people use substances like alcohol or marijuana in an attempt to calm manic symptoms.

Does Alcohol Affect Bipolar Disorder?

Some studies have found that those who abuse substances, including alcohol, have worsening symptoms of bipolar4. This could include more hospitalizations due to dangerous episodes, and more cycling between moods. While this may not be the case for everyone, there is a risk.

Experts point out that a cycle may occur between bipolar and alcohol misuse, with people abusing alcohol to manage symptoms, leading to worsening symptoms, and therefore more drinking. Fortunately, if individuals can get bipolar symptoms under control, it can make it easier to recover from alcohol abuse.

Signs of Bipolar Disorder

If you’ve wondered if you have bipolar disorder, there are signs you can watch for, especially when it comes to manic symptoms5. If you’ve already been diagnosed, these signs can also help you recognize that an episode is ramping up.

  • Sleep changes. Many people stop sleeping, or need significantly less sleep, during a manic episode. Sleep issues may also be present during depression episodes.
  • Risk-taking behaviors. If you wouldn’t normally take risks, but start to do so, this can be an indication that you’re experiencing mania. These may be physical, sexual, or financial risks. For example, some people may begin to compulsively gamble, drive recklessly, leave town suddenly despite family or job responsibilities, or have high-risk sexual encounters.
  • Compulsive behaviors. Some people spend excessively, or become obsessed with a specific idea or new activity. If these behaviors seem out of control, they are likely compulsions, which could be a part of mania.
  • Concerned comments from others. If you’re having a manic, or even hypomanic episode, those who know you well are likely to notice. They may comment that you’re acting differently, or that they’ve seen this pattern before.
  • Feeling down. During depressive episodes of any type of bipolar, you may experience extreme sadness, suddenly or frequently feeling down, loss of interest in activities, or thoughts of suicide. Even if you don’t believe you have bipolar disorder, these symptoms should be evaluated by a doctor or mental health professional.

What To Do If You Have Bipolar Disorder

Bipolar disorder isn’t something you should try to manage on your own. Finding a reliable mental health specialist experienced with this condition is important. For many people, daily medications can entirely or mostly manage symptoms.

In the midst of a manic or depressive episode it can be hard to acknowledge or follow up on medical care. Sometimes it takes an outside person to recognize, encourage, or assist you in finding professional support. If you’re not sure what to do, ask a trusted person for help, or contact a professional support line to find local resources.

If you have already been diagnosed with bipolar disorder, then follow up on recommendations from your medical team. A doctor, such as a psychiatrist, can help you manage the biological aspects that are causing the disorder. A therapist can also help you manage related stress and learn to understand and recognize your symptoms.

If you have bipolar disorder, try to avoid alcohol and other substances, or begin to cut back. Drinking while on certain medications can be very dangerous and can worsen symptoms. If you need support in cutting back or stopping your drinking, Ria can help. Our evidence-based program is proven to help people increase sober days and decrease alcohol use. Contact us to learn more about how it works.

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Written By:
Licensed therapist, writer, and published author, with a focus on trauma recovery.
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