Bipolar Disorder and Alcohol
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There are many ways that alcohol and mental health can overlap. People with mental health struggles sometimes turn to alcohol as a coping mechanism to improve their mood, or lessen their anxiety. Alcohol tends to be a particularly common coping technique for people who struggle with depression or low mood.
But for people with bipolar disorder, there are a few unique issues and considerations to keep in mind when thinking about alcohol use and misuse. Below, we’ll discuss just how bipolar and drinking behavior can go together, how alcohol can complicate bipolar disorder, and how to prevent and manage problems connected to both issues.
Table of Contents
About Bipolar and Drinking Behavior
Bipolar disorder1 is a mental health condition that’s categorized as a mood disorder—which means that the primary symptoms of bipolar disorder involve big fluctuations in mood. As far as mental health conditions go, bipolar disorder is fairly common: about 3% of US adults have bipolar disorder,2 which makes it slightly less common than other mood disorders, like anxiety and depression.
When a person has bipolar disorder, they experience alternating periods of mania and depression. During a depressive episode, people with bipolar disorder have symptoms that are similar to someone with depression: they’ll experience low mood, sadness, feelings of hopelessness, and low self-worth. During these periods, they might be more likely to use alcohol to cope with their low mood.3
When a person with bipolar disorder experiences a manic episode, their mood shifts dramatically to the other end of the spectrum. A manic episode is usually characterized by an intensely energetic mood and hyperactivity. When in a manic episode, people with bipolar disorder tend to engage in risky behaviors and have lowered inhibitions, which can also include extreme consumption of alcohol or other substances.4
Some people might even experience blackouts during manic episodes—experiencing memory time loss while manic.
Bipolar 1 vs. Bipolar 2
There are two main types of bipolar disorder: bipolar 1 and bipolar 2. These two types of bipolar vary in the degree to which the person experiences a more mild or extreme cycle of mania and depression.5
- People with bipolar 1 experience alternating periods of mania and major depression, displaying great degrees of shift in mood.
- For those with bipolar 2, manic episodes aren’t as strong. People with bipolar 2 tend to experience a less severe form of mania—called ‘hypomania’—along with alternating periods of major depression.
Can Alcohol Trigger Bipolar Disorder?
While it’s fairly common to use alcohol to cope with life’s challenges, some people might find their alcohol use crossing over into heavier or more problematic drinking behaviors. This can mean developing symptoms of alcohol use disorder or alcohol dependence.
Researchers have found a high level of overlap between bipolar and drinking behavior, with rates of alcohol abuse in people with bipolar being as high as 30%6 in some studies. In fact, rates of alcohol abuse in people with bipolar disorder are higher than with other kinds of mood disorders.7
Some people might wonder: If bipolar and drinking behavior seem to overlap so much, can alcohol trigger bipolar disorder?
The answer is unclear. Researchers still aren’t 100% sure why bipolar and drinking behavior seem to co-occur so much. Some speculate that the connection is due to inherited genetic traits common in both conditions. Other experts think that symptoms of bipolar disorder are particularly likely to lead someone to self-medicate with alcohol.8
Regardless of the true reason for the overlap between these two conditions, or if one can cause the other, there is clearly a strong link between bipolar disorder and alcohol abuse.
Why Alcohol Can Cause Problems for People with Bipolar Disorder
There are a lot of reasons why someone might want to stay away from alcohol or cut back their consumption. For people with bipolar disorder, there are several unique reasons that alcohol abuse or misuse can lead to problems.
During a manic episode, someone with bipolar experiences a state of elation and euphoria, to the point that they might think themselves invincible or impervious to harm.9 They might engage in riskier behavior than they would when not in a manic episode.
When combined with alcohol consumption, this can create a recipe for trouble. Alcohol can further lower a person’s inhibitions and increase impulsivity, making them more likely to engage in dangerous behaviors. This combination can increase the risk of someone wth bipolar disorder experiencing physical harm, danger, or even death or suicide.10
When someone gets a diagnosis of bipolar disorder, their medical provider will typically recommend medication as part of their treatment plan. Unfortunately, some psychiatric medications have interactions with alcohol that can make them less effective or even dangerous.
For example, many people with bipolar disorder are prescribed lithium, which can act as a mood stabilizer. Doctors typically regularly monitor lithium blood levels for patients taking lithium, as lithium toxicity can be deadly.
Lithium has shown great success in stabilizing moods and decreasing risk of suicide for people with bipolar disorder. However, when combined with alcohol, lithium can become less effective. Lithium can also increase alcohol tolerance, making someone more likely to consume dangerous quantities of alcohol.11
As mentioned above, research has found a strong link between alcohol abuse and bipolar disorder. Unfortunately, researchers have also found that alcohol use and abuse can actually increase the severity of the symptoms for people with bipolar disorder.12
Even moderate alcohol use can have a negative impact for some individuals with bipolar.13 If there’s a concern about symptoms getting worse, it might be best to stay away from alcohol altogether.
Coping and Skill Building
Many people use alcohol to cope with stress or challenging emotions. This isn’t necessarily a problem if it’s done every once in a while. But nevertheless, using alcohol this way means a person isn’t developing other healthier coping skills.
By replacing alcohol as a coping mechanism with something more constructive, people with bipolar disorder will be better prepared to manage their symptoms in the long run.
How to Reduce or Stop Drinking with Bipolar Disorder
Changing your relationship with alcohol is about more than just willpower, especially if you are drinking to cope with a condition like bipolar disorder. Fortunately, as with many mental health issues, alcohol abuse and dependence are treatable. Medications can help reduce drinking urges, and some can also help manage symptoms of anxiety or depression that motivate people to drink.
If you or someone you know has been diagnosed with bipolar disorder and also struggles with alcohol, get in touch with a member of our team to learn how we can help.
Dr. Chelsea Hetherington (she/her) is a developmental psychologist, writer, coach, and consultant. She helps therapists, coaches, and other businesses in the mental health space connect with their audiences and attract their dream clients through educational content writing. Her writing bridges the gap between research and practice by making complex mental health and personal development topics more accessible and easy to understand. You can find more of her writing at www.mindfultype.co