Why are Bipolar Disorder and Substance Use Often Mentioned Together?

Bipolar disorder is believed to result from imbalances in brain chemistry. Alcohol misuse and bipolar disorder can also produce overlapping symptoms, and they may trigger each other in some circumstances. Whether a person consumes or misuses alcohol during a manic or depressive phase, it can be hazardous and possibly life-threatening for them and for those around them. Bipolar disorder affects around 4.4 percent of people in the United States at some time in their lives. Please list any fees and grants from, employment by, consultancy for, shared ownership in or any close relationship with, at any time over the preceding 36 months, any organisation whose interests may be affected by the publication of the response.

All About Substance Use and Bipolar Disorder

Patients are told that the same kinds of thoughts and behaviors that will facilitate their recovery from one disorder will also aid in the recovery process from their other disorder. Conversely, thoughts and behaviors that may increase the risk of relapse to one disorder will similarly elevate their chances of relapse to the other disorder. A major depressive episode includes symptoms that are severe enough to cause you to have a hard time doing day-to-day activities. These activities include going to work or school, as well as taking part in social activities and getting along with others. These types may include mania, or hypomania, which is less extreme than mania, and depression. This can lead to a lot of distress and cause you to have a hard time in life.

1. Several studies have demonstrated success with cognitive behavioral therapy in treating alcoholism (Project MATCH Research Group 1998).
2. These individuals also exhibited more pronounced worsening of workplace function following a period of increased problematic alcohol use.
3. In the programmatic level, as exemplified by the work of Farren et al. (Farren and McElroy, 2008, 2010; Farren et al., 2010), patients enter a comprehensive integrated treatment programme that focuses on both psychiatric illness and substance use disorders.
4. All participants provided written informed consent and receive an annual stipend for participation.

Some evidence is available to support the possibility of familial transmission of both bipolar disorder and alcoholism (Merikangas and Gelernter 1990; Berrettini et al. 1997). Common genetic factors may play a role in the development of this comorbidity, but this relationship is complex (Tohen et al. 1998). Preisig and colleagues (2001) conducted a family study of mood disorders and alcoholism by evaluating 226 people with alcoholism with and without a mood disorder as well as family members of those people.

Alcohol and Bipolar Disorder: The Risks and Consequences

In addition, bipolar disorder can have a long-term negative impact on a person’s relationships, work, and social life. When problems occur, the person may use alcohol in an attempt to alter their mood in response to these negative feelings. For instance, the brains of people with bipolar disorder may be more sensitive to disruptions in communications that alcohol can cause, and slower to recover from those solution based treatment impacts. Contrary to the self-medication hypothesis, there was no evidence that having increased mood symptoms predicted lasting changes in alcohol use over the following six months.» All of them complete measures of mood symptoms, life functioning, alcohol use and more every two months throughout their involvement in the study. Whether they decide to drink or not, keeping alcohol consumption levels consistent and including discussions of drinking habits in mental health appointments could be key.

Objective  To characterize the longitudinal alcohol use patterns in BD and examine the temporal associations among alcohol use, mood, anxiety, and functioning over time. If people become disillusioned with their medications, some will stop using the drugs and consume alcohol as a form of self-medication. Some people use alcohol alongside their prescription drugs, adding to the risk.

Maxwell and Shinderman (2000) reviewed the use of naltrexone in the treatment of alcoholism in 72 patients with major mental disorders, including bipolar disorder and major depression. Eighty-two percent of patients stayed on naltrexone for at least 8 weeks, 11 percent discontinued the medication because of side effects, and the remaining 7 percent discontinued for other reasons. The authors concluded that naltrexone was useful in treating patients with comorbid psychiatric and alcohol problems. However, Sonne and Brady (2000) reported on two cases of bipolar women (both actively hypomanic) who received naltrexone for alcohol cravings, and both had significant side effects similar to those of opiate withdrawal. Given that there is only preliminary data on the use of naltrexone in bipolar alcoholics to date, naltrexone should be used with caution in patients who have been actively hypomanic. The role of genetic factors in psychiatric disorders has received much attention recently.

Bipolar disorder and alcohol misuse

Several studies have demonstrated success with cognitive behavioral therapy in treating alcoholism (Project MATCH Research Group 1998). Many of the principles of cognitive behavioral therapy are commonly applied in the treatment of both mood disorders and alcoholism. Weiss and colleagues (1999) have developed a relapse prevention group therapy using cognitive behavioral therapy techniques for treating patients with comorbid bipolar disorder and substance use disorder. This therapy uses an integrated approach; participants discuss topics that are relevant to both disorders, such as insomnia, emphasizing common aspects of recovery and relapse. Lithium has been the standard treatment for bipolar disorder for several decades. Unfortunately, several studies have reported that substance abuse is a predictor of poor response of bipolar disorder to lithium.

Bipolar Disorder and Alcohol Use Disorder

Consuming alcohol during a depressive phase can increase the risk of lethargy and can further reduce inhibitions. A person who consumes alcohol during a manic phase has a higher risk of engaging in impulsive behavior because alcohol reduces a person’s inhibitions. In clinical studies, AUDs affected more than one in three subjects with BD. Significant heterogeneity was found, which was largely explained by the geographical location of study populations and gender ratio of participants. Serotonin, noradrenaline (aka norepinephrine), and dopamine often don’t operate as they should in folks who have bipolar disorder. Almost all drugs that are misused — from nicotine to opioids — target a an area of the brain called the nucleus accumbens.