Bipolar and Alcohol Addiction as a Dual Diagnosis

What is the Experience of Bipolar Disorder Like?

When going through a manic episode, you may feel euphoric, energized, or unusually irritable. Often, there is an increased tolerance for risky behaviors during this time, and the need for sleep may decline.

Of course, those with a bipolar disorder diagnosis will experience symptoms that are much the opposite during depressive periods. At these times, feelings of sadness, hopelessness, and fatigue may set in. Things that once brought joy may lose all of their appeal and interest. It is during these times that affected individuals may be most likely to drink alcohol as a form of self medication. We will talk more about that progression later on the page.

What Constitutes a Diagnosable Alcohol Use Disorder?

Alcohol use disorder, also referred to as AUD, is a chronic condition in which the individual’s alcohol consumption levels are hard to control or completely beyond control. Despite negative consequences, the person keeps drinking, and those drinking habits usually get worse over time.

AUD exists on a spectrum from mild to severe. At first, you might start drinking a little more than intended just to calm anxiety and to relax after a hard day. Soon enough, however, the habit can expand and become harder and harder to control.

Eventually, you’ll have strong cravings after going even a short time without a drink, and you may find yourself continuing to drink even when your health, relationships, and responsibilities are harmed.

It’s important to understand that suffering from AUD does not point to a lack of willpower. This is a medical condition that needs to be treated, so it’s not as easy to just decide to drink fewer drinks and leave this issue in the past. Without the right treatment, AUD is likely to get worse over time, and very serious outcomes are possible.

The Connection Between Bipolar and Alcohol Addiction

On the surface, it might not seem like bipolar disorder and alcohol addiction are a likely pairing. After all, these conditions have different symptoms, and there isn’t an obvious link at first glance. With that said, research has consistently shown that people with bipolar disorder are at a significantly higher risk for all substance use disorders, including alcoholism.

When researchers look deeper at this connection, they are able to find that the connection is driven by a number of biological, psychological, and neurophysiological factors. Both of these conditions involve changes to brain chemistry, specifically in areas that involve mood regulation and reward processing. So, instead of seeing these as different issues, it’s best to see them as closely linked conditions that play off of and intensify each other.

Why Do People with Bipolar Turn to Alcohol as Self Medication?

There are a few different reasons why people with bipolar disorder might turn to alcohol misuse. At the top of that list is self medication, which is a common reason for many people to use alcohol in their daily lives.

When a depressive episode comes on, alcohol can seem like an easy way to temporarily escape and numb the emotional pain you are experiencing. It will reliably reduce feelings of sadness and help you escape the sense of hopelessness. The problem, of course, is that this solution is short-term and temporary. Alcohol itself is a depressant, and over time, heavy alcohol use will only make symptoms worse.

There is also a risk of using alcohol too frequently or aggressively during manic episodes. In that situation, people feel more impulsive and less concerned about consequences, which can lead to increased risk-taking, including excessive drinking. It could also be that you feel like using alcohol may help to calm down racing thoughts or agitation, but usually the opposite occurs.

How Alcohol Affects Bipolar Symptoms

People with bipolar spectrum disorders may notice that alcohol has a very specific impact on their symptoms. It’s common for alcohol use to seem like it’s helpful at first, as some relief may be enjoyed. That respite is short-lived, and when a person with bipolar disorder drinks heavily, severe implications can be soon to follow.

Specifically, mood symptoms can be influenced by the ongoing use of alcohol. Having increased mood symptoms is common when alcohol is used, as it can trigger depressive episodes or intensify existing ones. Drinking habits can also contribute to irritability and emotional instability, meaning it will be harder to maintain balance while also dealing with bipolar disorder.

The Effect of Alcohol Use on Psychiatric Medications

To make things more challenging, chronic alcohol use can also interfere with the medications that are often prescribed to treat bipolar. So, not only will you be dealing with the way that alcohol can impact mood symptoms, but you’ll also find that the medications you have been provided don’t work as well, or cause more side effects than they would without the alcohol.

Whether alcohol is turned to intentionally to mask symptoms, or if you simply end up drinking at social situations involving alcohol and the addiction grows from there, countless negative outcomes are possible.

What are the Risks of Untreated Dual Diagnoses of Alcohol Abuse and Bipolar Disorder?

Getting proper bipolar disorder care is always important when someone is diagnosed with this condition. However, that treatment is even more important when alcohol addiction is also present.

That’s because blending mental disorders with alcohol use can lead to a downward spiral where each condition makes the other worse. Soon enough, every last part of life will be impacted if both bipolar disorder and alcohol addiction are not treated properly and proactively.

The Role of Integrated Treatment Models for Dual Diagnosis

One of the fundamental keys to treating these two conditions is integrating the treatment approach effectively as soon as possible. You don’t want a situation where you go to mental health appointments for your bipolar disorder and then deal with alcohol use disorder separately (or you don’t deal with it at all). Since these two conditions are so closely connected, they should be approached with integrated treatment that addresses both sides of the issue at the same time.

The best treatment plan is the one that’s customized for the individual’s alcohol use patterns, their specific bipolar diagnosis, and more. Co occurring alcohol addiction and bipolar can be treated through the use of medication schedules, therapy, medical care, and other supportive services.

An integrated plan is best because instead of chasing specific symptoms, you’ll be taking a more complete path that outlines a specific road to recovery and then takes you in that direction one step at a time.

Detox and Medical Stabilization

For anyone struggling with alcohol addiction, the first step in the treatment process is usually detox. Going through this process is what allows the body to eliminate alcohol from the system. Doing detox under medical supervision makes it safer and more likely that it will be completed successfully.

While getting medical help with detox is a good idea, that doesn’t mean the process will be without its challenges. There are symptoms like anxiety, agitation, and mood swings that are likely to occur while your body is ridding itself of the remaining alcohol and then craving more. Getting through detox is not a finish line in the battle against alcohol addiction, but it does provide a strong platform on which lasting recovery has the chance to be built.

Therapy for Dual Diagnosis

Various forms of therapy often come into play for treating alcohol addiction and bipolar disorder, along with the mood instability that comes with it. Experiencing a range of therapeutic approaches helps the individual understand their condition, build healthier patterns, and develop coping strategies.

Two of the commonly used therapy options for these conditions are cognitive behavioral therapy, or CBT, and dialectical behavior therapy, or DBT. With CBT, you will learn how to identify and then change negative thought patterns that contribute to problems with mood instability and substance use. DBT, on the other hand, is useful for learning how to manage intense, powerful emotions when they arise, and it can also help you better manage interpersonal relationships.

Medication Management

Medication is often used to treat bipolar disorder. Additionally, it’s possible that medication will be used to help address your alcohol addiction. A big part of the value of getting help with your alcoholism with co occurring bipolar disorder is having access to the right medications to help confront these health challenges effectively.

For bipolar disorder, a variety of medications will be considered by your healthcare team. Those include mood stabilizers, antipsychotic medications, and antidepressants. The goal with the medications you may be prescribed is generally to help regulate your mood and reduce the frequency of the episodes you experience. It can take time to dial in the right combination of medications and the right dosages to enjoy optimal results.

While medications are not used as widely for alcoholism, there may be a role to play for medications that can help you reduce cravings or generally discourage drinking. Whatever the specifics are in your case, the important thing is to work closely with a medical professional to receive a treatment plan and then follow that plan as closely as possible while reporting honestly about the results.