Alcohol And Bipolar Disorder
Author: Hannah Zwemer
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What Is Bipolar Disorder?
Once called “manic-depressive illness” or “manic depression,” bipolar disorder is an illness that affects the mood, causing unusual and often abrupt shifts in energy, activity levels, concentration, and impacts the overall ability to perform daily duties. There are 3 forms of the disorder classified in the Diagnostic and Statistical Manual of Mental Disorder (DSM) and while the symptoms and manifestation vary, all 3 involve significant changes in mood, energy, and activity levels. Sometimes confused with schizophrenia and ADHD because of the intensity of the shifts, bipolar disorder consists of “up” (mania) and “down” (depression) cycles, where an individual can feel elated, energized, or irritable one day and indifferent, sad, or hopeless another. The length and severity of the symptoms determines the exact classification of the illness: bipolar I disorder, bipolar II disorder, or cyclothymic disorder (cyclothymia).
Types Of Bipolar Disorder
Bipolar I Disorder
This type is defined by the presence of manic episodes that last at least 7 days or the experience of severe manic symptoms that require immediate hospital care. Depressive episodes also occur and usually last around 2 weeks. It is not uncommon for a person with bipolar I disorder to experience periods of both manic and depressive symptoms.
Bipolar II Disorder
Determined by the frequency in patterns of depression and hypomania (a milder form of mania that involves mild to moderate symptoms and lasts at least 4 days), bipolar II disorder differs in the severity of the mania.
Cyclothymic Disorder (Cyclothymia)
Cyclothymia is diagnosed when an individual experiences shifts between feelings of hypomania and depression, yet the symptoms are not severe enough and do not meet the diagnostic requirements to qualify as explicitly a hypomanic or depressive episode. Not as debilitating as the other two, cyclothymia does not typically alter daily functioning, but it is disruptive.
Co-Occuring Disorders: Bipolar And Alcoholism
Co-occurring disorders are diagnosed when an individual exhibits symptoms of both a mental illness as well as a substance use disorder (or any other combination of more than one disorder). Because alcohol and other substances impair the senses, many will turn to these vices as a way to temporarily ease the pain they may feel in their own minds.
Despite popular belief, bipolar disorder is actually quite common; the National Institute of Mental Health (NIMH) has reported that roughly 5 million Americans, or 2.8%, are living with some version of the condition. However, there is evidence that bipolar disorder is under diagnosed; researchers speculate that it could be because people only seek professional help and treatment when experiencing a depressive episode which makes the manic or hypomanic tendencies undetectable.
In some cases of severe mood shifts and episodes of both extreme mania and depression, the individual might develop psychosis where they experience hallucinations or delusions which occasionally results in a misdiagnosis of schizophrenia. Perhaps due to the immense discomfort of feeling unsettled in one’s mind and body as their emotional landscape constantly shifts and changes, many self-medicate with alcohol.
In the National Epidemiologic Survey on Alcohol and Related Conditions survey from a few years ago, SAMSHA discovered a higher correlation between alcohol use and those diagnosed with bipolar disorder than any other mental illness included on the survey. As alcohol is a central nervous system (CNS) depressant and alters the way the mind processes information, often numbing the undesirable, it is relatively easy to grab alcohol in a time of need. This, however, only makes matters worse as alcohol is addictive and can severely impact both the body and mind’s functioning when large quantities are consumed over time.
How Are Bipolar Disorder And Alcoholism Related?
Studies show that 30-50% of individuals diagnosed with either bipolar disorder I or II will develop a substance use disorder (SUD) at some point over the course of their lives; on the inverse, about half of individuals classified as having a SUD will also experience a mental health diagnosis. Whether or not one explicitly causes the other is undeterminable, but according to the National Survey on Drug Use and Health (NSDUH) administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), the percentage of adults experiencing a co-occurring disorder increased from 3.3% in 2015 to 3.8% in 2019.
Alcoholism and bipolar disorder are somewhat cyclical and overlapping as they both affect the part of the brain that regulates things like motivation, impulsivity, and overall feelings of reward. Though bipolar disorder is neither preventable nor completely curable, there are many methods of treatment that help alleviate the intensity of the mood shifts.
Effective Treatment Must Address Both Disorders
In order for treatment to be as effective as possible, it is imperative that someone suffering from both bipolar disorder and an alcohol use disorder receives care that addresses both. Most regimens used to treat co-occurring disorders consist of some combination of pharmacological treatment with psychological therapy. While there are different approaches in terms of the timing and order of treatment, it is recommended that rehabilitation services are integrated and addressed together so as to understand the connection between the two disorders and learn ways to more effectively manage triggers and symptoms for each that causes the other. In general, recovery must be framed as a journey or a path; it is not easy, automatic, or even enjoyable, but the reward is bountiful and more life-giving. Approaching treatment as an opportunity to start a new life and focus on health and wellness is going to be significantly more impactful than harping on the illnesses themselves; the mind can work wonders depending on the thoughts that feed it.
Reach Out To Ask Questions And Get Help
Bipolar disorder can feel lonely and frightening when you’re shifting back and forth between such highs and lows that reaching for that bottle might seem like your only option. Yet, alcohol only makes things worse and often leads to an even bigger problem in an alcohol use disorder. Finding treatment that fits your needs and addresses both disorders with fervor and an understanding of their connectedness could change your entire life. Reach out to a treatment provider today ; there are people ready and willing to help you become your best, most authentic self. You are not alone and you do not have to suffer in silence. If you or someone you love is struggling with bipolar disorder and/or alcoholism, contact a treatment provider to get your questions answered and begin the journey toward recovery.
Author: Hannah Zwemer | Last Edited: May 10, 2022
Medical Reviewer: David Hampton