SUD comorbidity is not exclusive to adult bipolar patients but starts early in life. Pediatric onset BD rarely occurs in the absence of comorbid conditions, and the co-occurrence of additional disorders complicates both the accurate diagnosis of BD and its treatment. Manifestation of BD in children and adolescents is not as infrequent as previously assumed, with rates of bipolar spectrum disorder reaching an estimated 4%, especially in US samples (10).
- About 45 percent of people with bipolar disorder also have alcohol use disorder (AUD), according to a 2013 review.
- These episodes may be so severe that they require hospitalization in order to stabilize.
- One of the benefits of residential treatment is that the program will evaluate you thoroughly, so that all issues are diagnosed.
- Drinking on bipolar medication can turn one drink into several, especially drinking on an empty stomach.
There’s been a recent trend to consider treating both conditions simultaneously, using medications and other therapies that treat each condition. There is also a greater risk of suicide in individuals who have bipolar disorder and alcohol use disorder. It is thought that the genes that increase the risk of bipolar disorder may be the same genes that influence alcohol addiction. Genetic differences may affect the brain reward system making people with bipolar disorder more vulnerable to alcohol and drug addiction. Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis.
The Relationship Between Bipolar Disorder & Alcohol Misuse
Early abstinence predicted later abstinence, and a significant number of those who reduced their drinking by 6 months also achieved complete abstinence after 5 years (91). Comorbidity rates in Bipolar disorder rank define commission pay highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally.
According to SAMHSA, people with bipolar disorder may misuse substances for a number of reasons, including because both disorders change brain areas important in regulating impulsivity and feelings of reward and pleasure. People with bipolar disorder have a 21.7% to 59% increased chance of being diagnosed with substance use disorder at least once in their life, per SAMHSA. Alcohol misuse appears to be most common among people with bipolar disorder. Turning to alcohol or other illegal drugs might seem helpful in coping with painful symptoms in the short term, but it can have severe and disruptive consequences to daily life.
Diagnosing Bipolar Disorder
Whereas, criteria for a manic episode were tightened (13, 14) preceding substance use per se is no more an exclusion criterion for a genuine BD diagnosis as long as the mental alterations exceed well the physiological effect of the substance. This may change figures of future epidemiological studies on SUD and BD comorbidity to some degree. Both bipolar affective disorder (BD) and substance use disorder (SUD) are wide-spread in the general population. Most epidemiological and treatment studies were conducted according to DSM-IV https://sober-home.org/ or ICD-10 criteria that distinguishes between substance abuse and dependence as diagnostic entities on its own. Depending on the diagnostic system (ICD or DSM) used and subject sample studied, bipolar affective disorder (BD) in the general population has a lifetime prevalence between 1.3 and 4.5% (1). The World Health Organization World Mental Health Survey Initiative (2) conducted across eleven countries reported a 4.8% lifetime prevalence of all manifestations of bipolarity, including subthreshold and spectrum disorder.
Bipolar Disorder and Alcohol Use Disorder
Gender differences have a significant influence on treatment outcomes in BD (58) but not as much on outcomes in alcohol dependence (59). Especially a history of verbal abuse and rates of social phobia and depression are higher in female than male BD patients with AUD (32). Whereas, AUD in female BD patients fosters rather self-destructive consequences, males appear more likely to externalize anger and impulsivity, and stand out by a history of criminal actions (62). Specific numbers for AUD and BD are not available, but for affective disorders (AD) in general and SUD, criminal behavior has been observed twice as frequent in AD with SUD compared to AD without (63). If you have bipolar disorder and alcohol use disorder or another addiction, you have what’s known as a dual diagnosis.
Alcohol eases the anxiety between the crazy feelings and the ups and downs bipolar disorder brings about. Mild drugs don’t seem to cut out all the symptoms many feel with bipolar disorder. Additionally, many with bipolar disorder find that the side effects of most medications are so extreme that they would rather self-medicate and deal with the consequences. If you or someone you care about has bipolar disorder and is struggling with drinking, take steps to get help as soon as possible. Even if you don’t think you have an alcohol use disorder, drinking while living with this condition is risky.
It’s crucial to note that alcohol abuse not only affects the severity of bipolar symptoms but also the overall course of the disorder. Research has shown that individuals who engage in heavy alcohol consumption are more likely to experience a higher number of manic and depressive episodes. This cycle of instability can lead to a more challenging prognosis and poorer treatment outcomes. Acamprosate has also been evaluated in an open-label trial and a randomized controlled trial. No statistically significant treatment differences were detected in drinking or mood outcomes.