Depression and Bipolar Disorders in Patients With Alcohol Use Disorders PMC

There are a number of disorders in the bipolar spectrum, including bipolar I disorder, bipolar II disorder, and cyclothymia. Bipolar I disorder is the most severe; it is characterized by manic episodes that last for at least a week and depressive episodes that last for at least 2 weeks. Patients who are fully manic often require hospitalization to decrease the risk of harming themselves or others. People can also have symptoms of both depression and mania at the same time. This mixed mania, as it is called, appears to be accompanied by a greater risk of suicide and is more difficult to treat.

Is There a Link Between Bipolar Disorder and Addiction?

There are gold standard treatments for bipolar and SUD separately, but what the best approach is for treating both together is not as clear. People experiencing a depressive episode may feel hopeless, fatigued, and sad. They may isolate themselves from others and no longer find joy in their relationships or hobbies. However, self-medication through substance use has serious health risks, including overdose and death. Approximately 4.4% of U.S. adults will experience bipolar disorder within their lifetimes.

Familial Risk of Bipolar Disorder and Alcoholism

However, improvement of mood was not confirmed in a double-blind study with naltrexone add-on to cognitive behavioral therapy, and there was only a trend toward less alcohol consumption (121). Similar disappointing results have been reported from a controlled study with acamprosate in BD + AUD (122). The AUDIT is also recommended to screen comorbid individuals by several evidence- based guidelines, e.g., the German S3-Guidelines on AUD (49, 53). Treating both bipolar disorder and substance use disorder could help relieve or reverse some detrimental side effects. One review published in 2015 found that people with bipolar disorder who also had an addiction to alcohol experienced issues with their memory and ability to make sound decisions.

Possible Explanations for Comorbidity

A substance use disorder (SUD) is more than drinking socially or using drugs sometimes. An SUD is actually a mental health condition that impairs a person’s ability to control their substance use. Bipolar disorder is defined by mood episodes that fluctuate between highs and lows. When coupled with alcohol use disorder, symptoms of either condition may worsen.

These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. Meta-analytic techniques were employed to aggregate data on lifetime comorbidity and to explore possible sources is it safe to drink coffee with adderall of heterogeneity. We also delve into whether it is possible to regulate bipolar disorder with alcohol. Join us as Gabe and Dr. Nicole discuss the ins and outs of alcohol use and staying stable with bipolar disorder.

Patients with 4 or more mood episodes within the same 12 months are considered to have rapid cycling bipolar disorder, which is a predictor of poor response to some medications. Bipolar II disorder is characterized by episodes of hypomania, a less severe form of mania, which lasts for at least 4 days in a row and is not severe enough to require hospitalization. Hypomania is interspersed with depressive episodes that last at least 14 days. People with bipolar II disorder often enjoy being hypomanic (due to elevated mood and inflated self-esteem) and are more likely to seek treatment during a depressive episode than a manic episode. Multiple explanations for the relationship between these conditions have been proposed, but this relationship remains poorly understood.

You may find yourself needing less sleep, becoming easily distracted, or even acting out in ways that can have social, work, relationship, sexual, or legal consequences. Bipolar disorder is already difficult to diagnose, as it can share symptoms with other conditions, including attention-deficit hyperactivity disorder (ADHD), schizophrenia, and depression. In 2011, researchers noted that alcohol misuse can result in a misdiagnosis of bipolar disorder. 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. The effects of bipolar disorder vary between individuals and also according to the phase of the disorder that the person is experiencing. For example, some people may develop bipolar disorder first, while in others, AUD may appear first.

It can be difficult to get the medication right with bipolar disorder because each person is different and may respond differently to medications. People with bipolar disorder often use medications to stabilize their symptoms. This may cause alcohol misuse and bipolar disorder each to trigger symptoms of the other condition.

If you take lithium for mood stabilization, there is a risk of developing toxic levels of the drug in your body. The risk of toxic lithium levels is higher if you drink too much, as alcohol causes dehydration. It’s important to be aware of this connection if you struggle with bipolar disorder.

People with bipolar disorder and alcohol use disorder should work closely with a healthcare provider to determine the best medication regimen to manage symptoms. When bipolar disorder and alcohol use disorder how to detox your body while pregnant occur together, the combination can be more severe than having each condition independently. Depending on which drugs you take for bipolar disorder, alcohol may interfere with their ability to work correctly.

Despite some ongoing studies, the research field still reflects the current therapeutic field; namely there are few integrated treatment programmes in existence, and even fewer leading to therapeutic guidelines. It is only through demonstration of the effectiveness of treatment integration that there will be extensive therapeutic efforts to bridge psychiatric treatment programmes and services, and substance abuse treatment programmes and services. That treatment integration is still a long way off, despite the can you overdose on lsd acid accumulating research demonstrating the benefits of integration. If the AUD commences before the BD, then one hypothesis for the comorbidity would be that the AUD activates a predisposition towards BD in that subgroup; although there is no genetic or familial evidence for this (Maier and Merikangas, 1996). The other hypothesis, namely that patients with BD use alcohol to self-medicate their mood symptoms, or drink a result of their tendency towards impulsive behaviours, may also apply (Swann et al., 2003).

1. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40–70%, both for Bipolar I and II disorder, and with male preponderance.
2. Examples of traumatic events found to trigger attacks include childbirth, losing a job or a loved one, divorce, misusing or overusing drugs or alcohol, or traumatic head injuries.
3. Further, alcohol use complicates the course and prognosis of bipolar disorder, leading to higher rates of mixed mania, rapid cycling, suicidality, and increased symptom severity (2).
4. Someone who has BD will experience periods of mania and depression of varying severity and duration.
5. If you or someone you know is having thoughts of suicide, a prevention hotline can help.

Family history and severity of symptoms should also factor into diagnostic considerations. Given that bipolar disorder and substance abuse co-occur so frequently, it also makes sense to screen for substance abuse in people seeking treatment for bipolar disorder. The latter appears to be mainly driven by illicit drugs (OR 7.46 in BD-I and 3.30 in BD-II) (28). For AUD, however, a recent meta-analysis of 22 studies showed no difference between BD-I (OR 3.78) and BD-II (OR 3.81) (28).

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 person who is avoiding or cutting down on alcohol may find it helpful to replace the habit with an alternative feel-good solution . On the other hand, the person may decide to skip their medication in order to drink more “safely.” However, not taking the medication can cause symptoms to return. The person may experience hallucinations, or they may believe that they are very important, that they are above the law, or that no harm can come to them, whatever they do. 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. Bipolar disorder affects around 4.4 percent of people in the United States at some time in their lives.

Still, with this type, the symptoms are significant enough to affect daily functioning, relationships, and work or school. In rare and severe cases, people experience hallucinations and delusions during manic episodes. In addition, some people experience hypomanic episodes—less severe manic episodes lasting four or more days.

Research published in 2017 showed treatment with valproate and naltrexone can help people manage bipolar disorder and alcohol addiction. Citicoline is another adjunct treatment option that research suggests is effective for bipolar disorder and cocaine addiction and can also help with improving cognition. Substance use disorder can cause and complicate many health conditions. According to the National Institute of Mental Health (NIMH), almost half of people with substance use disorder also have a mental health condition. When a person takes their medication, they are in a better position to manage their condition. However, adhering to treatment can be difficult for some people with bipolar disorder.