Post-treatment prognosis can be influenced by a number of factors including early abstinence, baseline low anxiety, engagement with an aftercare program and female gender. The future development of novel therapies relies upon increased psychiatric and medical awareness of the co-morbidity, and further research into novel therapies for the comorbid group. The PLS-BD is a unique and detailed longitudinal study that has engaged over 1,500 individuals with and without bipolar disorder who are helping scientists identify biological, genetic, psychological, and environmental causes of bipolar disorder and its trajectory over time. All of them complete measures of mood symptoms, life functioning, alcohol use and more every 2 months throughout their involvement in the study. In a pioneer work, van Gorp et al. (1998) examined 12 BD patients with past history of alcohol dependence, 13 BD patients without such comorbidity, and 22 healthy controls. Only males were recruited and all outpatients were euthymic at the time of neurocognitive assessment.
Treating SUD in people with bipolar disorder
Both tend to occur more frequently in people who have a family member with the condition. Researchers haven’t identified a clear link between bipolar disorder and AUD, but there are a few possibilities. Having one or more of these risk factors is not a guarantee you will have an SUD. However, it’s important to be aware of the ways you may be uniquely vulnerable so you can take preventive measures. Prospective studies suggest that abstinence from alcohol results in partial neurocognitive recovery, especially regarding sustained attention (Schulte et al., 2014). Overall, a widespread pattern of impairment seems to remain stable during the first year of sobriety and neurocognitive performance tends to normalize only after 1 year of abstinence (Stavro et al., 2013).
Bipolar Disorder and Alcohol Use Disorder: A review
All of them complete measures of mood symptoms, life functioning, alcohol use and more every two months throughout their involvement in the study. Both bipolar disorder and alcohol consumption cause changes in a person’s brain. The researchers found a direct link between alcohol consumption and the rate of occurrence of manic or depressive episodes, even when study participants drank a relatively small amount of alcohol. In 2006, a study of 148 people concluded that a person with bipolar disorder does not need to drink excessive amounts of alcohol to have a negative reaction. Depending on which drugs you take for bipolar disorder, alcohol may interfere with their ability to work correctly.
Bipolar Disorder and Alcohol Use Disorder
Even if you don’t think you have an alcohol use disorder, drinking while living with this condition is risky. Seek treatment for bipolar disorder and talk to your doctor or therapist about drinking and how to stop. While it may seem daunting to try to manage bipolar disorder and give up alcohol, there is hope. Treatment is effective and helps many people manage their co-occurring disorders. The best course is a combination of medications and therapy, along with supplemental treatments such as holistic care and alternative, creative therapies. There is a lot that we still need to understand about the link between alcohol and depression, and this is an emerging area of research.
All that’s needed for a diagnosis of bipolar I disorder is the development of a manic episode. These episodes may be so severe that they require hospitalization in order to stabilize. People who receive a diagnosis of AUD may recover faster than people who first receive a diagnosis of bipolar disorder. Another explanation for the connection is that people with bipolar disorder can exhibit reckless behavior, and AUD is consistent with this type of behavior. The person with the conditions, their doctors, and possibly their friends or family 12 Steps of AA What Are the Principles of AA members can be part of a larger treatment strategy.
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. The relationship between alcohol and bipolar mania is particularly concerning. Alcohol can trigger manic episodes in individuals with bipolar disorder, leading to increased risk-taking behavior, impulsivity, and poor decision-making.
However, substance misuse to self-medicate isn’t a long-term solution to managing bipolar disorder or healing from trauma. A total of 584 individuals (386 females (66.1%); mean SD age, 40 13.6 years) were included. These participants had a BDI (445 76.2%) or BDII (139 23.8%) diagnosis, with or without a lifetime diagnosis of AUD, and a median (IQR) follow-up of 9 (0-16) years. To characterize the longitudinal alcohol use patterns in BD and examine the temporal associations among alcohol use, mood, anxiety, and functioning over time. “The reasons behind our findings likely have more to do with what alcohol and social situations involving alcohol do to a person’s circadian rhythms and brain-based reward circuits, not just the action of the substance in the brain,” says Sperry.
As a result of this process, a number of evidence-based psychotherapies have been developed for BD and for alcohol dependence. Similarly, motivational enhancement therapy, twelve-step facilitation therapy, and cognitive-behavioral relapse prevention therapy have all been shown to be effective in the treatment of alcohol dependence (Project MATCH Research Group, 1997). As a result, little psychotherapy research has focused on patients with co-occurring BD and alcohol dependence.
General Health
- Available research on the use of lithium, valproate, and naltrexone for comorbid patients is reviewed below.
- We agree with McIntyre et al. (2014) that this approach may be particularly relevant for BD with comorbid conditions.
- There are some gender differences also in that more men than women with BD tend to be alcoholic (Frye et al., 2003).
- Although research suggests that alcohol and other drug abuse may worsen the course of bipolar disorder, some data indicate that patients with bipolar disorder and alcoholism do better in substance abuse treatment than alcoholic patients with other mood disorders.
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. This mixed mania, as it is called, appears to be accompanied by a greater risk of suicide and is more difficult to treat.
Although the etiology of the BD-AUD comorbidity is poorly understood, several explanations have been put forward. Both BD and AUD are complex-trait conditions with overlapping etiopathophysiological pathways at the genetic, neurochemical, neurophysiologic and neuroanatomic levels (Farren et al., 2012). Shared genetic basis could confer risk for both BD and AUD (Johnson et al., 2009). Interestingly, this common genetic vulnerability would not be entirely driven by confounders, such as liability for anxiety disorders (Carmiol et al., 2014). Moreover, comorbid alcohol and substance use may also be a coping strategy by which patients try to manage (e.g., by self-treatment) their mood symptoms (Bizzarri et al., 2009; Do and Mezuk, 2013).
There is also growing evidence that neurocognitive impairments are major predictors of BD patients’ long-term functional outcomes (Tabarés-Seisdedos et al., 2008; Wingo et al., 2009). Therefore, neurocognitive improvement represents a therapeutic target in BD (Fuentes-Durá et al., 2012). There is pressing need to develop interventions specifically addressed to ameliorate these deficits by means of pro-cognitive medications (Dias et al., 2012) and cognitive training and rehabilitative strategies, such as functional remediation (Torrent et al., 2013). According to NIMH, it’s better to treat both conditions together than separately. You’re more likely to have depressive symptoms during withdrawal from alcohol use. You might experience helplessness, fatigue, or disinterest in activities that you used to enjoy.