Others may see the new findings as important for resisting peer pressure to binge drink during social situations. If you’re ready to explore getting help, we commend you — it’s a brave step. You can learn about what we offer and make the decision that’s right for you. Or, if you’d like to dig a little deeper into how we’re different, you can learn more about Cerebral Way and how Cerebral compares to other online therapy and medication management options.Images by wirestock, Freepik, and master1305 on Freepik.
Alcohol and Depression: Understanding the Connection
In spite of the significant prevalence of comorbid alcoholism and bipolar disorder, there is little published data on specific pharmacologic and psychotherapeutic treatments for bipolar disorder in the presence of alcoholism. The medications most frequently used for treating bipolar disorder are the mood stabilizers lithium and valproate. As stated previously, preliminary evidence suggests that alcoholic bipolar patients may have more rapid cycling and more mixed mania than other bipolar patients. There is also evidence to suggest that these subtypes of bipolar disorder have different responses to medications (Prien et al. 1988), which would help provide a rationale for the choice of agents in the alcoholic bipolar patient. Available research on the use of lithium, valproate, and naltrexone for comorbid patients is reviewed below. In conclusion, it appears that alcoholism may adversely affect the course and prognosis of bipolar disorder, leading to more frequent hospitalizations.
Bipolar Disorder and Alcohol Use Disorder
Alcohol use may worsen the clinical course of bipolar disorder, making it harder to treat. There has been little research on the appropriate treatment for comorbid patients. Some studies have evaluated the effects of valproate, lithium, and naltrexone, as well as psychosocial interventions, in treating alcoholic bipolar patients, but further research is needed. Cyclothymic Disorder involves milder, yet chronic, fluctuations between hypomanic and depressive symptoms. Even though mood swings aren’t as extreme as the other bipolar disorders, they’re still impactful and drinking alcohol can complicate things. If you have cyclothymic disorder, alcohol can worsen depression and make hypomanic episodes riskier by increasing impulsive behaviors.
They concluded that this finding is in accordance with results of clinical studies that suggest alcoholism is often a complication of bipolar disorder rather than a risk factor for it. The FIRESIDE Principles for an integrated treatment of bipolar disorder and alcohol use disorder. While the manic episodes of bipolar I disorder can be severe and dangerous, people with bipolar II disorder can be depressed for longer periods of time. It is also possible for people who had no prior history of bipolar disorder to develop it after year of substance abuse.
- When you stop using drugs and alcohol your body and mind go into withdrawal.
- Alcohol can affect a person with bipolar disorder differently, compared with someone who does not have it.
- Valproic acid is a CNS depressant that can have similar effects to alcohol.
- Side effects, including lethargy, weight gain, and tremors, were listed as the main reason for non-compliance with lithium (Weiss et al. 1998).
- Abnormalities in the cerebellar vermis, lateral ventricles, and some prefrontal areas may develop with repeated affective episodes, and may represent the effects of illness progression (Strakowski et al., 2005b).
Effects on diagnosis
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 what drug causes foaming at the mouth episode. Cyclothymia is a disorder in the bipolar spectrum that is characterized by frequent low-level mood fluctuations that range from hypomania to low-level depression, with symptoms existing for at least 2 years (American Psychiatric Association APA 1994). Multiple explanations for the relationship between these conditions have been proposed, but this relationship remains poorly understood.
If commonalities in the recovery and relapse process in the two disorders can be seen as parallels between the two disorders, the focus on the relationship between the two disorders can be viewed as the intersection between BD and alcohol dependence. Thus, patients are told that drinking will negatively affect the course of their BD, and that non-adherence to their BD medication will increase their risk of relapse to drinking. Again, the focus on the intersection between the two disorders is consistent with the single-disorder paradigm. Those with bipolar disorder are at a heightened risk for this disease, with approximately 56% of individuals with bipolar I or II disorder having a history of AUD.This highlights the need to watch for issues with substances.
Indeed, high trait impulsivity may mediate some severe manifestations of this comorbidity (Swann et al., 2009; Nery et al., 2013). Medication compliance is an important issue to consider when assessing the effectiveness of medications. One study of the lifetime medication compliance of lithium and valproate in 44 alcohol and other drug-abusing bipolar patients found that patients were significantly more likely to take valproate (50 percent compliant) compared with lithium (21 percent compliant). Side effects, including lethargy, weight gain, and tremors, were listed as the main reason for non-compliance with lithium (Weiss et al. 1998). However, it is also important to note that prescription bottles for lithium usually have a warning label on them not to drink alcohol while taking the medication.
