Understanding Bipolar Disorder
Bipolar disorder is a chronic illness typically experienced in early adulthood, although onset in childhood or older may also occur. Bipolar disorder can be divided into subtypes, including bipolar I and bipolar II. Bipolar and alcohol use disorder or other types of substance abuse can be dangerous. Alcohol and bipolar disorder can worsen the symptoms and severity of each other.
Bipolar I disorder is distinguished by full-blown manic episodes that are more impairing than the hypomanic episodes that characterize bipolar II disorder. Depression, the presenting symptom of bipolar disorder in most patients, may impose a greater disease burden, in terms of duration and impact, than manic symptoms. Depressive symptoms may be similar in bipolar I and II disorder; therefore, bipolar II disorder should not be considered a “milder” illness than bipolar I. 
The form of the disease that individuals experience tends to be stable over their lifetime. For patients with either condition, the primary care physician can play an important role, often working with psychiatric consultants:
- Managing bipolar disorder treatment
- Monitoring bipolar disorder and ensuring that other healthcare needs are met, including preventive care
- Managing chronic comorbid medical conditions with the help of bipolar and addiction treatment
Link Between Bipolar Disorder and Alcoholism
Depression is the presenting symptom of bipolar and alcoholics, or bipolar and alcohol abuse. DSM-5 criteria specify that depressed mood and a loss of interest or pleasure must be present for at least 2 weeks in combination with the symptoms. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by healthcare professionals in the United States and much of the world as the authoritative guide to diagnosing mental disorders.
Physicians should ensure that the depressive symptoms identified are not better explained by other causes, including medical conditions, alcohol or drug abuse, or bereavement. Of particular importance for patients who are experiencing depressive symptoms is to assess for risk of suicide and self-harm.
Bipolar and Alcohol Addiction
Patients with bipolar disorder are predisposed to other psychiatric disorders at elevated rates. Anxiety disorders (such as PTSD), personality disorders, ADHD, and alcohol or drug dependence are common comorbidities. Having co-occurring conditions increases the risk of mood swings, depression, violence, and suicide.
- Understanding Bipolar Disorder
- Link Between Bipolar Disorder and Alcoholism
- Bipolar and Alcohol Addiction
- What Causes Bipolar Individuals to Drink?
- Bipolar Disorder and Alcohol Abuse
- Bipolar 1 and Alcohol
- Bipolar 2 and Alcohol Abuse/Alcohol and Bipolar 2
- Bipolar and Alcohol Effects
- Bipolar and Alcohol Blackouts
- Bipolar and Alcohol Rage
- Can Drugs and Alcohol Cause Bipolar
- Mixing Alcohol and Bipolar Medication
- Bipolar and Alcoholism Symptoms
- Bipolar and Alcohol Withdrawal
- Bipolar and Alcoholism Recovery
- Co-Occurring Disorders – Bipolar and Alcohol Treatment Centers
- PTSD and Alcohol
- Alcoholic Cirrhosis Symptoms
- Alcoholic Hepatitis vs Cirrhosis
- Mixing Prescription Drugs with Alcohol
- Naltrexone and Alcohol
- Alcohol and Aging
- Acute Alcohol Intoxication
- Alcohol Headache
- How Alcohol Affects the Brain
- Giving Up Alcohol
- How to Reduce Alcohol Consumption Safely
- Medication-Assisted Treatment for Alcohol Addiction
- Alcohol Blackout
- Alcohol Induced Dementia
- Alcohol Induced Psychosis
- Inpatient Alcohol Treatment
What Causes Bipolar Individuals To Drink?
Bipolar illness patients may feel out of control or disconnected from their lives. When an episode begins, being unsure of what to do or how to feel causes turning to alcohol, a highly alluring approach for easing these numbing feelings. Alcohol eases tension, particularly in social situations. It may temporarily lessen the negative bipolar disorder symptoms, but it also increases the likelihood that the disease will eventually worsen.
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Bipolar Disorder and Alcohol Abuse
Alcohol sedative effects exacerbate bipolar disorders. Similar to several drugs, it causes a likelihood of depressive symptoms with every drink. Alcohol also significantly worsens mania, which many bipolar patients find delightful. Alcohol, however, can worsen bipolar disorder’s side effects in either direction, inciting the bipolar symptoms with every drink.
Bipolar 1 and Alcohol
Alcohol can temporarily lessen the symptoms of bipolar 1. Still, drinking alcohol and bipolar 1 also puts a person who has the condition in danger since the hazards grow over time as the disorder’s effects worsen. Since bipolar disorder can cause painful and undesirable episodes, it is not advised to drink when you have the condition.
Bipolar 2 and Alcohol Abuse/Alcohol and Bipolar 2
Alcohol use disorder (AUD) and bipolar disorder 2 are often treated separately. However, it is almost always better to treat the dual diagnosis simultaneously rather than have the untreated illness bring back symptoms of the one that received treatment. Bipolar 2 and alcohol drinking may seem to help, but in the long run, it worsens symptoms. With bipolar 2 and alcohol use, during an episode of mania, alcohol can increase impulsivity while worsening symptoms of depression.
Bipolar disorder, often called manic depression, is a mood disorder that is characterized by extreme fluctuations in mood from euphoria to severe depression, interspersed with periods of normal mood (i.e., euthymia). Bipolar disorder represents a significant public health problem, which often goes undiagnosed and untreated for lengthy periods.
Several disorders in the bipolar spectrum include bipolar I disorder, bipolar II disorder, and cyclothymia.
- Bipolar I disorder 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. 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 dangerous 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). They are more likely to seek treatment during a depressive episode than a manic episode.
- Cyclothymia is a disorder in the bipolar spectrum characterized by frequent low–level mood fluctuations ranging from hypomania to low–level depression, with symptoms existing for at least 2 years.
Alcohol dependence, also known as alcoholism, is characterized by a craving for alcohol, possible physical dependence on alcohol, an inability to control one’s drinking on any given occasion, and increasing tolerance to alcohol’s effects. It often starts in early adulthood. On the other hand, the criteria for a diagnosis of alcohol abuse do not include the craving and lack of control over drinking characteristic of alcoholism.
Rather, alcohol abuse is defined as a pattern of drinking that results in the failure to fulfill responsibilities at work, school, or home; drinking in dangerous situations, and having recurring alcohol-related legal problems and relationship problems caused or worsened by drinking. Alcohol abuse often occurs in early adulthood and is usually a precursor to alcohol dependence.
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Bipolar and Alcohol Effects
With bipolar 2 and alcoholism, alcohol would depress a bipolar person’s mood more than it would raise it, but for some people, the trade-off is worth it. Bipolar type 2 and alcohol can have similar adverse effects as bipolar 1. But we must understand much about alcoholism and bipolar disorder psychology today. For being bipolar and drinking alcohol, alcohol reduces the anxiety that comes with the irrational thoughts and ups and downs that bipolar illness causes.
Mild medications don’t appear to eliminate all of the bipolar disorder symptoms that many people experience. The negative effects of most drugs are sometimes so severe for people with bipolar illness that they would prefer to self-medicate and live with the consequences. Thus, resulting in alcohol use and bipolar disorder comorbidity.
Bipolar and Alcohol Blackouts
Depending on what medication you’re taking for bipolar disorder, the effects of alcohol may be intensified or cause new side effects. For this reason, there may be a connection between bipolar depression and alcohol, bipolar disorder and alcohol blackouts, vomiting, and other severe side effects of drinking.
Bipolar and Alcohol Rage
Alcohol is known to amplify bipolar disorder due to its sedating effects. It acts similarly to some medications, risking feelings of depression and rage with each consumption of alcohol. Alcohol also greatly increases the severity of mania, which many who suffer from bipolar find extremely pleasurable.
One of the prevalent bipolar and alcohol stories is having a bipolar and alcoholic husband. Many of you searching for “alcohol and bipolar rage” may think, “my husband is bipolar and an alcoholic.” Alcohol and bipolar rage are common for those who have mental conditions. It is also common that a bipolar alcoholic and refuses to get help. Alcohol and bipolar anger is a result of aggressive mood swings. Having bipolar and alcoholism conditions increases the risk of mood swings, depression, violence, and suicide. Bipolar anger and alcohol may lead to self-harm or harming others. Bipolar rage and alcohol should not be taken lightly.
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Can Drugs and Alcohol Cause Bipolar?
The exact cause of the bipolar disorder remains unknown. But several factors are involved, including:
- Genetics: People with a first-degree relative with the condition are more likely to develop bipolar disorder. However, researchers have not found the specific genes that trigger this disorder.
- Biological Factors: People with bipolar disorder tend to have physical changes in their brain’s structure. The consequence of these changes is still uncertain but does shed light on the causes of this disorder.
Some factors may increase the risk of developing bipolar disorder or trigger the first psychotic episode, such as:
- Excessive drug or alcohol abuse
- Periods of high-stress or traumatic experiences
- Having an immediate family member with bipolar disorder
Bipolar disorder and alcoholism commonly co-occur. Multiple explanations for the relationship between bipolar disorder and alcohol conditions have been proposed, but this bipolar disorder and alcohol addiction relationship remains poorly understood. Some evidence suggests a genetic link. This comorbidity also has implications for diagnosis and treatment. Alcohol use may worsen the clinical course of bipolar disorder, making it harder to treat. 
Mixing Alcohol and Bipolar Medication
Drinking is not advised when taking medication for bipolar disorder. “Bipolar and drugs and alcohol use disorders” increase the risk of overdose. bipolar disorder drugs and alcohol shouldn’t be mixed since doing so might have dangerous adverse effects, including serious damage or even death.
Certain medications can help manage bipolar disorder. These medications, often called mood stabilizers, include:
- Divalproex sodium (Depakote)
- Lamotrigine (Lamictal)
- Valproic acid (Depakene)
Benzodiazepines, usually used to treat anxiety, can help when bipolar disorder tandems with difficulty sleeping. Xanax, Klonopin, Valium, and Ativan are all potential bipolar disorder medications. Benzodiazepine bipolar medication and alcohol use is also extremely dangerous. Bipolar medication and alcohol use not only amplify the effects of each other but may also cause fatal overdose.
Other types of medication people can use for this specific mental illness include:
- Tricyclic antidepressants (Norpramin, Anafranil)
- Selective-serotonin reuptake inhibitor and serotonin-norepinephrine reuptake inhibitor (Celexa, Prozac, Zoloft, Luvox, Paxil, Effexor)
- Atypical Antidepressants (Wellbutrin, Serzone)
- Antipsychotics (Zyprexa, Risperdal, Abilify)
Lamotrigine and Alcohol Bipolar
Lamotrigine is sold under the brand name Lamictal. “Lamictal and alcohol bipolar” is a dangerous combination. It may make you sleepy or tired, and alcohol and hangovers can bring on seizures in some people with epilepsy. Alcohol and bipolar depression may also cause one person to misuse the drug.
Lithium for Bipolar and Alcohol
Bipolar medication and alcohol should not be mixed. People taking lithium should avoid drinking alcohol. Not only can alcohol worsen bipolar disorder symptoms, but it can also intensify side effects caused by lithium, including dizziness and drowsiness. Alcohol and bipolar disorder medication, when mixed, may also cause an overdose.
Other Alcohol and Bipolar Meds
Taking bipolar drugs and alcohol drinking is highly hazardous. Bipolar medication anddrinking alcohol is not recommended. Bipolar medicine and alcohol should not be combined as they can result in severe side effects, including severe injury or death. Tell your doctor immediately if you have side effects from bipolar meds and alcohol.
Bipolar and Alcoholism Symptoms
Before beginning a pharmaceutical treatment for bipolar illness, seek a medical expert. Advise your doctor if you have a history of addiction to bipolar disorder medication and alcohol. When combined with another prescription or a common substance like alcohol, certain drugs that have the potential for overdose can become highly dangerous to consume. Another negative consequence of drinking alcohol while taking bipolar medication is drowsiness. Other effects of mixing alcohol with bipolar medication include:
- Slowed breathing
- Increased depression
- Liver damage
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Bipolar and Alcohol Withdrawal
At first, alcohol and bipolar mania can feel satisfying. But having bipolar and alcohol consumption can cause one person to be less likely to stick with their treatment. Bipolar and alcoholism effects can also cause severe withdrawal symptoms. Alcohol withdrawal symptoms occur when patients stop drinking or significantly decrease their alcohol intake after long-term dependence. Withdrawal has a broad range of symptoms, from mild tremors to a condition called delirium tremens, which results in seizures and could progress to death if not recognized and treated promptly. 
Symptoms of alcohol withdrawal may include the following:
- Nausea and vomiting
- Auditory disturbances
- Paroxysmal sweating
- Visual disturbances
- Clouding of sensorium
Complications that can accompany alcohol withdrawal syndrome include:
- Delirium tremens
- Wernicke-Korsakoff syndrome
- Sleep disturbances
- Cardiovascular complications
Patients should be kept calm in a controlled environment for alcohol detox, such as inpatient alcohol rehab, to reduce the risks of progression from mild symptoms to hallucinations. Close monitoring is essential as the symptoms can suddenly become severe.
In most cases, mild symptoms of bipolar and drinking alcoholics may develop within hours after the last drink and, if left untreated, can progress and become more severe. Bipolar depression and alcohol abuse may also exacerbate these withdrawal symptoms. Also, alcohol withdrawal may trigger bipolar symptoms.
Because chronic alcohol use is widespread in society, all healthcare workers, including nurses and pharmacists, should be familiar with the symptoms of alcohol withdrawal, “bipolar disorder and alcohol effects,” and its management.
Nurses monitoring alcoholic patients should be familiar with the signs and symptoms of alcohol withdrawal and communicate to the interprofessional team if any deviations are from normal. In most cases, the symptoms are autonomic. For those who develop delirium tremens, monitoring in a quiet room is recommended.
Today, pharmacotherapy is often used to manage the symptoms of alcohol withdrawal. However, if the symptoms are severe and pharmacological treatment is required, the patient should be referred to an internist or an alcohol treatment specialist. Prompt referral and treatment can help lower the morbidity of alcohol withdrawal symptoms and may even be lifesaving.
After bipolar disorder and alcohol use disorder treatment, the patient should be referred to Alcoholics Anonymous and urged to abstain from alcohol. A social worker should be involved with patients without support to help facilitate addiction rehabilitation.
Bipolar and Alcoholism Recovery
bipolar disorder and alcohol consumption commonly co-occur. In two epidemiologic survey studies by NIAAA, alcohol dependence was more likely to occur with bipolar disorder than with all other psychiatric disorders except antisocial personality disorder. 
The nature of the relationship between bipolar disorder and drinking alcohol is complex and not well understood. It appears that alcohol use may worsen the clinical course of bipolar disorder, making it harder to treat. There is also evidence of a genetic link between the two conditions. Bipolar disorder complicated by alcoholism is associated with increased hospitalizations, mixed mania, earlier onset of bipolar disorder, and more suicidal ideation. Given the prevalence and morbidity of these two disorders, it is important to screen for substance abuse in all bipolar patients and to treat them aggressively because untreated bipolar and alcohol addiction can be deadly.
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Co-Occurring Disorders – Bipolar and Alcohol Treatment Centers
Fortunately, many accredited rehab centers now offer dual diagnosis treatment. Dual diagnosis is generally defined as treating someone simultaneously diagnosed with a substance abuse disorder and a mental health disorder. A report  published by the National Institute on Drug Abuse suggested that there is a reason why people with mental disorders are up to two times as likely to develop substance abuse disorders and alcohol addiction:
- Certain drugs can cause abusers to suffer one or more symptoms of another mental illness.
- Mental illness may precipitate or hasten substance or alcohol abuse. An individual suffering from symptoms of a mental illness may attempt to self-medicate.
- Drug use and alcohol disorders, and mental illnesses are caused by overlapping factors; genetic, deficits, and otherwise.
The good news is We Level Up FL can provide the highest quality of care in the beautiful tranquility of southeastern Florida. We Level Up Florida recognizes the intricacies of how bipolar and alcohol can result in a vicious cycle of addiction. That’s why we offer specialized treatment in dual-diagnosis cases to provide the greatest chance of true healing and long-lasting recovery.
The We Level Up FL primary mental health center is accredited in treating bipolar and alcoholism. We Level Up FL can inspire a support system through our mental health treatments to make you feel valuable. You can trust the treatment backed by leading recovery specialists practicing evidence-based therapy. We Level Up FL Treatment Center offers therapy under one roof. Get comprehensive therapy for mind, body & spirit.
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Search Bipolar and Alcohol & Other Resources
 Culpepper L. The diagnosis and treatment of bipolar disorder: decision-making in primary care. Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01609. DOI: 10.4088/PCC.13r01609. Epub 2014 Jun 19. PMID: 25317368; PMCID: PMC4195640.
[2-4] Bipolar Disorder and Alcoholism – National Institute on Alcohol Abuse and Alcoholism
 Newman RK, Stobart Gallagher MA, Gomez AE. Alcohol Withdrawal. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441882/
 Comorbidity – National Institute on Drug Abuse
 Jain A, Mitra P. Bipolar Affective Disorder. [Updated 2022 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558998/
 Kranzler HR, Soyka M. Diagnosis and Pharmacotherapy of Alcohol Use Disorder: A Review. JAMA. 2018 Aug 28;320(8):815-824. DOI: 10.1001/jama.2018.11406. PMID: 30167705; PMCID: PMC7391072.