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    Daniel K. Hall-Flavin, M.D.

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Question

Bipolar disorder and alcoholism: Are they related?

Is there a connection between bipolar disorder and alcoholism?

Answer

from Daniel K. Hall-Flavin, M.D.

Bipolar disorder and alcoholism often occur together. Up to half the people who have bipolar disorder also struggle with alcoholism.

Although the association between bipolar disorder and alcoholism isn't clearly understood, these factors likely play a role:

  • Inherited traits. Genetic differences appear to affect brain chemistry linked to bipolar disorder. These same traits may also affect the way the brain responds to alcohol and other drugs, increasing the risk of alcoholism and addiction to other drugs.
  • Depression and anxiety. Some people drink to ease depression, anxiety and other symptoms of bipolar disorder. Drinking may seem to help, but in the long run it makes symptoms worse. This can lead to more drinking — a vicious cycle that's difficult to overcome.
  • Mania. This upswing from depression is usually characterized by an intensely elated (euphoric) mood and hyperactivity. It commonly causes bad judgment and lowered inhibitions, which can lead to increased alcohol use or drug abuse.

Bipolar disorder and alcoholism or other types of substance abuse can be a dangerous combination. Each can worsen the symptoms and severity of the other. Having both conditions increases the risk of mood swings, depression, violence and suicide.

Someone who has both bipolar disorder and alcoholism or another addiction is said to have a dual diagnosis. Treatment may require the expertise of mental health care providers who specialize in the treatment of dual disorders.

If you've lost control over your drinking or you abuse drugs, get help before your problems become worse and harder to treat. Seeing a mental health expert right away is especially important if you also have signs and symptoms of bipolar disorder or another mental health condition.

Next question
Bipolar treatment: Are bipolar I and bipolar II treated differently?
References
  1. Dual diagnosis: Substance abuse and mental illness. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=23049. Accessed April 3, 2013.
  2. Chang YH, et al. Neuropsychological functions in bipolar disorders I and II with and without comorbid alcohol dependence. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2012;37:211.
  3. McDonald JL, et al. Self-report reasons for alcohol use in bipolar disorders: Why drink despite the potential risks? Clinical Psychology and Psychotherapy. 2011;18:418.
  4. Bipolar disorder. National Alliance on Mental Illness. http://www.nami.org/Content/NavigationMenu/Mental_Illnesses/Bipolar1/bipolardisorderbrochure-lores.pdf. Accessed April 3, 2013.
  5. Bipolar disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml. Accessed April 3, 2013.
  6. Kung S (expert opinion). Mayo Clinic, Rochester, Minn. April 4, 2013.
  7. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. April 5, 2013.
AN00920 April 10, 2013

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