One of the reasons people drink is to self medicate. This is a common term people use to describe the coping skill of escape through drugs or alcohol.
One could imagine all kinds of scenarios that might cause a healthy non mentally ill person to self medicate: the everyday stress of social relationships, work or family life parenting, financial problems. All of these situations may be a trigger for seeking relief through substances.
People with bipolar disorder are much more likely to suffer from alcoholism. In fact one study showed women , in particular, are 7 xs more likely to suffer from alcoholism if they are bipolar (Allen, 2003).
Stress is more of an issue for those with bipolar, as they are more sensitive to all forms of it.
A person who has bipolar disorder may constantly feel their life is out of control and too painful to cope with. Without proper help support and treatment their life can feel unmanageable. Alcohol gives them the false sense of control and provides a temporary escape from painful intense emotions. The connection between bipolar disorder and alcoholism can easily be understood in this way.
Unfortunately, being intoxicated is a false sense of control, and mood stabilizers prescribed by a physician can do a much better and safer job of treating the effects of bipolar disorder
There is a genetic component that contributes to the relationship between bipolar disorder and alcoholism that isn’t quite understood. We do know that there is a very high rate of alcoholism in the families of persons with bipolar disorder. Many of my clients who are bipolar have a strong history of alcoholism in their family. Of course there is a genetic component to both of these illnesses, so it seems that if you are bipolar you are likely to have someone in the family who was bipolar and if you are an alcoholic the same is true.
Complications with Diagnosis
The symptoms of bipolar disorder and alcoholism may look the same. Someone who is drunk may act manic while under the influence of alcohol. Depression is also commonly associated with alcohol withdrawal.
Most mental illness cannot be diagnosed unless the person has had a period of abstinence where they are not suffering from withdrawal and the symptoms of illness are present. People suffering from alcoholism also have dramatic mood swings that can mimic those a person with bipolar disorder suffers. Often when someone stops drinking or using drugs, they go through a period of withdrawal which may include depression, anxiety ,and mood swings which later levels out. Clearly these two illnesses interact in damaging ways and exacerbate one another.
The Course of the Illness and the Prognosis may be Worsened
Obviously if you have bipolar disorder and you are also suffering from alcoholism your prognosis for stability is not as good. The chemical changes alcoholism creates in the brain and body interact with the bipolar disorder in a way that makes it more difficult to treat. Also, the alcohol itself may alter the course of the illness. The course of an illness is how it evolves over time. If you have bipolar disorder and you are drinking, the cycles and severity of the episodes may be altered and permanently changed.
Alcohol abuse is more common in those who have bipolar than unipolar depression.
People with bipolar disorder are more likely than those with depressive disorders to have alcohol dependence. Some research suggests that this is almost twice as likely in bipolar than with unipolar depression. Additionally, about half of people who suffer from bipolar also have alcoholism. ( 1999).
Most studies have suggested that lithium is less effective in a client who has bipolar disorder and alcoholism. This could be because many of those clients present with a more rapid cycling -mixed manic bipolar and that is known to be less responsive to lithium. More often a doctor will choose Depakote which has actually been shown to decrease patients drinking (Allen, 2003) in addition to leveling out the mood. The exception seems to be adolescents with BPD and alcoholism who, in one study, were shown to respond to lithium. (Sonne, 2002)
What to do if you suffer from alcoholism and bipolar disorder.
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Allen, C. (2003, May 5). Alcoholism and Bipolar Disorder. Retrieved May 4, 2008, from Psychology Today Online: http://www.psychologytoday.com/articles/pto-20030505-000003.html
Sonne, S.C. P. a. (2002). Bipolar Disorder and Alcoholism. Retrieved May 4, 2008, from National Institute on Alcohol Abuse and Alcoholism (NIAAA): http://pubs.niaaa.nih.gov/publications/arh26-2/103-108.htm
Sonne, S.C., and BRADY, K.T. Substance abuse and bipolar comorbidity. Psychiatric Clinics of North America. 22:609–627, 1999b.
University Of Pittsburgh Medical Center (2005, January 19). Anticonvulsant Drug Cuts Drinking In Bipolar Alcoholics, Shows University Of Pittsburgh Research. ScienceDaily. Retrieved May 4, 2008, from http://www.sciencedaily.com¬ /releases/2005/01/050110123206.htm
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