Why are Bipolar Disorder and Substance Use Often Mentioned Together?

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They will also gather information about a person’s past and current behavior with alcohol and other substances. Though more work is needed, researchers have linked genetics with an increased risk of developing bipolar disorder. This condition is heritable, making family history a risk factor; people with a parent or sibling with the condition are more likely to have it.

What you need to know about Manic Disorder

  1. Therefore, making wise eating choices is essential for a person to help themselves to maintain a healthy weight and to preserve overall well-being.
  2. This suggests that lithium may be a good choice for adolescent substance abusers.
  3. Bipolar disorder represents a significant public health problem, which often goes undiagnosed and untreated for lengthy periods.
  4. Analyzing SUD and bipolar comorbidity in clinical settings, the same group reports the highest prevalence for AUD (42%) followed by cannabis use (20%) and any other illicit drug use (17%) (21).

Thus, the evidence for choosing a mood stabilizer in BD with comorbid AUD is rather weak; strictly speaking, high levels evidence consists of altogether three placebo-controlled studies in this patient group (104–106). To make any suggestion (not even recommendations) about best available treatments we therefore rely on additional low-level evidence from open or retrospective studies and expert opinion. The use or digital media and “blended care” is likely to increase in the future across treatment settings and will facilitate diagnosis and treatment of mental disorders including comorbid conditions. It’s usefulness in BD patients comorbid with AUD, however, still needs to be further investigated. People who have a diagnosis of both bipolar disorder and alcohol dependence will need a special treatment plan. In the past, researchers have noted that symptoms of bipolar disorder appear as a person withdraws from alcohol dependence.

Mania Treatment and Recovery

A 2018 review looked at epidemiological data to evaluate the likelihood of people diagnosed with mood and anxiety disorders to self-medicate with alcohol or drugs to cope with challenging symptoms. While both bipolar disorder and SUDs have established treatment approaches, further study is needed on how to best treat both conditions together. The depression, anxiety, or racing thoughts accompanying bipolar disorder can be exhausting, scary, and stressful. Feelings of relaxation, euphoria, and the sense of distraction substance use can provide can seem a welcome relief to people with untreated bipolar disorder.

Alcohol use and depression symptoms

The evidence base for suitable psychotherapies in comorbid BD and AUD remains poor. The German S3 Guidelines for AUD (49) recommends cognitive behavioral therapy (CBT) as the best evidenced modality whereas there is no recommendation for nutrition guide for addiction recovery other psychotherapies due to insufficient data. Symptoms of AUD and SUD may often obscure an underlying diagnosis of BD, and frequently result in a long delay before a BD diagnosis has been established by careful clinical observation.

Depressive Symptoms and Alcohol

This, in addition to both substance use disorder and bipolar disorder having shared genes increasing the likeliness of the conditions in some people, are why scientists believe they often coincide. In fact, the lifetime prevalence of SUDs in people with bipolar I disorder is at least 40%. A study of imipramine use in actively drinking outpatients found decreased alcohol consumption only for those whose depression responded to treatment.47 However, there was no influence on drinking outcome. Patients whose mood improved reported decreased alcohol consumption after imipramine therapy. This review details methods for meeting the challenges of diagnosing and treating mood disorders that coexist with substance use disorders.

Alcohol use disorder and depression are two conditions that often occur together. What’s more, one can make the other worse in a cycle that’s pervasive and problematic if not addressed and treated. Your doctor will take into account how severe your symptoms are,  how long they last, and how often they happen. To be diagnosed with bipolar disorder, your symptoms must match the ones listed in the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

Another explanation for the connection is that people with bipolar disorder can exhibit reckless behavior, and AUD is consistent with this type of behavior. Therefore, healthcare providers should conduct a thorough alcoholism: can people with alcohol use disorder recover evaluation to determine how to treat each person based on their diagnosis and symptoms. When symptoms of a depressive episode last for at least two weeks, it meets the criteria for a bipolar 2 diagnosis.

Other risk factors of mania include using drugs recreationally or failing to treat underlying mental health conditions that may cause mania. Drug-induced mania is quite rare but is still something that may be experienced. However, also the reverse is true (66), the pattern and frequency of AUD can foster new episodes of BD, both mania and depression (67, 68); increasing severity of AUD predicts occurrence of a new major depressive episode (MDE) (69).

For AUD, however, a recent meta-analysis of 22 studies showed no difference between BD-I (OR 3.78) and BD-II (OR 3.81) (28). A recent catchment area study in Northeast England found a 40% lifetime comorbidity between BD II and AUD, surprisingly with little difference between female (38%) and male (43%) subjects (36). Acamprosate has also been evaluated in an open-label trial and a randomized controlled trial. No statistically significant treatment differences were detected in drinking or mood outcomes.

Some scientists have suggested that alcohol use or withdrawal and bipolar disorder affect the same brain chemicals, or neurotransmitters. Both valproate and alcohol consumption are known to cause temporary elevations in liver function tests, and in rare cases, fatal liver failure (Sussman and McLain 1979; Lieber and Leo 1992). Therefore, the safety of valproate in the alcoholic population has been questioned because of the potential for hepatotoxicity a trip on bath salts is cheaper than meth in patients who are already at risk for this complication. However, recent preliminary evidence suggests that liver enzymes do not dramatically increase in alcoholic patients who are receiving valproate, even if they are actively drinking (Sonne and Brady 1999a). Thus, valproate appears to be a safe and effective medication for alcoholic bipolar patients. Still, alcoholic patients going through alcohol withdrawal may appear to have depression.

Given that bipolar disorder and substance abuse co-occur so frequently, it also makes sense to screen for substance abuse in people seeking treatment for bipolar disorder. Bipolar disorder is a mood disorder characterized by distinct high and low mood episodes. Periods of mania, hypomania, and depression in bipolar disorder can significantly affect a person’s level of functioning and quality of life. Alcohol use disorder (AUD) is a pattern of alcohol use characterized by an inability to control drinking and other behaviors that cause significant impairment. For episodes of bipolar mania, additional sleep medications may also be prescribed. During ongoing treatment for bipolar disorder, mania and mood changes can still occur.