According to the experts at the National Institute of Alcohol Abuse and Alcoholism, it isn’t unusual for an individual to suffer from both bipolar disorder and alcoholism at the same time. While the relationship between the two disorders is not entirely understood, one aspect of this comorbidity is vitally important: treatment. Most medications carry a warning not to mix them with alcohol; however what happens when someone is addicted to alcohol and requires treatment for their bipolar disorder?
The most obvious solution is to treat both conditions simultaneously. The National Institute on Drug Abuse has conducted years of research into the most effective treatments for addiction. One of their enduring principles, for instance, centers on the fact that treating one condition without treating the other is less effective than addressing all the concerns. To understand this relationship from the position of someone who is receiving medication for their bipolar disorder, but ignoring their addiction to alcohol, it is important to understand how various types of bipolar medication is affected by alcohol consumption, as well as how bipolar disorder differs in those individuals who suffer from alcoholism.
Are Alcoholics More ‘Bipolar’ Than Others?
There are four major types of bipolar disorders, according to the National Institute of Mental Health. These are differentiated by the symptoms and whether the individual is more predisposed to the highs, or manic states, or the lows, known as depressive episodes. They range from bipolar I disorder, which is the most severe and could require immediate medical attention and hospitalization for mania to cyclothymia, which has milder symptoms including hypomania (mania that is less severe than a full manic episode) and mild depression.
Someone who also suffers from alcoholism can have any of the main categories or diagnoses of bipolar disorder, but they often have an additional element known as rapid cycling bipolar disorder. If an individual has more than four mood changes, or instances of mania, hypomania, depression or a mixture of mania and depression at the same time, they can be diagnosed as rapid cycling. They may even cycle between two or more of these conditions in a single day. This particular type of bipolar disorder is more difficult to treat and can be resistant to some medications.
Lithium and Alcohol
In 1998, researchers studied the effects of lithium for the treatment of bipolar disorders in adolescents who were also suffering from addiction, with alcohol being one of the more prevalent substances of choice. According to the study, these individuals responded very well to the lithium not only for the bipolar conditions, but also for the alcoholism itself. This is contrary to information gleaned from studies 10 years earlier that suggested lithium was not best suited for those who suffer from bipolar disorders that involved mixed mania and depression. Because the more recent study did not indicate specifically what type of bipolar disorders the youths suffered, it is unclear if, perhaps, none of the subjects of the study suffered from the harder-to-treat rapid cycling variety.
Treating the Alcoholism
Naltrexone is a medication that has been used effectively to treat alcoholism according to the Substance Abuse and Mental Health Services Administration. Because it is so common for those suffering from bipolar disorder to also have a diagnosis of alcoholism, it was important to determine if the two conditions would benefit, or at the very least, if naltrexone would still be effective. In a study conducted in 2000, researchers found that more than 80 percent of participants took the medication effectively for eight weeks. They concluded that, on the whole, this medication was still effective for treating alcoholism when another mental condition existed.
Bipolar Disorder Medications Can Enhance Alcohol to Create Dangerous Situations
One of the worse situations that can occur when one mixes bipolar medications with alcohol is a worsening of the original symptoms, according to the Mayo Clinic. The experts have stated that the alcohol can actually work against your medication, making it non-effective. This can lead to a manic or depressive episode that is then exacerbated by the effects of the alcohol. Some medications, such as MAOIs, when mixed with alcohol, can cause dangerously high blood pressure. Others may cause you to feel tired and sluggish, which can also occur when one drinks alcohol. This doubling of the effect can make it difficult to drive, even if you haven’t had so much to drink that you would have been otherwise impaired.
Before you choose to drink while taking bipolar medication, consider the following:
- Talk to your doctor about what the effects of mixing your medication with alcohol might be.
- Ask yourself whether you are willing to risk your treatment program because you wish to drink.
- If you are unable to set aside your desire for alcohol, you may be suffering from alcohol addiction.
- Ask yourself if you are willing to put yourself and your family at risk.
If you or someone you love suffers from alcoholism and bipolar disorder, we here at Axis have the experience and the confidence to create a treatment plan that will address your specific needs. Please do not hesitate to contact us with any questions you may have.