Bipolar Disorder and Alcoholism: A Dangerous Duo Guest Post by Ryan Jackson

Think about the most serious and life-threatening diseases you’ve ever heard of. Would it surprise you to know that one that one of the most debilitating illnesses has nothing at all to do with physical health?

The World Health Organization (WHO) ranks bipolar disorder (BD) as the 6th leading cause of disability in the world. We’re not talking about America alone or even an entire continent – but the whole world!

The National Institute of Mental Health (NIMH) estimates that 5.7 million adult Americans age 18 or older have been diagnosed with BD. This means that if you haven’t been affected personally, you undoubtedly know someone who has.

You’ve probably heard that BD is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

What does that feel like though?

Sara was a twenty-year-old college student living in Chicago when she was first diagnosed with bipolar disorder. She’d been missing a lot of classes, not sleeping well, and pulling her hair out due to exceedingly high anxiety levels that seemed to worsen by the day.  Sara went on to describe a list of problems that are common symptoms of diagnosed individuals:

 Initial symptoms:

  • Bursts of energy and staying up all night
  • Rapid speech that tends to go in a hundred directions
  • Distractibility
  • Promiscuous behavior
  • Multiple tasks going on at once but unable to complete them

  Subsequent symptoms:

  • Inability to focus or concentrate
  • Immense regret, depression, and shame
  • Low energy and sleeping all day
  • Decreased appetite and forgetting to eat
  • Thoughts of self-harm and suicide

Sufferers often describe feeling drained from a “roller coaster of emotions,” – from euphoria one minute, to overwhelming depression the next. Fortunately, for Sara and the millions of Americans like her, treatment for BD is typically helpful when you are compliant with the recommendations by physicians and professional caregivers.

Ten months after beginning Lithium and intensive psychotherapy, Sara was back in school, sleeping better and stated, “I feel like myself for the first time in almost a year!”

Medication and therapy are the mainstays of treatment for BD. The change in mood, temperament, personality and even physical appearance are drastically improved after several weeks of mood stabilizing medicine. Additionally, ongoing therapy helps you understand coping skills and strategies that will be essential in managing the illness long-term.

Medication plus therapy – a useful combination that has saved many lives. However, there’s a caveat that threatens optimal health that must be taken into consideration: Many people with BD are also alcoholics.

When a dual-disorder is present, the addiction is an additional complication that needs to be dealt with first. Alcoholics often have years of inner turmoil related to childhood trauma or a painful life experience, and if you want to recover from BD, you need to be sober.

You’re likely thinking substance abuse throws an enormous monkey in the wrench. You couldn’t be more correct.

Alcoholics are often in denial that their addiction is a problem. Combine excessive drinking with mania characteristics, (thrill-seeking and impulsivity), and the pair can be disastrous and even fatal.

In Current Psychiatry, Comorbid Bipolar Disorder and Substance Abuse: Evidence-Based Options, the author states: “Among DSM axis I diagnoses, bipolar disorder (BD) has the highest rates of comorbid substance use disorders (SUDS), and 60% of patients with bipolar I disorder have a lifetime diagnosis of a SUD. Alcohol is the substance most often abused” (Nery, 2016).

Drinking makes you feel less inhibited because it impairs the region of the brain that helps you self-monitor. If you have BD, the enticement of alcohol feels like a temporary escape from disorganized, racing thoughts that accompany mania.

However, accompanying the lowered inhibition from intoxication is an increased tendency to partake in risk-taking behaviors such as overspending, unsafe driving, sexual indiscretions and acting on grandiose ideas.

Do you see why liquor and BD are a bad mix?

Poor impulse control and impaired judgment are already interwoven into the lives of people with BD without alcohol as part of the equation. Throw alcohol in the mix and the likelihood for you to make risky decisions is even higher.

Additionally, think about how someone without BD feels after an alcohol buzz wears off. There’s sluggishness, headaches, and irritability that serve as a reality check that life’s problems were only briefly masked.

If you have BD, coming down from an alcoholic binge is like opening the floodgates to a whirlwind of racing thoughts, illogical thinking, and crippling anxiety. During this downward spiral to sobriety, depression comes rushing back at full speed, and the urge to commit suicide can seem like the only real escape or solution.

Have you struggled with alcoholism and BD, or do you know someone who has? As devastating as this dual-disorder is, there are treatment options available. Sometimes the hardest step is the first one. Go talk to someone you trust, and say three words may very well save your life, “I need help.”