Living with bipolar disorder can make it feel like you never get a break from big emotions. Alcohol and its numbing effect provide temporary relief, but your relationship with it can quickly become toxic.
Bipolar disorder and alcohol use disorder (AUD) are certainly interconnected. It’s widely believed that people with bipolar disorder use alcohol as a tool to self-medicate. However, the relationship between bipolar disorder and alcohol isn’t that simple. Its negative impact on bipolar symptoms and interactions with treatment options is about more than just self-medication.
If you have bipolar disorder and a co-occurring substance use disorder like AUD, you’re not alone. As of 2023, 35% of adults living with a serious mental illness also have a co-occurring substance use disorder.
At Oceans Healthcare, we know that living with bipolar disorder is complicated. We’ll work with you to find the combination of medication and therapy that works for you. We’ll work as a team, empowering you to develop the skills to get a handle on your bipolar symptoms and manage your AUD.
Understanding the Relationship Between Alcohol and Bipolar Disorder
There is a definite relationship between AUD and bipolar disorder; in fact, as many as 48% of people living with bipolar disorder also have a co-occurring alcohol use disorder. However, there isn’t just one reason that people with bipolar disorder drink alcohol.
Let’s review a few of the reasons people with bipolar may choose to drink alcohol:
- An attempt to numb themselves to negative feelings
- Increased risk-taking behavior due to mania
- To slow down their central nervous system
- To fit in with other people who are drinking
While some people with bipolar disorder do use alcohol as a method for self-medicating their symptoms, the relationship is more complicated than that. Alcohol consumption is actually linked to worsening symptoms of bipolar disorder. If you’re experiencing the unstable emotions associated with manic, depressive, and mixed episodes, they may drive you to participate in riskier behaviors than you otherwise would.
Manic episodes, in particular, could cause you to change your behavior. When you’re experiencing mania, you are likely to feel more social and excitable than normal. It’s not uncommon for people in this state to want to go out and party, resulting in consuming more alcohol or recreational substances than is normal. If this happens to you, you’re not alone. This highlights just one of the ways that the relationship between bipolar disorder and alcohol is more complicated than simply self-medicating.
Alcoholism and Bipolar Disorder Symptoms: Seeing the Overlap
Bipolar disorder and AUD share several symptoms, and if you’re living with both conditions, they often overlap. This can exacerbate your symptoms to a much greater extent than they would be if you had only one condition.
Let’s take a look at 4 of the most common symptoms that AUD and bipolar disorder share:
- Mood swings: Alcohol use and bipolar disorder both lead to severe fluctuations in mood. Depending on the type of bipolar disorder you’re diagnosed with, you’ll experience periods of mania, hypomania, and depression that can last for days or even weeks. These mood changes are often caused by triggers, but can also occur without warning.
Short-term alcohol use also causes changes in your mood. After a few sips, you may feel your nervous system relax, but after that, you’ll experience more negative shifts, like anger, irritability, or sadness. You’ll also feel your cognitive functioning and decision-making skills decrease. Long-term alcohol use worsens these mood swings, especially in people living with bipolar disorder. Over time, alcohol dependence will cause mood swings even when alcohol isn’t in your system.
- Impulsivity and risky behavior: Manic and hypomanic episodes often lead to impulsive decision-making and increasingly risky behaviors for people living with bipolar disorder. Because alcohol also lowers your inhibitions, it has a similar effect, which is compounded when you’re experiencing a manic episode. Both alcohol and bipolar disorder disrupt functioning in the frontal lobe of the brain, where impulse control and decision-making take place. This results in more risk-taking behavior, such as impulsively spending money or having unsafe sex.
- Sleep disruptions: Bipolar disorder and alcohol consumption both lead to changes in sleep patterns. Insomnia is particularly common leading up to and during manic episodes, but it also occurs during depressive episodes. Alcohol is a sedative and can make falling asleep easier. However, it reduces the quality of sleep you experience. It disrupts your brain’s ability to get rapid eye movement (REM) sleep, which is the deepest part of the sleep cycle. Poor REM sleep leads to worsening symptoms of bipolar disorder.
- Anxiety and depression: Many people consume alcohol in an attempt to numb negative feelings like anxiety and depression. If you’re living with bipolar disorder, you’ll likely experience these symptoms more often than the general population. The unfortunate reality is that alcohol often ends up amplifying these feelings. For people with bipolar disorder, this can mean cycling through depressive and manic episodes more often.
Do People With Bipolar Disorder Self-Medicate With Alcohol?
It’s commonly said that people with bipolar disorder use alcohol to self-medicate their symptoms, but recent research shows that the relationship isn’t that simple. In 2024, a team at the University of Michigan published a study that looked at 10 years’ worth of data regarding the alcohol use of nearly 600 people with bipolar disorder.
The study found that people who increased the amount of alcohol they drank, even for a short time, consistently had more intense bipolar symptoms over the next six months. This held true even if the amount of alcohol they consumed did not meet the criteria for what experts would consider binge drinking: 8 drinks in a single week for women and 15.
However, the study did not find the opposite of this to be true. So, people who experienced increased bipolar symptoms over six months did not consistently increase their drinking to indicate self-medicating practices. The fact that there was no evidence of the self-medicating hypothesis suggests that we may need to reexamine our understanding of the relationship between bipolar disorder and alcohol.
This study doesn’t mean that self-medicating doesn’t happen on a case-by-case basis. If you have bipolar disorder and use alcohol to self-soothe, you face a significant risk of developing alcohol use disorder. The more often you drink, the more your body adjusts to having alcohol in your system. You will quickly build a tolerance, meaning you’ll need more and more alcohol to feel the same effects. This quickly evolves into the cycle of alcohol use disorder, and you’ll begin to feel withdrawal symptoms when you stop drinking alcohol.
What Happens When You Mix Alcohol With Bipolar Disorder Medication?
The fact that alcohol can amplify the symptoms of your bipolar disorder isn’t the only reason you should consider abstaining from drinking. Alcohol can also have serious interactions with bipolar medication.
The following chart highlights how alcohol interacts with different types of medication used to treat bipolar disorder.
| Medication Type | Examples of Medication | How the Medication Interacts with Alcohol |
|---|---|---|
| Mood stabilizers | Lithium, valproic acid, divalproex sodium, carbamazepine, and lamotrigine. | Alcohol reduces the effectiveness of mood stabilizers, increases the uncomfortable side effects, and worsens bipolar symptoms. |
| Antipsychotics | Aripiprazole, olanzapine, quetiapine, and lurasidone. | Both alcohol and antipsychotics function as central nervous system depressants, causing serious side effects. |
| Antidepressants, including selective serotonin reuptake inhibitors (SSRIs); and serotonin-norepinephrine reuptake inhibitors (SNRIs). | Citalopram, escitalopram, fluoxetine, paroxetine, and sertraline; venlafaxine, duloxetine, and desvenlafaxine. | The sedative effects of antidepressants when mixed with alcohol are similar to both antipsychotics and mood stabilizers. |
Finding Effective Bipolar Disorder Treatment
Living with bipolar disorder is not simple. If you have a co-occurring alcohol use disorder, that complicates your life even further. But there is hope. The right bipolar treatment program will empower you to manage your symptoms in a healthy way while also developing the skills to heal from AUD. A combination of therapy and medication will ensure you have power over your symptoms. With the proper support system, you won’t just live with bipolar disorder; you’ll thrive.
At Oceans Healthcare, we have experience treating the highs and lows of bipolar disorder. Each of our programs is overseen by a board-certified psychiatrist, ensuring you get the quality treatment you deserve. Across 30 locations throughout the United States, we treat more than 34,000 clients every year, and we respect the trust each client places in us. Call us today at 888-293-6899 to find out more.
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