Over time, your brain’s reward pathway builds tolerance and requires more and more dopamine (via alcohol) to feel pleasure. This can lead to addiction and feelings of depression in the absence of the rewarding substance. Alcohol consumption can lead to feelings of depression due to chemical reactions. In the short term, drinking alcohol can make you feel good, sociable, and even euphoric. Another way that depression could lead someone to drink alcohol is through changes in their brain as a result of depression. These changes can heighten the physiological “rewards” of alcohol and increase the likelihood that they will continue their pattern of drinking.
It is very likely that this relationship is not simply a reflection of cause and effect but rather that it is complex and bidirectional. Integrated treatment can occur either at the programmatic level or at the individual or group patient level. In the programmatic level, as exemplified by the work of Farren et al. (Farren and McElroy, 2008, 2010; Farren et al., 2010), patients enter a comprehensive integrated treatment programme that focuses on both psychiatric illness and substance use disorders. This series of studies on bipolar subjects with alcohol dependence examined the response to an inpatient integrated four-week psychoeducational programme with appropriate individualised pharmacotherapy. The programme consisted of specifically developed relapse prevention group therapy, individualised interpersonal therapy, with psychoeducational video and group sessions, together with self-help groups including Alcoholics Anonymous, and Dual Recovery Anonymous.
Does Depression Drive You to Drink Alcohol?
AUDIT indicates Alcohol Use Disorders Identification Test; BDI, bipolar disorder type I; BDII, bipolar disorder type II. The AUDIT score range is from 0 to 40, with 8 or higher indicating AUD is highly probable; 8 to 14 indicating hazardous or harmful drinking; and 15 to 40 indicating severe drinking or dependence. While both bipolar disorder and SUDs have established treatment approaches, further study is needed on how to best treat both conditions together.
The transatlantic difference for illicit drug use might be even higher, as SUD other than AUD was only present in 8.5% of the German SFBN sample (37). The higher SUD comorbidity rates in the US might directly relate to the poorer prognosis and higher treatment resistance in the SFBN US compared to the European sample (38). The combination of bipolar disorder and AUD can have severe consequences if left untreated. People with both conditions are likely to have more severe symptoms of bipolar disorder.
Or, the symptoms of bipolar disorder might overlap with other disorders, and you also may have another health condition that needs to be treated along with bipolar disorder. Some conditions can make bipolar disorder symptoms worse or make treatment less successful. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, healthcare professionals use medicines and talk therapy, also known as psychotherapy, to treat bipolar disorder. Researchers believe a potential cause for the high rate of SUDs in people with bipolar disorder is self-medicating to treat symptoms of mania and depression.
Bipolar Affective Disorders and Alcohol Dependence: Comorbidity, Consequences, and Treatment
There’s been a recent trend to consider treating both conditions simultaneously, using medications and other therapies that treat each condition. To receive a bipolar 2 disorder diagnosis, you must have had at least one major depressive episode. The FIRESIDE Principles for an integrated treatment of bipolar disorder and alcohol use disorder. Weiss et al. (2007) then conducted a randomized controlled study in which IGT was compared to an active control condition, Group Drug Counseling (GDC) (Daley et al., 2002).
Alcohol Worsens the Symptoms of Bipolar Disorder and Increases the Risk of Complications.
No statistically significant treatment differences were detected in drinking or mood outcomes. Post-hoc analysis showed that acamprosate treatment resulted in lower Clinical Global Impression scores of substance abuse severity in the last two weeks of the trial (Tolliver et al., 2012). In spite of the significant prevalence of comorbid alcoholism and bipolar disorder, there is little published data on specific pharmacologic and aa vs na psychotherapeutic treatments for bipolar disorder in the presence of alcoholism. The medications most frequently used for treating bipolar disorder are the mood stabilizers lithium and valproate. As stated previously, preliminary evidence suggests that alcoholic bipolar patients may have more rapid cycling and more mixed mania than other bipolar patients. There is also evidence to suggest that these subtypes of bipolar disorder have different responses to medications (Prien et al. 1988), which would help provide a rationale for the choice of agents in the alcoholic bipolar patient.
Having either depression or alcohol use disorder increases your risk of developing the other condition. If you’ve lost control over your drinking or you misuse drugs, get help before your problems get worse and are harder to treat. Seeing a mental health professional right away is very important if you also have symptoms of bipolar disorder or another mental health condition. The complete PLS-BD cohort currently consists of individuals enrolled for a median (IQR) of 9 (0-16) years. The present study analyzed data collected from February 2006 to April 2022.
- Several studies have demonstrated success with cognitive behavioral therapy in treating alcoholism (Project MATCH Research Group 1998).
- The findings were seen even in people who were not engaging in binge drinking, drinking with high intensity or frequency, or experiencing impairment related to their alcohol use.
- Severity of depression correlated significantly with craving and drinking behavior 1 week later.
- Family history and severity of symptoms should also factor into diagnostic considerations.
This is a common part of diagnosis because both so frequently occur together. Your doctor will likely conduct a physical exam and a psychological evaluation. These tests help them calculate your risk factors for either condition. This multi-test approach will help them rule out other conditions that might account for your symptoms. However, the flip side is that people who frequently use alcohol are more likely to also be depressed. Drinking a lot may worsen these feelings, which may actually drive further drinking.
Whereas, AUD in female BD patients fosters rather self-destructive consequences, males appear more likely to externalize anger and impulsivity, and stand out by a history of criminal actions (62). Specific numbers for AUD and BD are not available, but for affective disorders (AD) in general and SUD, criminal behavior has been observed twice as frequent in AD with SUD compared to AD without (63). In conclusion, it appears that alcoholism may adversely affect the course and prognosis of bipolar disorder, leading to more frequent hospitalizations. In addition, patients with more treatment-resistant symptoms (i.e., rapid cycling, mixed mania) are more likely to have comorbid alcoholism than patients with less severe bipolar symptoms.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), if depression symptoms persist after one month without consuming alcohol, then a different depressive disorder diagnosis would apply. One study of people with both AUD and depression undergoing treatment for both conditions found that the majority of symptom improvement for both conditions happened during the first three weeks of treatment. It causes more noticeable problems at work, school and social activities, as well as getting along with others. These types may include mania, or hypomania, which is less extreme than mania, and depression.