Alcohol, the social lubricant. Some people drink because alcohol relaxes them in social situations. The drink isn’t called “liquid courage” for nothing.
But alcohol is an addictive substance, which has great potential to be misused, especially by people who also suffer from bipolar disorder.
The Connections Between Alcohol Use and Bipolar Disorder
Studies have shown that people who abuse alcohol are more likely to have bipolar disorder. According to a 2013 review, up to 45% of people with bipolar disorder also have alcohol use disorder (AUD).
Overwhelming feelings of sadness from bipolar depression make people more likely to self-medicate with substances like alcohol. And self-medicating makes it more likely for people with bipolar disorder to not stick to their medication regime or attend therapy sessions.
Alcohol also affects people with bipolar disorder in different ways than the neurotypical population.
A 2006 study showed that people with bipolar disorder are adversely affected by even small amounts of alcohol, which may both trigger and worsen manic and depressive symptoms.
Mania is known to increase impulsiveness. Because alcohol reduces inhibitions, consuming alcohol during a manic episode may encourage risky and irrational behaviors.
Alcohol, a central nervous system depressant, also contributes to lethargy and sadness during depressive episodes. The symptoms of depression triggered by alcohol are increased when people first stop drinking, so recovering alcoholics with a history of depression may relapse in the first few weeks of dealing with withdrawal.
People who suffer from psychosis triggered by manic episodes are also adversely affected by alcohol. Consuming alcohol during psychosis contributes to both long-term and short-term complications. Alcohol also complicates the treatment of psychosis, contributing to dangerous medication interactions.
How Alcohol Affects Medications
Medications that are part of your treatment plan are strongly affected by alcohol.
Valproic acid, known commonly as Depakote, is often prescribed to treat symptoms of bipolar disorder. Similar to alcohol, Depakote is a central nervous system depressant which affects the liver. Combining alcohol and Depakote increases the chance of liver damage.
Similarly, consuming alcohol with lithium, which is frequently prescribed to treat symptoms of bipolar disorder, can contribute to liver disease. Lithium has side effects such as gastrointestinal problems, lethargy, and tremors, all of which alcohol can increase.
Antidepressants and antipsychotics may not work as well when combined with alcohol. Side effects can be increased, and you may feel more depressed and anxious.
You may decide to skip your medication in order to drink. This is a bad idea, as your symptoms of bipolar disorder may return quickly, triggering an episode. Stopping your dosages of medications without tapering off under the guidance of a professional is detrimental to your mental and physical health.
Alternatives to Alcohol
Alcohol can help you relax and socialize. Cutting down on alcohol can be difficult. It may be helpful to replace some of your drinking with relaxing habits.
Some alternatives to having a drink are:
- Getting a massage
- Attending a yoga or taekwondo class
- Meditating
- Exercising
- Taking a warm bath
- Using aromatherapy
Final Thoughts
Drinking responsibly takes on a whole new level when you suffer from bipolar disorder. You not only need to be aware that drinking, especially to excess, triggers and worsens manic and depressive episodes, but also that your medication may interact poorly with the substance.
I’m not saying to cut all alcohol out of your life if you have bipolar disorder. If you are a responsible adult, there is no reason you can’t drink. But be aware of the complications alcohol brings to your life. You may find it easier to abstain.
I wish you well in your journey.
Related:
- Substance Abuse and Bipolar Disorder
- Why Should You Chart Your Moods if You Have Bipolar Disorder?
- Bipolar Disorder is Toxic–-Literally
The Bipolar Parent 
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