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Bipolar and Alcohol

Dealing with both bipolar and alcohol use disorder can be dangerous. Read on to learn more about the relationship between the two.

Bipolar and Alcohol

Article Contents

What is Bipolar Disorder?

The dual diagnosis of bipolar disorder and alcoholism, or other forms of substance abuse disorders, can be deadly. The symptoms and severity of one can exacerbate the other and lead to dangerous side effects. When these conditions co-occur, there is a greater chance of intense mood swings, sadness, and violence.

High and low manic episodes are the hallmarks of bipolar illness. Bipolar disorder’s manic, hypomanic, and depressive episodes can seriously impair a person’s ability to function and overall well-being.1

What's a Bipolar Person Like?

A person with bipolar disorder generally experiences chronic depression and mania throughout most of their life. Mania is characterized by an overpowering sense of joy, excitement, or euphoria, a reduced desire for sleep (insomnia), and diminished inhibition. 

Many people who have bipolar disorder drink alcohol, which can make their mood swings worse depending on how much alcohol they drink. However, each person’s experience with being bipolar and using alcohol is unique. Those who deal with both things don’t always even experience the same symptoms or experience them to the same degree.

Signs of Manic Depression or Bipolar Disorder

Hypomanic episodes for those who have bipolar disorder are categorized under either Bipolar I or Bipolar II. Bipolar I illness is characterized by both manic and depressive symptoms. To be diagnosed with Bipolar I, the person must experience at least a single manic episode that lasts for seven days, or manic symptoms that necessitate hospitalization. Depression can occur before or after this. Manic and depressive symptoms may coexist in patients with this form of bipolar illness, which is known as “mixed features.”2

There are also depressive episodes in Bipolar II, but they tend to be brief and less intense. Furthermore, hypomanic episodes, often shorter and milder than traditional manic episodes, are part of this type of bipolar disorder.

Symptoms of Bipolar Disorder

The following signs and symptoms characterize manic and hypomanic episodes:3

  • High energy levels
  • Euphoria
  • Insomnia
  • Racing thoughts
  • A very high degree of activity (for example, too much fidgeting and moving around)
  • Irritability or agitation (drinking while bipolar can also lead to severe bipolar alcohol aggression)
  • Overconfidence
  • The inability to focus
  • Participating in risky behavior
  • Grandiose beliefs or delusions
  • Suicidal or self-harming thoughts
  • Having a more outgoing and sexually active personality than usual
  • Talkativeness
  • Psychosis
  • Hallucinations

Symptoms of a Depressive Episode

The possible symptoms of a depressive episode are:

  • Depression, hopelessness, or the belief that one has no value
  • Lack of energy or exhaustion
  • Seclusion
  • The inability or difficulty in doing routine duties
  • Insomnia
  • Over- or under-indulging in food
  • Indifference to the things one used to enjoy
  • Contemplating death or self-harm

What is the Relationship Between Alcohol and Bipolar Disorder?

Does alcohol make bipolar disorder worse? The fact is that alcohol and bipolar disorder do not mix well. Even though alcohol-induced bipolar disorder is uncommon, abusers of drugs or alcohol are more likely to acquire the disease than those who do not abuse drugs.

Alcohol isn’t the primary cause of bipolar disorder, but it may exacerbate mood swings and hasten the onset of a wide range of symptoms, including bipolar-alcohol aggression. Because of this, someone may need alcohol detoxification before a doctor can diagnose them with bipolar illness.

The Common Factors Between Alcoholism and Bipolar Disorder

Genetics, a family history of alcohol use disorders, peer pressure, drinking to deal with PTSD, and illnesses related to physical and mental health are all common causes of alcoholism. Also, the majority of bipolar individuals also misuse alcohol. The mix of alcohol and bipolar disorder may be deadly, leading to issues like bipolar-alcohol aggression.

So, can alcohol use cause bipolar disorder? The simple answer is no. Drinking does not cause bipolar disorder, but having bipolar disorder increases your chance of abusing and becoming addicted to alcohol. The actual etiology of bipolar illness is unclear, but certain things might make one more likely to have it or could set off a first episode. These will be detailed below.


Manic episodes cause lowered inhibitions, poor judgment, and self-destructive behaviors. When one experiences these emotions, they could drink too much, which might worsen bipolar symptoms over time. 


Those with parents or siblings who have bipolar disorder or alcohol abuse disorders are more likely to grapple with bipolar disorder. Researchers are looking for genes that could contribute to the development of bipolar illness, as alcohol-induced bipolar symptoms are increasing much more rapidly than scientists are used to seeing.4

Depression and Anxiety

Many individuals with mental health symptoms use alcohol as a form of self-medication. For such people, drinking is a coping strategy, but it is neither healthy nor helpful. If one is not controlling their bipolar symptoms, the risk of self-medication is increased, and it can make alcohol and bipolar symptoms worse.

Why Is It Common for Those With Bipolar Disorder to Drink?

People with bipolar illness sometimes drink because they think it somewhat reduces their symptoms. However, those who use alcohol as a coping method risk developing a dependence on the substance, even if the effects of drinking are temporary. As a result, those with bipolar disorder should abstain from drinking. 

For the same reasons, if you are taking medication for bipolar illness, you shouldn’t drink alcohol while simultaneously taking that medication.

Bipolar Disorder and Alcoholism: The Consequences of Comorbidity

Drinking alcohol can worsen the symptoms and problems of bipolar illness, leading to things such as:

  • Severe impairments
  • Social phobias
  • Feelings of hopelessness and despair
  • Anxiety disorders
  • Suicidal thoughts or ideations
  • Low rate of patient compliance with prescribed therapy options

Impact of Substance Use and Bipolar Disorder

People with bipolar disorder who also have a drug use problem are less likely to adhere to their treatment regimens than other patients. As a result, they’re more likely to end up in potentially life-threatening circumstances or encounter dangerous side effects.

Suicide is a potentially life-threatening consequence of bipolar disease. Even though everyone who struggles with comorbid consequences of bipolar disorder and alcoholism do not experience suicidal thoughts, for those it does affect, it tends to be quite dangerous and sometimes results in death. 

How to Diagnose These Disorders

There are a few different ways in order to try to diagnose these comorbid disorders. Doctors should know that those who have a family history of either illness, or those that struggle with other mental health conditions, are at a higher risk.

Chemicals involved in controlling moods are thought to not work properly in people with bipolar illness or alcohol use disorders. A few other ways doctors try to diagnose the two are:

  • Medical exam: A medical team will review your medical history and go through any symptoms you may be experiencing to get a diagnosis of bipolar illness. Your doctor may also perform a physical examination to rule out the possibility of other ailments.
  • Screening questions: A doctor or therapist will ask several questions regarding your behaviors and how drinking affects your body. Additionally, they may classify AUD as mild, moderate, or severe.

Treatment for Bipolar Disorder and Alcohol Use Disorders

Bipolar illness and alcoholism are generally diagnosed and treated independently. Even when researching the two, researchers primarily focus on one ailment at a time. Consideration of treating both illnesses at once with drugs and other treatments specific to each ailment has been recently growing in popularity. Your doctor or therapist may suggest one of the following three approaches to treating AUD and bipolar illness:

  • Treat one disease before moving on to the next. The more severe ailment is addressed first
  • Treat each ailment independently but concurrently
  • Combine therapies to deal with both sets of symptoms at once

Therapy Opportunities

Combining therapies to deal with both sets of symptoms at once is generally seen as the most effective method. This has led most specialists are now opting to treat both conditions simultaneously.5

Other methods include medication, along with a combination of individual, family, and group counseling, 12-step programs, and dialectical-behavioral therapy or cognitive-behavioral therapy.

Get Help Today for Co-Occurring Disorders at Iris Healing®

The route to treatment and recovery from bipolar disorder and alcoholism requires acceptance of one’s situation. In many cases, the most challenging aspect of overcoming a disease, affliction, or addiction is doing the legwork necessary to get professional support. You are more likely to adhere to your treatment plan if you are willing to seek help since you are already committed to making a transformation and getting better. 

Immediate assistance for co-occurring disorders is available at the Iris Healing® facility. Contact us today if you or a loved one need help.

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