5 Things to Know About Bipolar Disorder and Alcohol Use

Bipolar disorder is a difficult mental illness. It causes manic moods and depression, both of which can be debilitating and dangerous. Alcohol use disorder commonly co-occurs with bipolar disorder, and it increases the risk for complications, worsens symptoms, and makes treatment more difficult. It is important to understand the risks, to know the facts, and to be cautious about drinking when living with bipolar disorder.

Mental illness has long been known to be connected to substance use disorders. Studies show that about half of all people diagnosed with a mental health disorder will also struggle with a drug or alcohol use disorder. The opposite is true as well: Nearly half of all people with substance use disorders will also have a mental illness. The connection is particularly strong with serious mental illness.

Bipolar disorder is a condition that causes cycling between manic and depressive moods, and it has a strong correlation with addiction. Over 60 percent of people with bipolar disorder will also be diagnosed with a substance use disorder at some point in their lives. The rate for alcohol use disorder specifically is nearly 50 percent.

It’s important to be aware of this connection if you struggle with bipolar disorder. It may be tempting to drink in order to manage symptoms and mood changes, but the risks are high. If you have bipolar disorder, you are at a much greater risk of developing alcohol use disorder. Here are a few other things to know.


There is no certain explanation for why people with bipolar disorder are at risk for alcohol use disorder, and vice versa, but several factors are at play:

  • Genetics may be a link, as family history is a risk factor for both substance use disorder and bipolar disorder. It may be that there are genes that contribute to both conditions. It’s important to understand, though, that having a family member with one or the other does not guarantee that you will, too. It only increases your risk.
  • Many people with difficult mental health symptoms turn to alcohol as a type of self-medication. Drinking is a coping mechanism in these cases, but it is not a healthy or productive one. The risk of self-medicating is higher if you are not managing your bipolar disorder symptoms.
  • Specific to bipolar disorder is mania. Manic episodes lower inhibitions and trigger poor judgment and self-destructive behaviors. You may drink excessively during these moods, and over time that can lead to a substance use disorder.
  • It is also possible that alcohol use is a contributing factor for episodes of mania or depression. If you are already at risk for bipolar disorder—for instance, if you have a family history—excessive drinking may trigger symptoms or make symptoms and moods more severe.

2. Alcohol Worsens the Symptoms of Bipolar Disorder and Increases the Risk of Complications.


Alcohol use has been shown to increase the severity of bipolar disorder, its symptoms and its complications. People who struggle with any substance use disorder and have bipolar are less likely to stick with their treatment. They are also more likely to be hospitalized.

A very serious complication of bipolar disorder is suicide. Not everyone with this condition will be suicidal, but it is a real risk. Those with both bipolar and a substance use disorder are more likely to commit suicide.

3. Alcohol May Interfere With Bipolar Medications.


There are many reasons to avoid drinking if you have bipolar disorder, including the potential interactions with medications. Therapy and other treatment strategies are important in managing bipolar disorder, but so is medication. Antidepressants, mood stabilizers, antipsychotics, and other drugs help manage symptoms and reduce the frequency and severity of mood cycles.

Depending on which drugs you take for bipolar disorder, alcohol may interfere with their ability to work correctly. If you take lithium for mood stabilization, there is a risk of developing toxic levels of the drug in your body. The risk of toxic lithium levels is higher if you drink too much, as alcohol causes dehydration.

4. Treating Both Bipolar Disorder and Alcohol Use Disorder Is Essential.


Treatment for substance use disorder is most effective when all your needs are addressed. This includes many factors, but most importantly it means that you must be treated for both bipolar disorder and alcohol use disorder.

If you are only treated for bipolar disorder and continue to drink, not only can your substance use disorder become more severe, it can trigger recurrences of mental health symptoms. Likewise, if you are only treated for addiction, the symptoms of bipolar disorder will likely trigger you to relapse and drink again, even after a successful period of sobriety.

One of the benefits of residential treatment is that the program will evaluate you thoroughly, so that all issues are diagnosed. You can then work with the facility’s staff of experts to manage bipolar disorder and your drinking, as well as any other issues. An outpatient program doesn’t necessarily have the resources or experts to address all of your needs.

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5. Treatment for Bipolar Disorder and Alcohol Use Disorder Can Be Effective.


While it may seem daunting to try to manage bipolar disorder and give up alcohol, there is hope. Treatment is effective and helps many people manage their co-occurring disorders. The best course is a combination of medications and therapy, along with supplemental treatments such as holistic care and alternative, creative therapies.

Medications help manage symptoms, but it can take some time to find one that works well for you and minimizes side effects. This is one good reason to consider residential care for comorbid substance abuse and bipolar disorder. A residence provides a safe place to stabilize on the appropriate medications.

Therapies, including cognitive behavioral therapy, group therapy, and others, will also help. A good therapist can give you an outlet for expressing your feelings but also practical strategies for managing bipolar symptoms and alcohol cravings.

Also essential in effective treatment is aftercare. This is especially true for alcohol use disorder. A plan for ongoing treatment or strategies to avoid drinking after a stay in residential treatment will help you avoid relapsing. It is hard work to go through treatment for both bipolar disorder and alcohol use disorder, but if you put in the time and effort it really can be effective.

If you or someone you care about has bipolar disorder and is struggling with drinking, take steps to get help as soon as possible. Even if you don’t think you have an alcohol use disorder, drinking while living with this condition is risky. Seek treatment for bipolar disorder and talk to your doctor or therapist about drinking and how to stop.

If you’re concerned about a loved one and believe they may need residential care, we can help. BrightQuest offers long-term treatment for people struggling with schizoaffective disorders, schizophrenia, and severe bipolar disorder as well as other co-occurring conditions. Contact us to learn more about our renowned program and how we can help you or your loved one start the journey toward recovery.