Can I Drink Alcohol if I have Bipolar Disorder?

Research has found a strong connection between bipolar disorder and alcoholism. Estimates show that up to 45% of individuals with bipolar disorder also engage in alcohol abuse.[i] Even on its own, bipolar can be a difficult diagnosis to handle. And when substance abuse of any kind is added to the list of problems, treatment and recovery become even more complicated.

Considering this strong connection, what should you do if you have bipolar disorder and want to enjoy alcohol recreationally? Perhaps you have never abused alcohol and just want to have an occasional drink on the weekend. How risky is this? Is it necessary to stay away from all alcohol all of the time? Or, is it possible to have bipolar and drink alcohol responsibly?

This is a good question to bring up in individual counseling at the addiction treatment center you may currently be attending. You may want to ask a therapist or trusted friend to discuss this topic with you on an individual and personalized level. However, as you engage in this conversation, know that it is best to approach alcohol with a great deal of caution. Let’s look at four compelling reasons individuals with bipolar disorder should avoid drinking alcohol.

1. Individuals with bipolar have a high risk of developing a substance abuse disorder. A bipolar diagnosis increases an individual’s chances of becoming an alcoholic. If you have had a bipolar diagnosis for any length of time, you likely know that one of the symptoms of manic episodes is engaging in high levels of risky behavior. Individuals with bipolar are often impulsive. They often act first and think later. This is one of the reasons a dual diagnosis of bipolar and alcohol abuse is so common.
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   Although you may be committed to drinking responsibly, you need to seriously consider the possibility that you may not be able to hold to your best intentions. In the midst of a manic episode, you might find yourself drinking way more than you planned. By making alcohol off limits in the first place, you better equip yourself to avoid drinking irresponsibly and developing an alcohol abuse problem.
2. Drinking alcohol can increase the severity of your symptoms. Alcohol and bipolar have an interesting relationship. As noted above, the impulsivity and risk-taking of bipolar can lead to alcoholism. However, a reverse relationship is also present – alcoholism can increase the severity of bipolar symptoms. Individuals with bipolar who drink alcohol have been found to be more violent, more impulsive, and more likely to engage in other types of substance abuse. In addition, they present with more manic symptoms than individuals with bipolar who do not drink alcohol.[ii] For this reason, drinking alcohol, even responsibly, is a big risk.
3. Alcohol doesn’t mix well with many psychiatric medications. Are you on any medications to help manage your bipolar disorder? Take a look at the prescription bottles and information packets and see if any ask you to not drink alcohol while you are taking them. Alcohol does not mix well with many medications, potentially causing unpleasant or even dangerous side effects.
4. Alcohol helps you avoid healthy means of coping with life. In the end, this may be the most compelling reason of all. Consider for a second why you are even asking this question about alcohol in the first place. Why is alcohol important to you? Perhaps it is because alcohol has become a means of coping when your symptoms are difficult. Alcohol can numb the pain. It can take the edge off of depression, anxiety, and racing thoughts. Alcohol can make life feel easier. But only for a moment. As long you use alcohol to manage your mental health, you won’t take the time to find healthy means of coping. Alcohol is dangerous for all of the reasons listed above. But it is also dangerous because it helps you avoid recovery. It helps you avoid what you are really feeling and experiencing. It’s hard to do the work of getting better if you don’t even know how you actually feel.

Instead of drinking alcohol to take the edge off of the pain, what could you do instead? What step do you need to take today to better cope with your symptoms and pain?

Resources:
[i] Farren, C. K., Hill, K. P., & Weiss, R. D. (2012). Bipolar disorder and alcohol use disorder: A review. Current Psychiatry Reports, 14(6), 659-666

[ii] Salloum, I. M., Cornelius, J. R., Mezzich, J. E., Kirisci, L. (2002). Impact of concurrent alcohol misuse on symptom presentation of acute mania at initial evaluation. Bipolar Disorders, 4(6), 418-421.