Alcohol and Bipolar Disorder

Estimated reading time: 31 minute(s)

Research confirmed the connection between alcohol and bipolar disorder a long time ago. Despite the fact that as many as 45% of people with bipolar disorder also misuse alcohol, the relationship between the two conditions remains widely misunderstood. Bipolar is a complex condition that can be extremely difficult to manage, and when alcohol abuse adds to the list of problems, treatment can quickly become more complicated.

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Nevertheless, all people fighting the two issues must remember that recovery may be challenging but not impossible. By educating themselves about the connection between alcohol misuse and bipolar disorder and seeking professional treatment, they can keep them under control and live healthy lives.

Why Does Bipolar Disorder and Alcohol Addiction Occur Together?

Many people suffer from bipolar disorder and alcoholism at the same time. Even though the association between them is not always clear, the following factors are likely to play a role:

Inherited Traits

Genetic differences in individuals affect brain chemistry, increasing the risk of bipolar disorder. The same traits also determine how the brain responds to alcohol and drugs; hence, an individual with these traits can develop both conditions together.

Anxiety and Depression

A lot of people resort to drinking alcohol to ease the symptoms of bipolar disorder, such as anxiety and depression. While alcohol may help temporarily manage the symptoms, it can significantly worsen overall health in the long run. As the symptoms worsen, an individual is more likely to drink to control them, entering into a vicious cycle that may not be easy to overcome.


Mania, a state of bipolar disorder, includes an elated mood in addition to hyperactivity. It can easily lower inhibitions and force the patients to practice bad judgment, which can also make them abuse alcohol. On the other hand, many people also experience alcohol-induced mania that makes their life difficult to handle

What Causes a Bipolar Person to Consume Alcohol?

Regardless of the fact that alcohol can cause severe hangovers and a mix of intensified feelings, especially when it starts to leave the body, many bipolar people still continue to drink it. For some of them, the relaxed feeling that alcohol induces outweighs its adverse effects on the mind and body.

In reality, the higher a person feels after drinking alcohol, the lower their mood would be projected in daily life. Yet, for some people, it is all worth it as alcohol helps them ease anxiety and the crazy ups and downs that their bipolar disorder usually brings about. Additionally, many people find that the medications they take to keep their bipolar symptoms under control lead to intense side effects. As a result, they prefer replacing these medications with alcohol as a way to deal with the symptoms through self-medication.

Whatever reason a bipolar alcoholic chooses to justify their behavior, the crux of the matter is that alcohol only brings temporary relief from bipolar disorder. At the same time, it also endangers individuals with ill health, intensified bipolar symptoms, and other life-threatening issues. Hence, bipolar people are usually not advised to drink, which may lead to unwanted and uncomfortable episodes.

Bipolar Alcoholic Traits: How Alcohol Affects the Symptoms of Bipolar Disorder

The symptoms of bipolar disorder can be categorized into three types: manic symptoms, depressive symptoms, and psychotic symptoms. Alcohol affects each of these sets of symptoms differently.

Alcohol and Manic Symptoms

Both alcohol and mania lead to lowered inhibitions. Additionally, many people become impulsive, i.e., they do not think before acting. Hence, such people easily land themselves in risky situations that lead to painful consequences, and one such risky behavior is excessive alcohol use. Conversely, the use of alcohol itself worsens the symptoms of mania.

Alcohol and Depressive Symptoms

A depressive episode can easily make a person experience a low mood and lethargy. Consuming alcohol in such situations can further worsen these depressive feelings, as alcohol itself is a depressant of the central nervous system. Additionally, the risk of suicidal tendencies is extremely high in bipolar individuals going through a depressive phase and drinking alcohol at the same time.

Alcohol and Psychotic Symptoms

In some cases, bipolar disorder may trigger psychosis with hallucinations and delusions. Drinking alcohol in an actively psychotic episode is likely to worsen these symptoms and increase the risk of life-threatening complications.

Drinking Alcohol and Bipolar Disorder: Why You Should Avoid the Combination

People who have been diagnosed with bipolar disorder are advised to refrain from using alcohol, even occasionally. Following are the reasons why this combination must be avoided:

People with bipolar disorder are at a very high risk of developing a substance use disorder.

A bipolar diagnosis significantly increases the chances of acquiring substance use disorder. People who have been suffering from it for a long time would know how this condition makes it likely for them to engage in risky behaviors and exhibit impulsiveness. Due to these symptoms, they usually act first and think later, making it easier for them to abuse alcohol to the point of addiction.

Drinking alcohol makes the symptoms more severe.

Bipolar and drinking alcohol have a complex relationship. As mentioned before, the risk-taking behavior and impulsivity in bipolar disorder can easily lead to alcohol use disorder. What’s important to remember is that some people develop a reverse relationship, i.e., their alcohol use increases the intensity and frequency of the bipolar symptoms. Research has found that bipolar individuals who drink alcohol are generally more impulsive and violent and much more likely to engage in other drug abuse. Additionally, their manic symptoms are more frequent than other bipolar individuals who do not drink, making alcohol a critical risk factor.

Alcohol does not work well with psychiatric medications

People who are taking medications to manage their bipolar symptoms are strictly advised not to engage in any drinking behavior. Alcohol does not mix well with many psychiatric medications, including those used by experts to manage bipolar disorder. Combining both can easily lead to unpleasant and potentially dangerous side effects.

Alcohol prevents learning healthy coping mechanisms.

Perhaps the most compelling reason why you should not be drinking if you are bipolar is the fact that alcohol does not let anyone develop healthy coping mechanisms. For many people, this substance becomes a means of coping with their difficult symptoms as it helps them numb the pain and take the edge off of racing thoughts, anxious feelings, and low mood. In simpler words, drinking makes their life feel more accessible, but only temporarily. As long as a person keeps using alcohol to cope with the negatives in their life, they will never learn how to truly get over the problems more healthily and permanently. Moreover, it will only lead to more complexities and side effects and delay recovery.

Alcohol and Bipolar Disorder Management: What Options are Available?

The symptoms of bipolar disorder and alcohol can manifest differently in different people. For example, some may develop alcohol use disorder first, while others may experience bipolar symptoms earlier. It is also possible for both conditions to present at the same time. Hence, for optimal treatment, a healthcare provider must conduct a thorough assessment to determine the pattern of symptom development. Based on this assessment, they can then plan a treatment approach to help each patient according to their individual circumstances.

Depending on the circumstances, a doctor may treat alcohol addiction and bipolar disorder sequentially, independently, or through an integrative plan.

Treatment for Alcohol Use Disorder

Individual, group and family therapies are helpful for managing alcohol use disorder. Depending on an individual’s needs and requirements, these therapies may take place in outpatient or inpatient settings. Other treatment options for alcohol use disorder include the following:

  • Depending on the duration and frequency of alcohol use, experts may suggest a medically-supervised detox to control withdrawal symptoms
  • Medically-assisted treatments are also a standard treatment method for alcoholism where certified medical professionals prescribe certain medications in controlled amounts to treat the issue along with other counseling and behavioral techniques
  • Research has indicated that cognitive behavioral therapy can be particularly effective in helping individuals identify triggers, explore their feelings and thoughts about self, and review their relationship with alcohol
  • Motivational interviewing is another form of behavioral therapy that aims to explore the ambivalence about changing alcohol-related behaviors by increasing a person’s motivation to change. This therapy can be used alone or in conjunction with other behavioral treatments
  • 12-step programs, such as Narcotics Anonymous and Alcoholics Anonymous, provide clients with an atmosphere where they can find support for recovery
  • Group therapy is also available for people with alcohol use disorders which allows them to identify their relapsing behaviors and thoughts and helps them develop skills to overcome them

Treatment for Bipolar Disorder

Individuals living with bipolar disorder can benefit from talking therapies, such as cognitive behavioral therapy, which helps them learn healthier ways of thinking about themselves and their diagnosis. Additionally, it also assists with developing positive problem-solving and coping skills.

Dialectical behavior therapy, or DBT, teaches bipolar individuals to regulate their emotions healthily to avoid any emotional discomfort.

Interpersonal and social rhythm therapy helps bipolar individuals understand their sleep-wake cycle, improve their mood, manage their relationships, and establish healthy habits for an overall improved quality of life.


Can I drink alcohol while taking medication for bipolar disorder?

It is common for most people with bipolar disorder to use medications to keep their symptoms under control. These medicines are known as mood stabilizers and may include lamotrigine, carbamazepine, valproic acid, lithium, and divalproex sodium. Drinking alcohol while on any of these medicines is unsafe, as the combination may lead to intense side effects, including severe injury or even death. Other adverse effects that you may experience by mixing alcohol with any bipolar medication include drowsiness, slowed breathing, dizziness, tremors and shakiness, liver damage, and worsening of depression.

Do alcoholism, and bipolar disorder share common risk factors?

Both alcohol use disorder and bipolar disorder share some similar traits. For example, both issues frequently occur in those with a positive family history. Experts believe that in such people, the natural chemicals in the brain responsible for regulating mood fail to work properly. Moreover, the environment they grew up in during childhood can also influence the risk of developing alcohol use disorder and bipolar disorder.

How will an expert diagnose bipolar disorder and alcohol use disorder?

To diagnose bipolar disorder, a mental health professional begins by taking a keen look at your health profile and discussing the symptoms you are currently experiencing. In some cases, they may also conduct a medical exam to rule out the risk of any other medical reason contributing to the symptoms you are suffering from. In case of an alcohol use disorder, the doctor will take you through a series of questions regarding your drinking habits. They may also ask a few more questions to check how your body reacts to alcohol use. Using these questions, experts also categorize the issue as mild, moderate, or severe.

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