Bipolar disorder, formerly known as manic depression, is a mental health condition characterized by extreme mood swings. People with bipolar disorder experience alternating episodes of mania (elevated moods, increased energy and activity) and depression (low mood, loss of interest, low energy). These mood episodes can last for days, weeks or months at a time.
Bipolar disorder affects about 2.8% of American adults each year. It typically begins in late adolescence or early adulthood, though it can occur at any age. Bipolar disorder is a chronic, lifelong condition with recurring episodes throughout a person’s life. Between episodes, many people with bipolar disorder live normal, productive lives.
There are several different types of bipolar disorder, classified by the intensity and frequency of mood episodes:
- Bipolar I Disorder – Defined by the occurrence of at least one manic episode, with or without depressive episodes
- Bipolar II Disorder – Characterized by depressive episodes alternating with hypomanic episodes (less severe mania)
- Cyclothymic Disorder – Involves chronic, fluctuating hypomanic and depressive symptoms that don’t reach full manic/depressive severity
- Other Specified and Unspecified Bipolar Disorders – Episodes don’t match diagnostic criteria but cause significant impairment
Treatment for bipolar disorder aims to reduce the severity and frequency of mood episodes. Medications like mood stabilizers, antipsychotics and antidepressants help manage symptoms. Psychotherapy provides coping strategies for daily stability. With proper treatment, many people with bipolar lead productive, fulfilling lives. However, the severity of bipolar episodes can interfere with relationships, work performance, and overall wellbeing.
Do bipolar people drink alcohol more than average?
There is a common perception that people with bipolar disorder tend to drink alcohol heavily or have problems with alcohol use. But does research actually support this assumption? There are several factors to consider when examining alcohol use among those with bipolar disorder:
Prevalence of alcohol use disorders
Studies show a higher lifetime prevalence of alcohol use disorders (AUDs) in people with bipolar compared to the general population:
- About 60% of people with bipolar disorder experience an AUD at some point in their lives
- In the general population, the lifetime prevalence of AUDs is around 30%
So based on lifetime rates, people with bipolar disorder are roughly twice as likely to suffer from alcohol abuse or dependence.
However, when examining current rates of alcohol disorders, studies find mixed results:
- Some research shows up to 65% of bipolar patients have a current alcohol use disorder
- Other studies find no significant differences in current alcohol abuse between bipolar groups and controls
So while lifetime rates of AUDs appear clearly elevated in bipolar disorder, it’s less clear whether that corresponds to increased current alcohol misuse compared to the general public.
Binge drinking rates
Binge drinking generally refers to consuming 4-5+ alcoholic beverages in one occasion. Studies find that rates of binge drinking tend to be higher among those with bipolar disorder compared to non-bipolar controls:
- About 25-35% of people with bipolar engage in binge drinking, compared to 15-20% of the general population
- Up to 75% of bipolar adolescents report binge drinking
So based on this data, binge drinking seems more common among bipolar individuals, especially younger patients. However, research is still limited in this specific area.
Factors contributing to increased drinking
There are several factors that may explain the higher rates of alcohol misuse seen in some studies among bipolar patients:
- Genetics – Bipolar disorder and alcoholism share overlapping genetic risks
- Self-medication – Some people use alcohol to manage mood swings or medication side effects
- Impulsivity – Impulsive behavior and poor judgment during mood episodes may increase drinking
- Early onset – Developing bipolar disorder early often predicts later substance abuse
Additionally, alcohol abuse can worsen the course of bipolar disorder:
- Drinking triggers mood instability and psychiatric symptoms
- Alcohol interferes with medication adherence and effectiveness
- Substance use is associated with lower recovery rates and poorer outcomes
So while inherent to bipolar disorder itself, alcohol misuse can also exacerbate the condition through various mechanisms.
Does drinking exacerbate bipolar disorder?
Excessive drinking has clear negative impacts on the course of bipolar disorder:
- Increased mood episodes – Alcohol use significantly increases manic and depressive episodes
- Reduced treatment efficacy – Drinking lowers effectiveness of medications and psychotherapy
- Higher relapse rates – Bipolar patients with alcohol use are more likely to relapse
- Increased suicidality – Alcohol abuse heightens suicide risk during depressive phases
- Poorer medication adherence – Intoxication and addiction decrease ability to take medications consistently
Additionally, alcohol interacts negatively with many bipolar medications:
- Lithium – Alcohol dehydrates the body and elevates lithium levels, causing toxicity
- Anticonvulsants – Drinking can decrease efficacy and increase side effects
- Antipsychotics – Alcohol intensifies sedative effects, raising overdose risk
So clearly, excessive alcohol consumption exacerbates bipolar disorder by increasing mood episodes, reducing treatment effectiveness, heightening suicidality, decreasing medication adherence, and interacting negatively with many pharmacological treatments.
Conclusion
While lifetime rates of alcohol use disorders are elevated among those with bipolar disorder, research on current drinking rates remains mixed. Some studies show increased binge drinking and daily consumption in bipolar groups, while others find no differences compared to the general public.
But when bipolar patients do engage in problem drinking, alcohol clearly exacerbates their condition. Drinking triggers more frequent and severe mood episodes, reduces treatment efficacy, heightens suicide risk, decreases medication adherence, and interacts negatively with many bipolar medications.
So bipolar disorder involves a susceptibility to alcohol abuse. And when present, alcohol misuse then worsens the course and symptoms of bipolar illness. This reinforcing relationship highlights the importance of careful alcohol assessment and integrated treatment of co-occurring substance use disorders in patients with bipolar disorder. Targeted psychosocial interventions combined with medications can help this vulnerable population reduce drinking behaviors and improve long-term outcomes.