Patients with 4 or more mood episodes within the same 12 months are considered to have rapid cycling bipolar disorder, which is a predictor of poor response to some medications. Bipolar II disorder is characterized by episodes of hypomania, a less severe form of mania, which lasts for at least 4 days in a row and is not severe enough to require hospitalization. Hypomania is interspersed with depressive episodes that last at least 14 days. People with bipolar II disorder often enjoy being hypomanic (due to elevated mood and inflated self-esteem) and are more likely to seek treatment during a depressive episode than a manic episode.
Conditions
It is only through demonstration of the effectiveness of treatment integration that there will be extensive therapeutic efforts to bridge psychiatric treatment programmes and services, and substance abuse treatment programmes and services. That treatment integration is still a long way off, despite the accumulating research demonstrating the benefits of integration. Bipolar disorder (BD) and alcohol use disorder (AUD) are independently a common cause of significant psychopathology in the general population. BD can affect up to 3% of the population in some countries; with the increasing awareness of the bipolar spectrum of disorders, this figure could increase over time. AUD, incorporating alcohol abuse and dependence, which can affect up to 13% of the general adult population in some surveys (Regier et al., 1990), and can have a lifetime incidence of up to 18% (Hasin et al., 2007), is a major cause of psychopathology in the general population.
Several Factors Explain the Link Between Bipolar Disorder and Alcohol Misuse.
BD and addictions may share common mechanisms, including high impulsivity, executive dysfunction, susceptibility to behavioral sensitization to stressors, as well as poor modulation of motivation and responses to rewarding stimuli (Swann, 2010; Tolliver and Hartwell, 2012). Indeed, high trait impulsivity may mediate some severe manifestations of this comorbidity (Swann et al., 2009; Nery et al., 2013). Bipolar disorder and alcohol use disorder represent a significant comorbid population, which is significantly worse than either diagnosis alone in presentation, duration, co-morbidity, cost, suicide rate, and poor response to treatment. They share some common characteristics in relation to genetic background, neuroimaging findings, and some biochemical findings. They can be treated with separate care, or ideally some form of integrated care. There are a number of pharmacotherapy trials, and psychotherapy trials that can aid program development.
All participants provided written informed consent and receive an annual stipend for participation. There were no additional incentives offered for participation in this specific secondary data analysis. The IRB approval of PLS-BD applies to the present study, and all participants agreed to the use of their data in future secondary data analysis. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.
- A second key concept underlying IGT is a focus on common features in the recovery and relapse process in the two disorders.
- If your bipolar disorder symptoms or substance use is causing regular stress to your mental health, it can be valuable to find a therapist to work with regularly.
- The FIRESIDE Principles for an integrated treatment of bipolar disorder and alcohol use disorder.
- Criteria for a diagnosis of alcohol abuse, on the other hand, do not include the craving and lack of control over drinking that are characteristic of alcoholism.
- However, it’s important to be aware of the ways you may be uniquely vulnerable so you can take preventive measures.
International Patients
Despite the considerable public health significance of co-occurring BD and alcohol dependence, there are few effective pharmacotherapeutic interventions. Pharmacotherapy clinical trials for BD and those for alcohol dependence have often excluded co-occurring disorders in an attempt to reduce confounding variables. As a result, there is a limited literature that clinicians can draw upon when treating patients with co-occurring BD and alcohol dependence. 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. There is a strong link between alcohol use and depression, a mental health condition that includes feelings of hopelessness, emptiness, fatigue, loss of interest, and more.
This condition mimics the symptoms of bipolar disorder but is directly caused by alcohol consumption. The symptoms may include mood swings, impulsivity, and changes in energy levels that resemble those of bipolar disorder. However, these symptoms typically resolve once alcohol use is discontinued, unlike true bipolar disorder which persists independently of substance use. Participants selected for the Gary Jackson, Author at Sober-home present study were those with a diagnosis of BD type I (BDI) or type II (BDII) who had been in the study for at least 5 years.
In other words, alcohol use or withdrawal may “prompt” bipolar disorder symptoms (Tohen et al. 1998). It remains unclear which if any of these potential mechanisms is responsible for the strong association between alcoholism and bipolar disorder. It is very likely that this relationship is not simply a reflection of cause and effect but rather that it is complex and bidirectional.
