Dual Diagnosis of Bipolar Disorder and Alcohol Dependency

Having to deal with and work through a mental health diagnosis can be very difficult. When you have a mental health issue, it can be hard to navigate life and function as one would if one did not have the diagnosis. There are many different mental health issues but we are going to mainly talk about a dual diagnosis of bipolar disorder and alcohol abuse.

When someone has been diagnosed with both a mental health disorder and a drug or alcohol abuse disorder it is called a dual diagnosis. Also termed co-occurring disorders or comorbidity, dual diagnosis can be very difficult to deal with due to the nature of how those two disorders interact with each other and how they affect each other.

Bipolar is a mental health condition that makes those who suffer from it experience extreme moods that range from depressive episodes to manic highs. Due to these explosive states, it can be hard to function. Bipolar has been seen to co-occur with either alcohol or drug abuse. The reasons for this can be varied but what is certain is that the interaction of both worsens each state.

When trying to understand the dual diagnosis of alcohol abuse and bipolar disorder, it can be difficult to know which started first or which caused the other, or if they both just intersected. It can also be hard to determine which started first because the risk factors that contribute to bipolar disorder are the same as those that contribute to alcoholism (i.e. – genetics, trauma, life stresses, and anxieties). However, studies have shown that there is a high probability of a person who suffers from bipolar also ending up with an alcohol problem.

There have been various reasons why this relationship between bipolar and alcohol abuse exists, for example, those struggling with bipolar alcohol can be taken as self-medication, which means that the alcohol helps them deal with hard emotions and memories brought about by their disorder. They drink to numb their feelings.

As mentioned earlier, those who suffer from Bipolar experience manic episodes. During a manic episode, one might drink to feel good and calm down since the feeling of heightened excitement can be hard to handle.

On the flip side, others might drink to get some form of excitement and uplifting of their mood. This is due to the depressive state of bipolar. In this state, they will drink to help with a temporary change in mood.

Reasons for correlation in a dual diagnosis.

Drinking alcohol can start as self-medication for bipolar patients but they can easily become dependent on it as they try to regulate their ever-changing emotional state. Another reason it became easy for those struggling with bipolar to get hooked on alcohol is the fact that it is legal, easy to get, and initially not as expensive. This has been a huge contributor to many people suffering with mental health problems and also being diagnosed with alcoholism.

While most medications will say that they should never be taken with alcohol, those struggling with bipolar and alcohol abuse might not take heed of this instruction. This can be detrimental to their health and even their life. Alcohol intake affects brain function and emotional and psychological functioning.

Dangers of drinking while dealing with bipolar.

Inability to diagnose correctly. Most people will not know that they have an underlying mental health problem due to their drinking hence they go through life undiagnosed.

Treatment resistance. For those who might have been put on medication, alcohol intake can contribute to the ineffectiveness of medication. Also, this can have dire health consequences. Most medications come with a warning that they should not be taken with alcohol.

Heightened symptoms. It has been noted that of those that struggle with bipolar, those who take alcohol tend to exhibit more manic symptoms than those who do not drink alcohol. Without alcohol, a person with bipolar already has to deal with manic episodes, risky behavior, and sometimes aggressive and violent behavior. These get aggravated with the introduction of alcohol.

Inability to develop healthy coping mechanisms. Alcohol helps those struggling with bipolar manage their symptoms and at times alter their mood for the better. This is a short-term solution and also a very destructive one in that it does not leave room for the development of long-lasting healthy coping mechanisms.

Trigger other mental health symptoms. When was is experiencing extreme alcohol withdrawal symptoms, they can experience any of the following:

• Extreme anxiety
• Hallucinations
• Hearing Voices
• Paranoia

This is only mentioning a few of the other health symptoms that can be triggered by abusing alcohol while on bipolar medication.

Treatment for dual diagnosis.

Both bipolar and Alcohol dependency is incurable, but with the proper diagnosis, over time a treatment plan can be developed which will allow the individual to cope with the symptoms of both and lead a balanced and normal life. There has to be a concerted effort of all those involved in giving care and treatment to the individual.

This would have to be a multi-disciplinary effort. Those who are working to treat bipolar disorder have to work with those that are aiding with the treatment of alcoholism. The interplay must be acknowledged, and an integrated approach has to be adopted.

Below are some interventions for Bipolar, depending on the symptoms.

Cognitive Behavioral Therapy. addresses and challenges learned destructive thought patterns that contribute to depression, anxiety, suicidal thoughts, and addiction.

Motivational Interviewing. This is a process of encouraging a client to find it within themselves to be motivated about life and set achievable goals.

Solutions-Focused Therapy. This type of therapy does not focus on the causes of mental disorders but more on what can be done now, and what can be achieved. It is a client-centered approach that focuses on specific goals.

Trauma Therapy. A traumatic history if not dealt with, worsens symptoms of bipolar. This therapy focuses on processing painful memories that could otherwise hinder growth or exacerbate feelings of depression and anxiety.

Medication. Medication can be prescribed for the presenting symptoms of a patient. Some might require mood stabilizers, anti-depressants, antipsychotic medication, or any other medication that might be needed to curb some physical ailments brought about by bipolar.

Interventions for alcohol dependency.

Wherever possible, patient rehab will always be recommended as it provides a good structure and supervision of clients that enable them to have a strong foundation for recovery when they are discharged. Rehab also makes it possible for patients to have supervised and professionally advised medical detox. The 12-step program of the Alcoholics Anonymous group is invaluable for providing accountability, encouragement, and education.

The above-mentioned interventions for both Bipolar and alcohol dependency will always be patient-specific. Attention needs to be paid to the presenting mental health symptoms as well as behaviors associated with alcohol dependency to come up with a comprehensive approach. Both treatments have to be done at the same time wherever possible and within the same program for effective measurable change.

There is help for dual diagnosis.

Having laid out all that a dual diagnosis is, it is important to know that there is hope, it like any other diagnosis can be treated with the right team of professionals. If you or anyone you know suffers from Bipolar and alcohol dependency at the same time, reach out to our offices. We have a team that will take you through the process as it pertains to your particular situation.