Alcohol is Bad Medicine in Bipolar Disorder
Drinking alcohol to cope leads to a worse life
I don't drink. I don't smoke. I use drugs. I never have. I also have bipolar disorder. These decisions about life are related. The fact that I enjoy, in theory, being correct is tempered by the grim reality for so many people who are not me. Alcohol is dumpster-fire lighting life choice for those with bipolar disorder. Welcome to The Frontier Psychiatrists.
A recent rather large study followed patients who both had bipolar disorder and reported how much they were drinking. Alcohol misuse is very common in bipolar disorder, with twice as many men > women impacted.
In clinical studies, AUDs affected more than one in three subjects with BD. Significant heterogeneity was found, which was largely explained by the geographical location of study populations and gender ratio of participants. AUDs affected more than one in five women and two in five men.1
These are people with Bipolar Disorder who have their act together enough to be in a clinical trial, and thus, not representative of people who are just, ya know, partying!
This is actually a more complex issue than my joke belies—those who develop bipolar disorder first—before they start drinking—actually have a more severe course of illness than those who started drinking in a alcohol use disordered way prior to the onset of their bipolar disorder.2
And prior sudies have found that despite this “alcohol-first” lower risk effect, those who keep drinking over the course of their bipolar disorder have a worse course of illness: