It is not uncommon for alcoholics to have a secondary bipolar diagnosis. While the reasons for this coexistence remain muddied, as does an understanding of which condition appears first, what is clear is that the presence of both in unison can complicate an often already complex treatment plan. Understanding the challenges inherent in both diseases, along with the added dimension brought about by the two occurring in tandem, can be helpful when seeking diagnosis and treatment.
Theorizing Why the Two Conditions Coexist
There are many theories to explain why so many alcoholics also suffer from bipolar disorder, according to alcoholismresources.com. While some evidence points to a genetic component or link, the Mayo Clinic argues that this point has not been clearly established. The National Institute on Drug Abuse suggests that while genetic factors may make a person susceptible to both alcoholism and bipolar disorder, environmental triggers like stress and trauma are all likely to play a role.
Effects of One Disease on the Other
According to Mayo Clinic psychiatrist Daniel K. Hall-Flavin, bipolar disorder can clearly develop prior to the onset of alcoholism and vice versa. AlcoholismResources.com states that symptoms of bipolar disorder can appear during alcohol intoxication or withdrawal. According to the National Institute on Drug Abuse (NIDA), this may be because early exposure to drugs or alcohol may alter the brain such that it increases the risk for mental disorders like bipolar disorder. Others suggest that those with bipolar disorder may be at greater risk for becoming alcoholics because the mental health disorder precipitates the need to self-medicate with alcohol during manic or depressive episodes.
Treatment
The term "dual diagnosis" is often used when a patient has both a mental health diagnosis together with a substance abuse disorder. While more research is still needed to determine the most effective treatment for dual diagnosis patients, most agree that patients benefit most from the expertise of medical professionals who specialize in both disorders and who have experience treating them in tandem. Many dual diagnosis patients begin treatment by entering a detox program to eliminate alcohol from the body. Step two usually involves substance abuse rehabilitation together with mental health treatment. A combination of medications used for bipolar disorder together with behavioral therapies are usually employed.
Exacerbated Symptoms
Alcoholics with bipolar disease often have more severe cases of each, according to Dr. Hall-Flavin. He points out that the treatment of one disease can be greatly hampered if the other disease is undiagnosed or goes untreated.
The Numbers
According to NIDA, alcoholics and others with a substance abuse problem are twice as likely as the general population to also have a mental health condition like bipolar disorder. Likewise, those with bipolar disorder are twice as likely as the general population to become alcoholics.
