By Shreeya Tuladhar
So far, I have written blogs about the issue of stigma against Bipolar Disorder - whether it is through common vernacular (“you’re so bipolar!”), songs (“I’ve got bipolar disorder, my shit’s not in order.”), or even the portrayal of celebrities with the mental illness (Demi Lovato was “highly publicized”). Clearly, the society’s and the media’s relationship with Bipolar Disorder hasn’t been quite friendly. However, they are not the only ones fueling this mental disorder. Moving towards more of a medical aspect, the mortal enemy of Bipolar Disorder is actually the most commonly used addictive substance - Alcohol.
When the topic of Bipolar Disorder is brought up, alcohol is unfortunately almost always involved. As a manic-depressive illness causing unusual shifts in mood as well as affecting activity levels and the ability of carrying out daily tasks, Bipolar Disorder is more than likely to cause damage on its own - ranging from relationships to jobs. Add in alcohol in the mixture and you’ve got yourself the logic behind environmental factors being big influences during mental disorders. Scientists have been trying to find a definitive cause of Bipolar Disorder, as well as the relationship between the disorder and alcohol abuse, but have failed to come to a consensus. (NIH, 2012) It is, however, confirmed that substance abuse is common with people suffering from Bipolar Disorder. (Strakowski, 2000)
The co-occurrence of this behavior is well documented, even if the reason is not clear. In an attempt to explain this conjoined behavior, there are many theories such as substance abuse is a symptom, a cause, an attempt to self medicate, or occurs because of common risk factors (Strakowski, 2000). Some even suggest a genetic link between the two, but whatever the case may be – alcohol abuse seems to worsen the clinical course of the disorder, making treatment harder than it should be (Sonne, 2002). Alcoholism, or addiction to alcohol, is known to cause failure in coherency and responsibility – which leads to more frequent hospitalization of patients suffering from Bipolar Disorder (Sonne, 2002). Alcohol is mostly thought of as the ‘cause’ of such disorders, but research has shown that there are differences between people who got the disorder before substance abuse and after (Feinman, 1996). Regardless of what came first, alcohol abuse seems to decrease cooperation of the patients, negatively impacting the effectiveness of treatment and medication (Hall-Flavin, 2013).
Alcohol is more likely to occur with patients with Bipolar Disorder than all other psychiatric disorders. (Sonne, 2002). A dual diagnosis – alcoholism and bipolar disorder – is given to patients when the situation becomes severe. Treatment consists of mental health care providers that specialize in treatment of dual disorders (Hall-Flavin, 2013). However, since more concrete explanation is needed for the co-occurrence of these two, treatment hasn’t always been effective (Strakowski, 2000). So what can we do?
We can care. We’re quick to dismiss alcoholism as a ‘choice’ – and tend to forget that mental disorders can have an impact on our behaviors. If a loved one is suffering from Bipolar Disorder and slipping onto the path of alcoholism, get help. Seeing a mental expert right away is especially important when dealing with this situation (Hall-Flavin, 2013). Though there will be challenges to recovery, with the right support system there isn’t a thing that should be discouraging such patients! So please take a pledge to stand up for our fellow brothers and sisters with Bipolar Disorder – as well as stand up against their habits of alcoholism. Please call your local rehab center, a therapist, a medical professional, people closest to you/the patient, or even 1-888-599-4340 (National Addiction Treatment Hotline) to build a support system and help a patient out (Recovery.org). Let us save our loved ones and not allow their manic or depressive states to be permanently combined with a liquid state.
Dunner, D.l., and J. Feinman. "The Effect of Substance Abuse on the Course of Bipolar Disorder." Biological Psychiatry 39.7 (1996): 617. Web. Retrieved November 1, 2015 from <http://www.sciencedirect.com/science/article/pii/0165032795000801>.
Hall-Flavin, Daniel K., Dr. "Bipolar Disorder." And Alcoholism: Are They Related? MayoClinic, 10 Apr. 2013. Web. Retrieved November 1, 2015 from <http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder/faq-20057890>.
NIMH, Bipolar Disorder in Adults. (2012). Retrieved November 1, 2015 from <http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml>.
Sonne, Susan C., Kathleen T. Brady, and D. Pharm. "Substance Abuse And Bipolar Comorbidity." Psychiatric Clinics of North America 22.3 (1999): 609-27. Web. Retrieved November 1, 2015 from <http://pubs.niaaa.nih.gov/publications/arh26-2/103-108.htm>.
Strakowski, S. "The Co-occurrence of Bipolar and Substance Use Disorders." Clinical Psychology Review 20.2 (2000): 191-206. Web. Retrieved November 1, 2015 from <http://www.sciencedirect.com/science/article/pii/S0272735899000252>