Alcohol and drug use is very common among people with bipolar disorder. A history of alcohol or substance use often makes the course of bipolar disorder much worse.

What is bipolar disorder?

Bipolar disorder (or manic-depressive illness) is a medical condition, an illness, that effects the functioning of the brain, so that the person experiences extreme mood swings. Moods range from extreme elation (mania) to deep depression. Sometimes the experience is so intense that the person experiences psychotic symptoms – they lose touch with reality. Symptoms generally respond well to treatment and most people recover well from episodes of the illness.

What are the symptoms?

People with bipolar disorder can experience extreme highs, during which they can become over-excited, reckless, sleepless and highly energetic. They can become highly delusional. They can also experience deep lows, feel helpless and depressed and unable to function normally. Sometimes symptoms of both mania and depression appear at the same time.

Facts about bipolar disorder and substance use

• People with bipolar disorder are eleven times more likely to abuse alcohol or drugs than the general population
• Substance use is the single most common predictor of bad outcomes for people with mood disorders
• Cocaine and amphetamines are the leading substances that precipitate manic episodes. Hallucinogens are second, followed by marijuana (in some people)
• Alcohol is the leading precipitator of depressive episodes
• Some people with bipolar disorder and substance use issues will choose substances over medication because they do not want to mix the two.

This can lead to major problems when the medication is foregone in favour of the substance.

Alcohol and bipolar disorder

Alcohol is classified as a central nervous system depressant. It depresses areas of the brain that are used in complex and rational thinking and voluntary control of behaviour. In large amounts and over extended periods, alcohol eventually depresses parts of the brain that tells our heart to beat, causing respiratory arrest.

People who use drugs and alcohol may develop depression as a result of their drug and alcohol use. Alcohol can accentuate many of the symptoms of depression. It can also interfere with a person’s ability to successfully resolve the very situations that may have originally caused their depression.

Alcohol and antidepressants

Alcohol is incompatible with many of the medications that are used to treat depression. It can intensify the sedative
effects of certain antidepressants.

Useful references

Mental Health Services Website (Vic)
www.health.vic.gov.au/mentalhealth

National Alliance of the Mentally Ill (NAMI) (USA)
www.nami.org

Mental Health Council of Australia
www.mhca.com.au

SANE Australia
www.sane.org

Beyond Blue
www.beyondblue.org.au

Australian Drug Foundation
www.adf.org.au

Turning Point Alcohol & Drug Centre DirectLine 24/7 Counselling and information 1800 888 236
www.turningpoint.org.au

Mental Illness Fellowship of Victoria fact sheets

Understanding bipolar disorder

Understanding dual diagnosis

What can friends and family do to help a person experiencing mental illness?

Family and carer supports and services

Substance use: stages of change model