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  • Alcohol Use Disorder & Bipolar Disorder | Dual Diagnosis Risks & Treatment

    Alcohol Use Disorder & Bipolar Disorder

    Bipolar disorder is a mental health condition that causes extreme mood swings, resulting in manic highs and depressive lows. This can cause difficulties with daily life and people may turn to substances to cope. 

    Almost half of all people with a diagnosis of bipolar disorder also develop alcohol use disorder

    Although alcohol may seem to relieve symptoms, it can worsen them and impact the course of treatment. Therapy, medication, and addiction counseling can be effective tools for long-term recovery. 

    Symptoms Of Alcohol Use Disorder

    Alcohol use disorder (AUD) is a disease of the brain characterized by intense cravings for alcohol and an inability to stop using alcohol regardless of the consequences. 

    Symptoms of AUD may include:

    • inability to control drinking
    • intense cravings for alcohol
    • alcohol abuse interferes with relationships, school, or work
    • withdrawal from activities, family, or friends
    • high-risk behavior
    • alcohol dependence

    Symptoms Of Bipolar Disorder

    Bipolar disorder also referred to as manic depression, is a mood disorder that causes significant fluctuations in mood, energy, and activity levels. 

    People with bipolar disorder experience alternating episodes of mania and depression. Mania can cause someone to feel highly energized, elated, or irritable. Depressive episodes can cause someone to feel down, hopeless, or indifferent. 

    Sometimes these episodes occur separately for prolonged periods. They can also occur together, known as a mixed episode. 

    Manic symptoms include:

    • feeling euphoric, energized, or irritable
    • decreased sleep and appetite
    • racing thoughts
    • high-risk behaviors

    Depression symptoms include:

    • feeling hopeless or low
    • restlessness
    • slowed activity
    • trouble sleeping or sleeping too much
    • increased appetite
    • trouble concentrating

    Severe cases of mania and depression can result in psychosis, including hallucinations and delusions, or suicidal thoughts. These symptoms often require hospitalization and immediate treatment. 

    The two most common types of bipolar disorder include:

    Bipolar I

    Bipolar I disorder is considered the most severe form of the disorder. Manic episodes may last at least a week and depressive episodes can last up to two weeks at a time. 

    Bipolar II

    Bipolar II disorder is similar to Bipolar I but people likely experience hypomania followed by episodes of depression. Hypomania can be less severe than mania and episodes may only last a few days. 

    Dual Diagnosis Risk Factors

    Bipolar disorder and alcohol use disorder co-occur at a high rate. One study found that alcohol use disorder occurred in 46.2% of individuals with bipolar I and 39.2% of individuals with bipolar II. 

    In addition, people with bipolar I who experience severe symptoms have a higher risk of developing a co-occurring substance use disorder. 

    A combination of risk factors can affect the development of a dual diagnosis. 


    Both alcohol use disorder and bipolar disorder have strong genetic links.  One study found that bipolar disorder occurred in family members of 80% of individuals in the trial. Certain genes can also make someone more vulnerable to the effects of alcohol. 

    Brain Structure

    Brain structure in people with bipolar disorder can also influence how someone responds to the effects of alcohol. Substance abuse can worsen symptoms, lead to more frequent hospitalizations, and increase the risk of developing an alcohol use disorder. 


    People who develop bipolar disorder first may use alcohol to self-medicate symptoms of depression. During periods of mania, some people may drink alcohol excessively or abuse other substances.

    Dual Diagnosis Treatment For Bipolar & Alcohol Use Disorders

    Alcohol use disorder and bipolar disorder can be effectively treated with a comprehensive treatment plan. Treatment may involve a combination of medication and therapy to help decrease cravings, improve coping skills, and manage symptoms.

    Most inpatient and outpatient treatment programs offer the following dual diagnosis services:


    Inpatient detox is an important step in alcohol addiction treatment. Depending on the severity, alcohol withdrawal can be dangerous. A detox program provides 24/7 monitoring and medications, when necessary, to ease severe symptoms. 


    Psychotherapy, also known as talk therapy, is a safe environment to talk one-on-one with a counselor. With a trusted therapist, you can discuss past traumas, set goals, and overcome challenges.

    Cognitive Behavioral Therapy

    Cognitive-behavioral therapy (CBT) helps individuals learn to be aware of negative thoughts and behavior patterns. CBT also teaches healthy coping skills that can help improve alcohol cravings and symptoms of bipolar disorder. 


    Mood stabilizers, antidepressants, or antipsychotics may be prescribed for bipolar disorder depending on the severity of symptoms. There are also medications, like naltrexone, that may help with alcohol cravings. 

    Healthy Activities

    Healthy activities promote a well-rounded approach to treatment that focuses on physical, mental, and emotional health. Activities may include yoga, meditation, or journaling. These types of activities can help increase mindfulness and reduce stress. 

    If you or a loved one would like more information about dual diagnosis treatment, please contact us today to speak with a treatment specialist. 

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    National Institute Of Mental Health - Bipolar Disorder
    National Institute On Alcohol Abuse And Alcoholism - Bipolar Disorder And Alcoholism
    National Library Of Medicine - Bipolar Disorder and Alcohol Use Disorder: A Review

    Medically Reviewed by
    Manish Mishra, MBBS
    on August 10, 2022
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