Bipolar Disorder And Alcoholism: How Are They Related?

Bipolar disorder and alcoholism have a high rate of dual diagnosis. Scientists still do not fully understand the prevalence of this co-occurrence. However, co-occurring disorder treatment can help people with these disorders to reach lasting recovery.

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Dr. Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS


The exact relationship between bipolar disorder and alcoholism is not well-understood.

What we do understand is that people with bipolar disorder are far more likely to also have an alcohol use disorder (AUD). There are also connections between alcohol abuse and other co-occurring disorders.

In national surveys, approximately 60% of people with bipolar I also had an AUD. About 50% of people with bipolar II and 40% of people with cyclothymia had an AUD.

Fortunately, treatment can help people learn to manage the symptoms of each disorder for long-lasting recovery.

Why Do Alcohol Use Disorder And Bipolar Disorder Co-Occur?

There are many theories as to why alcohol use disorders and bipolar disorders tend to co-occur.

Common explanations include:

  • Both conditions share an underlying genetic cause.
  • Alcohol use begins in response to bipolar disorder and is a form of self-medication.
  • Alcohol use aggravates latent symptoms of bipolar disorder.
  • Bipolar disorder is a biological risk factor for alcohol use disorders.

Regardless of why these disorders happen together, each can aggravate symptoms of the other. This can make treatment more difficult, however, dual diagnosis treatment addresses this issue by treating both disorders at the same time.

Factors That Contribute To Alcohol Use And Bipolar Disorder

Evidence for the existence of a shared genetic marker is building, but that doesn’t rule out other explanations.

The link between alcohol use and bipolar disorder is complex with layers of connection.

Genetic Traits

Bipolar disorders and alcohol use disorders tend to occur among family members.

There is the possibility of an environmental link, but researchers currently believe it is more likely to be genetic.

Continued research supports this hypothesis, but the specific marker(s) haven’t been precisely identified.

If the hypothesis is correct, it is possible that both disorders are expressed independently as a result of the same genetic factor.

Depression And Anxiety

Bipolar disorder is a health condition that causes moderate to severe mood fluctuations depending on the exact diagnosis.

When you’re experiencing a low point in your mood disorder, you’re going to have all of the symptoms associated with depression and anxiety.

During this time, you are more likely to use alcohol as a form of self-medication. Drinking alcohol may provide short-term relief, but it may also worsen your bipolar disorder.


Episodes of mania are the “high” of bipolar disorder. Your manic symptoms may make you feel energized and active.

Your behavior is likely to be abnormal with an increase in impulsivity and a decrease in inhibitions during this time.

While you’re experiencing mania, you may be more likely to engage in risky behaviors. Risky behaviors often include alcohol and drug use.

Types Of Bipolar Disorders

There are three major types of bipolar disorders. Each can have variations.

Some mood disorders can be difficult to categorize if you don’t demonstrate the exact bipolar disorder symptoms associated with a specific type.

Bipolar I Disorder

Bipolar I is the most intense bipolar disorder. If you have bipolar I, you may have manic episodes that last at least a week and depressive episodes that last at least two weeks.

With bipolar I you are more likely to be hospitalized during an episode. The intensity of mood changes with bipolar I increase the risk of self-harm and suicide.

Bipolar II Disorder

Bipolar II is a moderate form of bipolar disorder. If you have bipolar II, you may have milder manic episodes called hypomania.

These episodes last for around four days, while the depressive episodes last around two weeks. With bipolar II you are far less likely to self-harm or require hospitalization.


Cyclothymia is the mildest form of bipolar. It can take a long time to diagnose because the mood swings are frequent and relatively mild.

Professional psychiatry recognizes cyclothymia if you have had frequent, low-level mood swings for at least two years.

Not Otherwise Specified (NOS)

NOS is a mood disorder that doesn’t fit the exact criteria of the three main types of bipolar disorder.

If you’ve been diagnosed with a not otherwise specified mood disorder, your symptoms could vary.

Rapid Cycling

Any form of bipolar disorder can be categorized as rapid cycling. You have a rapid cycling bipolar disorder if you have four or more episodes within a 12-month period.

Treatments For Co-Occurring Bipolar Disorder And Alcoholism

Integrated treatment for co-occurring bipolar disorder and alcoholism requires a multifaceted approach.

With the help of medication and targeted therapy, you can address your co-occurring disorders and have a much better chance of recovery.


Naltrexone is a medication used to treat people with substance use disorders.

If you’re being treated for alcohol dependence or abuse, then naltrexone will usually be administered after detox. Often, Naltrexone is one of the medications used in alcohol withdrawal treatment.

Naltrexone effectively blocks the effects of alcohol. By removing the “reward” you associate with drinking, naltrexone can reduce cravings and prevent relapse.


Lithium is administered to help reduce the severity of bipolar disorder. It’s a mood stabilizer that can help to prevent severe mania and depression.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a hybrid approach that combines cognitive and behavioral therapy.

CBT is one of the most common treatments for co-occurring mental illness and substance abuse. It’s a highly adaptable therapeutic approach that has two dominant aims.

On the cognitive side, CBT is designed to help you evaluate your own thoughts. By learning to recognize self-destructive thoughts, you can begin to challenge them.

On the behavioral side, CBT helps you to recognize potential triggers and destructive behavioral patterns. By increasing your awareness, you can start to make positive changes.

Find Drug And Alcohol Treatment Services At Bedrock Recovery Center

At Bedrock Recovery Center in Canton, Massachusetts, we specialize in integrated treatments that help the whole person.

When you’re ready to get treatment for your alcohol addiction and bipolar disorder, our treatment center can provide medically supported detox and other targeted treatments.

We provide an integrated approach that offers multiple treatment options to improve your chance of success.

If you’re ready to end the cycle of alcohol dependence and bipolar disorder, give us a call today.

  1. Mayo Clinic
  2. National Institute on Alcohol Abuse and Alcoholism
  3. National Library of Medicine
  4. Substance Abuse and Mental Health Services Administration,and%20diversion%20potential%20with%20naltrexone.

Written by Bedrock Recovery Center Editorial Team

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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