There is a strong link between alcohol use and depression, a mental health condition that includes feelings of hopelessness, emptiness, fatigue, loss of interest, and more. But does regular drinking lead to depression, or are people with depression more likely to drink too much alcohol? In this case, manic episodes last for a week or more and/or are so intense that they require a hospital visit. Depressive episodes last for about two weeks at a time, and mixed episodes of mania and depression are also possible. Conversely, researchers suggest that decreased alcohol use may reduce bipolar disorder symptoms and vice versa.

The first is the “single-disorder paradigm,” in which patients are encouraged to think of themselves as having a single disorder, i.e., “bipolar substance abuse,” rather than trying to tackle two discrete disorders at once. Thinking of themselves as having a single disorder aids in the process of acceptance. There are a number of pharmacotherapy trials, and psychotherapy trials that can aid programme development. Post-treatment prognosis can be influenced by a number of factors including early abstinence, baseline low anxiety, engagement with an aftercare programme and female gender.

Psychiatric comorbidity in alcohol use disorders: results from the German S3 guidelines

This could have a carryover effect on depression since loneliness and lack of social support are linked to depression. One study of 421 people found that 25% had both alcohol misuse and sunrock thc depression. Our state-specific resource guides offer a comprehensive overview of drug and alcohol addiction treatment options available in your area.

Conditions that occur at the same time

This section examines some of the issues to consider in treating comorbid patients, and a subsequent section reviews pharmacologic and psychotherapeutic treatment approaches. One study of people with both AUD and depression undergoing treatment for both conditions found that the majority of symptom improvement for both conditions happened during the first three weeks of treatment. At Healthgrades, our Editorial Team works hard to develop complete, objective and meaningful health information to help people choose the right doctor, right hospital and right care. Our writers include physicians, pharmacists, and registered nurses with firsthand clinical experience. All condition, treatment and wellness content is medically reviewed by at least one medical professional ensuring the most accurate information possible. The prefrontal cortex, a region essential for decision-making, self-control, and emotional regulation, is particularly vulnerable to the effects of chronic alcohol use.

There is a lot that we still need to understand about the link between alcohol and depression, and this is an emerging area of research. Existing research indicates that depression can cause alcohol overuse, and alcohol overuse can cause depression. On the other hand, both conditions also share certain risk factors, such as genetics and social isolation. Having either depression or alcohol use disorder increases your risk of developing the other condition. Long-term alcohol consumption has profound effects on brain health, impacting not just neurotransmitter function but also the physical structure of the brain. These changes significantly contribute to the co-occurrence of alcoholism and depression, making recovery more challenging.

Comorbidity of Bipolar Affective Disorders in Alcohol Use Disorder Patients

Alcohol also has some stimulatory effects early on, such as raising dopamine. A controlled study with topiramate in BD + AUD failed due to slow recruitment (114). In BD, there is an equal incidence of men and women, emphasising the genetic origin of the disorder.

Chronic alcohol use can damage critical areas of the brain that govern decision-making, emotional regulation, memory, and overall mental health. But getting treated as soon as you notice a mental health disorder can help stop bipolar disorder or other mental health conditions from getting worse. Besides psychotherapy an individually tailored pharmacotherapy is essential in almost all BD patients with comorbid AUD. For BD, pharmacotherapy is an essential component to stabilize mood and prevent recurrences, whereas its role for treating AUD beyond controlling acute withdrawal symptoms is less clear. Randomized controlled studies in BD traditionally exclude patient with concurrent SUD.

1. Cannabis is likely to be second after alcohol as substance of abuse in BD patients, affecting approximately one quarter of bipolar patients (7).
2. More specifically, as stated previously, compared to non-substance abusers, alcoholics appear to be at greater risk for developing mixed mania and rapid cycling.
3. Whereas, AUD in female BD patients fosters rather self-destructive consequences, males appear more likely to externalize anger and impulsivity, and stand out by a history of criminal actions (62).

The lack of efficacy of quetiapine against AUD was also confirmed in another placebo- controlled study (120). No controlled data for other aAP or antidepressants have, so far, been generated (see Table 1). Other guidelines, e.g., the Canadian Network for Mood and Anxiety Treatments (CANMAT) do not recommend CBT but rather the integrated group therapy (IGT) developed by Weiss and colleagues which includes CBT and psychoeducation components.

Possible Explanations for Comorbidity

If commonalities in the recovery and relapse process in the two disorders can be seen as parallels between the two disorders, the focus on the relationship between the two disorders can be viewed as the intersection between BD and alcohol dependence. Thus, patients are told that drinking will negatively affect the course of their BD, and that non-adherence to their BD medication will increase their risk of relapse to drinking. Again, the focus on the intersection between the two disorders is consistent with the single-disorder paradigm. Alcohol dependence is also highly genetic (Mayfield et al., 2008), and a wide range of studies confirm that association (Kendler et al., 2009). The Prechter Longitudinal Study is also still enrolling both people with bipolar disorder and people with no mental health conditions or close relatives who have mental health conditions, to act as comparisons. If you’re concerned about a loved one and believe they may need residential care, we can help.