Alcohol and Bipolar Disorder: A Cocktail For Disaster?

I rarely watch television, but since I was feeling a little blue last night I flipped on the tube and settled on watching a couple of sitcoms for some comedic relief. In the course of one hour's viewing time I witnessed at least five beer commercials. I finally had to turn the TV off because it was making me crave a beer something fierce, and I was seriously considering breaking into the cooking wine, since there is currently no beer in the house.

As you may well be aware, substance abuse is fairly common with sufferers of mental illness. While I personally don't see anything dreadfully wrong with an occasional drink to let off some steam, great care must be taken in making sure it does not become a habit that you depend on. It is also important that you make sure alcohol does not interact dangerously with your medication. In addition, since alcohol is a depressant, it can often worsen your symptoms. Another risk is the loss of inhibitions, which can be especially detrimental in the already unbridled territory of mania.

Ranking only second to caffeine, alcohol is a wildly consumed psychoactive drug. While caffeine is often consumed for its get-up-and-go effects, people choose alcohol for many different reasons. It's the legal drug of choice at many celebrations. It is also a quick fix for the the ailments of stress, depression, and anxiety. If I have a social function to go to I often will drink a small amount of alcohol before I go because it loosens me up enough to reduce the chance of a socially induced panic attack, and allows me to actually enjoy the company of others. It is tricky business, mind you, to drink just enough to cope with the anxiety but not enough to appear like I have been drinking. I have been known to show up at a family Christmas get-together quite sloshed. I would not recommend doing it that way, as it is embarrassing for all involved!

The following illustrates the effects of alcohol more specifically:

Published on DrugsAlcohol.info (http://www.drugsalcohol.info)

Blood alcohol concentration (BAC) is usually recorded in milligrams of alcohol per 100 millilitres of blood. This can be shortened to milligrams percent, written as mg%.

One unit is equivalent to 15mg% for an average man and 20mg% for an average woman.¹

BAC	Effect
20mg%	More relaxed, pleasantly calm, a feeling of well being.
30mg%	More talkative, losing some inhibitions, risk of accidents starts to increase.
50mg%	Carefree, inhibitions going fast, judgement beginning to be affected, decision-making skills start to deteriorate.
80mg%	Hand-eye coordination markedly diminished, accident rate doubled.
100mg%	Obvious deterioration in physical and social control, clumsy and emotional.
160mg%	Swaying and slurring, obviously drunk.
200mg%	Some staggering, double vision and perhaps vomiting.
300mg%	Grossly intoxicated and semi-comatose.
400mg%	Unconscious and unable to arouse, breathing shallow, cough reflex lost, high risk of suffocating on inhaled vomit.
500mg%	Death likely from paralysis of breathing.

References

1. National Health and Medical Research Council. Australian Alcohol Guidelines: Health risks and benefits. Canberra: National Health and Medical Research Council, 2001.

And here's a nifty little calculator to determine what impact your drink of choice may have on you  BAC Calculator

While mild to moderate alcohol consumption can somewhat assist in uplifting mood, reducing stress, and facing social obligations, there is a thin line between a healthy amount of drinking and substance abuse. Not only is alcohol dependence harmful to physical health (say goodbye to your liver), but it can wreak havoc on your home life and job performance, and can also delay recovery and even worsen psychological disorders.

Generally, drinking is not the greatest activity for someone with Bipolar Disorder, as it can trigger depressive episodes and increase the severity of other symptoms associated with the illness.  Neurological effects of alcohol in a patient with Bipolar Disorder can make treatment more difficult, thereby delaying recovery from depressive or manic episodes. Moreover, alcohol use affects sleep patterns, preventing your body from reaching the deep REM sleep stage that accounts for the most beneficial duration of rest. Adequate sleep is essential for mood management in Bipolar Disorder. There are also serious dangers to mixing alcohol with psychiatric medications. Here you will find a list of common interactions associated with alcohol and certain prescription drugs: Alcohol-Medication Interactions  Speak to your doctor about whether drinking, of any amount, is safe with your medications.

Studies conclude that women with Bipolar Disorder are seven times more likely to become alcoholics than those without the illness, and men with Bipolar Disorder are three times more likely. According to researchers from the University of California at Los Angeles, "Men with bipolar, who are alcoholics, most often had a family history of alcoholism, bipolar disorder and drug abuse when compared with nonalcoholic bipolar men. Alcoholism among bipolar women, however, did not stem from family lineage. Their addiction had more to do with anxiety and depression". It is important to understand why you drink, and to prevent it from taking over your life. Like any addiction, the dependence on alcohol can be a gradual development that you are not aware of until it has become a problem.  To examine your drinking habits and determine whether you may need help, fill out this Alcohol Abuse Questionaire.

In closing, only you and your doctor can decide whether a little innocent bubbly will be a safe venue for enjoyment. If the doc gives you the okay, then remember to drink responsibly and DON'T DRINK AND DRIVE!

-Amy Purdy