Bipolar Disorder and Alcoholism

By Sonne, Susan C.; Brady, Kathleen T. | Alcohol Research, Spring 2002 | Go to article overview

Bipolar Disorder and Alcoholism


Sonne, Susan C., Brady, Kathleen T., Alcohol Research


Bipolar disorder and alcoholism commonly co-occur. Multiple explanations for the relationship between these conditions have been proposed, but this relationship remains poorly understood. Some evidence suggests a genetic link. This comorbidity also has implications for diagnosis and treatment. Alcohol use may worsen the clinical course of bipolar disorder, making it harder to treat. There has been little research on the appropriate treatment for comorbid patients. Some studies have evaluated the effects of valproate, lithium, and naltrexone, as well as psychosocial interventions, in treating alcoholic bipolar patients, but further research is needed. KEY WORDS: comorbidity; manic-depressive psychosis; AODD (alcohol and other drug dependence); alcoholic beverage; prevalence; genetic linkage; disease onset; disease course; diagnosis; drug therapy; lithium; valproate; naltrexone; patient compliance; psychosocial treatment method; literature review

**********

Bipolar disorder and alcoholism co-occur at higher than expected rates. That is, they co-occur more often than would be expected by chance and they co-occur more often than do alcoholism and unipolar depression. This article will explore the relationship between these disorders, focusing on the prevalence of this comorbidity, potential theoretical explanations for the high rates of comorbidity, effects of comorbid alcoholism on the course and features of bipolar disorder, diagnostic issues, and treatment of comorbid patients.

Bipolar disorder, often called manic depression, is a mood disorder that is characterized by extreme fluctuations in mood from euphoria to severe depression, interspersed with periods of normal mood (i.e., euthymia). Bipolar disorder represents a significant public health problem, which often goes undiagnosed and untreated for lengthy periods. In a survey of 500 bipolar patients, 48 percent consulted 5 or more health care professionals before finally receiving a diagnosis of bipolar disorder, and 35 percent spent an average of 10 years between the onset of illness and diagnosis and treatment (Lish et al. 1994). Bipolar disorder affects approximately 1 to 2 percent of the population and often starts in early adulthood.

There are a number of disorders in the bipolar spectrum, including bipolar I disorder, bipolar II disorder, and cyclothymia. Bipolar I disorder is the most severe; it is characterized by manic episodes that last for at least a week and depressive episodes that last for at least 2 weeks. Patients who are fully manic often require hospitalization to decrease the risk of harming themselves or others. People can also have symptoms of both depression and mania at the same time. This mixed mania, as it is called, appears to be accompanied by a greater risk of suicide and is more difficult to treat. Patients with 4 or more mood episodes within the same 12 months are considered to have rapid cycling bipolar disorder, which is a predictor of poor response to some medications. Bipolar II disorder is characterized by episodes of hypomania, a less severe form of mania, which lasts for at least 4 days in a row and is not severe enough to require hospitalization. Hypomania is interspersed with depressive episodes that last at least 14 days. People with bipolar II disorder often enjoy being hypomanic (due to elevated mood and inflated self-esteem) and are more likely to seek treatment during a depressive episode than a manic episode. Cyclothymia is a disorder in the bipolar spectrum that is characterized by frequent low-level mood fluctuations that range from hypomania to low-level depression, with symptoms existing for at least 2 years (American Psychiatric Association [APA] 1994).

Alcohol dependence, also known as alcoholism, is characterized by a craving for alcohol, possible physical dependence on alcohol, an inability to control one's drinking on any given occasion, and an Increasing tolerance to alcohol's effects (APA 1994).

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Bipolar Disorder and Alcoholism
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.