Bipolar and the Risks of Alcohol
Staggeringly, it is estimated about 45 percent of people with bipolar disorder also have an alcohol use disorder.
So why do we drink? I can only answer this question based on my personal experience with bipolar and from those around me experiencing the same.
I have battled (note I'm not saying “coped” here because in all honesty I haven't for the majority of the time) with rapid cycling bipolar disorder for nine years, and although I wouldn't class myself as having an alcohol use disorder, I have definitely used alcohol in the past to cope.
I have consumed alcohol to:
- Self medicate
- Block out pain
- Bring down mania
- Push mood into instability as anywhere is better than where I'm feeling at that moment
- Lose inhibitions and feel alive
- Self harm and punish myself
What is interesting is that prior to drinking alcohol I know it is introducing mood-altering chemicals to the brain and will always cause instability. However, I go ahead and drink because I don't think of the aftermath.
My motivation to drink is in the moment where I have a compulsive need to do one or all of the things I've listed above. For the last nine years I have been encouraged to live in the moment, as the future is too overwhelming, so I find it a struggle to rationalize the consequences of some of my actions.
We also know that compulsion is symptomatic of bipolar disorder and stopping yourself from fulfilling a need, no matter how risky, is extremely difficult.
You are at risk of losing your inhibitions when you drink, which is where you lose your judgment and impulse control.
We make different decisions to the ones we would if we were sober. We take more risks, lose rationality and, ultimately, don't think straight.
I have been at the hands of this many times, particularly during hypomania. I can feel high, irritable and impulsive and guess what comes with that? Thoughts and impulses related to sex.
When I was single I used to online date. To gain confidence and focus on fulfilling my need, I drank. Looking back I was most likely perceived as “easy.”
I would meet up with guys, drink far too much and stay with them overnight. Over time I questioned why the relationships never went very far, but found myself in a cycle of behavior.
When the alcohol wore off I often felt shame, and once my mood changed I would fall back into depression. At that point, shame and disgust would really kick in, and on the flip side I would want to drown my sorrows in alcohol. I'd gone from drink to stimulate to drink to block it all out.
What Does Alcohol Do to the Brain?
Alcohol is a depressant and depletes the amount of serotonin in your brain. This is a chemical many bipolar mood stabilizers are trying to steady — so you can see how drinking alcohol is risky.
It's a bit like drinking a sugary drink while trying to calm down. It defeats the objective and doesn't make any sense!
Alcohol can affect our thoughts, feelings and actions — all of which are daily impacted by bipolar disorder. This is partly down to neurotransmitters, which are chemicals that help to transmit signals from one nerve in the brain to another.
When you first feel relaxed after drinking alcohol there are chemical changes going on in your brain. This is where we can feel more confident and less anxious, which is when we start to lose our inhibitions.
The more we drink the more our brain becomes affected. No matter what mood we were in beforehand, once high levels of alcohol are involved, the pleasure effects can be replaced with more negative emotional responses, like anger, anxiety, aggression or depression.
My Experience With Bipolar and Alcohol
I remember taking a trip to another town with my friends for a party. We were staying over night and making a weekend of it.
I shouldn't have gone. I'd been feeling very low, having lots of emotional outbursts and trying to hide the fact I had slipped back into depression. However, I was managing to function and I wanted to block it all out for a weekend.
I started drinking early in the day and continued at the party. I forget how much I had to drink but I know I had to be taken home early and I know I lost my bag.
I couldn't stand up. I'd ruined everybody's night. The worst part was when I arrived back at the apartment.
The chemical changes in an already poorly brain made my behavior shoot out in all different irrational directions. I mumbled, cried, shouted and scrambled around on my knees trying to find the contents of the bag, which had been lost back at the party.
I was a complete mess. I can remember seeing my friends’ faces and they were disgusted. I think one friend realized I was in a really bad way and put me to bed.
On top of the severe hangover I experienced the next day, the shame was immense. I felt as though I was dying and my mental state was so fragile I thought, “Am I relapsing again?”
I cried and apologized to my friends, but for the next few weeks I was confined to my bed with depression, hating myself. My friends told me it was ok but I'd done the damage and I couldn't cope with the overwhelming feeling of shame.
I stopped drinking for six months after that — didn't touch a drop. I was too scared that my mood would switch again and I would cause further devastation to myself and to those relationships around me.
Everything in Moderation
I do not condone drinking on medication, but it is a personal decision, and I’m realistic. I am now able to have the odd glass of wine or pint of cider, but I know when to stop.
This is possible because I am relatively stable at the moment and I have the rationality of thought to know I can't be dealing with the hangover or subsequent mood instability.
I am realistic to say that in the future it is likely I will reach for alcohol to self-medicate, but I'm much more informed about this scenario now — and I've had enough experience to be able to question myself at the point of self-destruction.
Once, when I was in a bipolar mixed state (hypomanic and depressed at the same time), I wanted to drink to keep my agitation down and to block out my suicidal thoughts. I remember sitting in the garden with my third can of beer wanting the world to open up its mouth and swallow me whole.
However, something clicked in my alcohol-fused state and I called a helpline number I had saved in my phone. I continued to drink while talking to them, but as I spoke and offloaded to this kind, non-judgmental person on the other end it did make me consider my actions.
The need to lose my head in alcohol had been met by simply opening up to someone who just listened. I hope in the future if ever I am fuelled by my illness to drink I'll make that call again. It really helped.
How We Can Prevent Ourselves From Using Alcohol?
We can help to prevent alcohol impacting our moods by exercising, practicing relaxation, learning breathing techniques to deal with anxiety, talking to someone about our problems, having a good sleep routine and always being aware of why we are drinking and if we do drink, what our limitation should be.
Remember that if we are drinking to block, it is likely we are going to feel a whole lot worse once the alcohol wears off.
Ultimately, however we look at it, no good can come from drinking excessive alcohol with an illness such as bipolar disorder.