People often think that those with bipolar disorder use alcohol as a form of “self-medication” to deal with their symptoms, which include mood swings, anxiety, and sleep problems.
However, a new study suggests that the relationship between bipolar disorder and alcohol is more complex.
Researchers from the University of Michigan studied nearly 600 people with bipolar disorder over ten years. They found that even small increases in drinking could have lasting negative effects on mood and behavior.
Surprisingly, the opposite was not true; increased mood symptoms did not lead to increased drinking, suggesting that people with bipolar disorder do not drink more to self-medicate.
The study was published in the journal JAMA Network Open. It was conducted by researchers from the Heinz C. Prechter Bipolar Research Program, who believe these findings are important for both patients and their healthcare providers.
The study showed that when people with bipolar disorder drank more than usual, they experienced an increase in depressive and manic symptoms over the next six months. This was true even for those who did not have a diagnosed alcohol use disorder.
Dr. Sarah Sperry, the study’s lead author, highlighted the importance of this finding. She explained that previous studies have shown that more than half of people with bipolar disorder also have alcohol use disorders at some point in their lives.
Many of these individuals use alcohol to help them sleep. However, few studies have explored the interaction between bipolar disorder and alcohol use.
The researchers used data from the Prechter Longitudinal Study of Bipolar Disorder, which has collected information from over 1,500 people with and without bipolar disorder. Participants provide updates on their mood, functioning, alcohol use, and more every two months.
Dr. Sperry and her team used advanced data analysis methods to understand the relationship between alcohol use and mood symptoms.
They found that increased drinking led to worse functioning, especially in work life, over the following six months. This was true for both bipolar I and bipolar II disorders, with a more pronounced effect in bipolar II disorder.
Interestingly, these negative effects were observed even in people who did not engage in heavy or frequent drinking. This suggests that even moderate increases in alcohol consumption can be harmful.
The researchers recommend that clinics use standardized tools, such as the Alcohol Use Disorder Identification Test (AUDIT), to monitor alcohol use in patients with bipolar disorder. Regular discussions about drinking habits should be part of mental health appointments.
Dr. Sperry’s team is now investigating the psychological and neurophysiological factors that contribute to alcohol use and symptom changes in bipolar disorder. They aim to develop new interventions to address both issues.
For now, the key message for people with bipolar disorder is to keep their alcohol consumption consistent. Just as maintaining regular sleep and medication schedules is important, so is keeping alcohol use stable.
Patients should avoid using alcohol as a sleep aid or to calm anxiety and resist peer pressure to binge drink.
These findings can help patients and clinicians have better conversations about whether to abstain from alcohol or use harm reduction strategies.
Dr. Sperry explains that the negative effects of alcohol on people with bipolar disorder are likely due to disruptions in circadian rhythms and brain reward circuits, rather than just the direct impact of alcohol on the brain.
To further explore these effects, Dr. Sperry and her colleagues are using EEG and wearable technologies to study brain activity and real-world behaviors in people with bipolar disorder. They are currently enrolling participants for this study.
The Prechter Longitudinal Study is also recruiting people with and without bipolar disorder to help scientists understand the causes and progression of this condition. Interested individuals can find more information about eligibility and participation.
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The research findings can be found in JAMA Network Open.
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