People who misuse alcohol are more likely to have bipolar disorder. Among people with bipolar disorder, the impact of drinking is noticeable. About 45 percent of people with bipolar disorder also have alcohol use disorder (AUD), according to a 2013 review.

The combination of bipolar disorder and AUD can have severe consequences if left untreated. People with both conditions are likely to have more severe symptoms of bipolar disorder. They may also have a higher risk of dying by suicide.

However, both conditions can be successfully treated. Read on to learn more.

Researchers haven’t identified a clear link between bipolar disorder and AUD, but there are a few possibilities.

Some theorize that when AUD appears first, it can trigger bipolar disorder. There’s no hard scientific evidence for this idea, though. Others have suggested that bipolar and AUD may share genetic risk factors.

Other theories suggest that people with bipolar disorder use alcohol in an attempt to manage their symptoms, especially when they experience manic episodes.

Another explanation for the connection is that people with bipolar disorder can exhibit reckless behavior, and AUD is consistent with this type of behavior.

If someone has both conditions, it matters which condition appears first. People who receive a diagnosis of AUD may recover faster than people who first receive a diagnosis of bipolar disorder.

On the other hand, people who receive a diagnosis of bipolar disorder first are more likely to have difficulty with the symptoms of AUD.

Bipolar disorder is marked by extreme shifts in mood. Drinking alcohol can often amplify these mood shifts.

In the United States, about 4.4 percent of adults will experience bipolar disorder at some point in their lives, according to the National Institute of Mental Health. A bipolar diagnosis is described as type 1 or 2, depending on the severity of symptoms.

Bipolar 1 disorder

To receive a diagnosis of bipolar 1 disorder, you must have experienced at least one episode of mania. This episode may precede or follow an episode of depression, but isn’t necessary.

All that’s needed for a diagnosis of bipolar I disorder is the development of a manic episode. These episodes may be so severe that they require hospitalization in order to stabilize.

Bipolar 2 disorder

Bipolar 2 disorder involves hypomanic episodes. To receive a bipolar 2 disorder diagnosis, you must have had at least one major depressive episode. This episode must last 2 weeks or more.

You also must have experienced one or more hypomanic episodes lasting for at least 4 days. Hypomanic episodes are less intense than manic episodes. Learn more about the difference.

Bipolar disorder and AUD are similar in some ways. Both tend to occur more frequently in people who have a family member with the condition.

In people with bipolar disorder or AUD, it’s believed that the chemicals that regulate moods don’t work properly. Your environment as a young person can also influence whether you’re likely to develop AUD.

To diagnose bipolar disorder, your doctor will look at your health profile and discuss any symptoms you may have. Your doctor may also conduct a medical exam to rule out the possibility of other underlying conditions.

To identify AUD, your doctor will ask you a series of questions about your habits and your body’s reactions to drinking. They can also categorize AUD as mild, moderate, or severe.

Doctors often diagnose and treat bipolar disorder and AUD separately. Because of this, people with both conditions may not get the full treatment they need at first. Even when researchers study bipolar disorder or AUD, they tend to look at just one condition at a time. There’s been a recent trend to consider treating both conditions simultaneously, using medications and other therapies that treat each condition.

Your doctor might recommend one of three strategies to treat bipolar disorder and AUD:

  1. Treat one condition first, then the other. The more pressing condition is treated first, which is usually AUD.
  2. Treat both conditions separately, but at the same time.
  3. Combine treatments and address the symptoms of both conditions together.

Many people consider the third approach to be the best method. There isn’t much research that describes how to best combine treatment for bipolar disorder and AUD, but emerging recommendations from studies are available.

For bipolar disorder, medication and a mix of individual or group therapy have shown to be effective treatments.

Several options are available to treat AUD. This may include a 12-step program or cognitive behavioral therapy.

In someone who has bipolar disorder, drinking can increase symptoms of mood shifts. However, it may also be difficult to control the impulse to drink during shifts in mood.

Getting treatment for both bipolar disorder and AUD is important. Alcohol can also increase the sedative effects of any mood stabilizers being used to treat bipolar disorder. This could be dangerous.

If you have bipolar disorder, AUD, or both, talk to your doctor about treatment options that will work for you.