Co-Occurrence

• The difficulty coping with a taxing mood disorder like manic depression frequently causes an understandable dependence on mood- and mind-altering substances to provide temporary relief. As a result of this correlation, estimates indicate that anywhere from 30 percent to half or more of people with bipolar disorder demonstrate a concurrent problem with alcohol and/or substance abuse.
  
  

Diagnosis

• Given the high co-occurrence of manic depression and alcohol abuse, a related and very troublesome Catch-22 is that alcohol dependence often masks the presence of a mood disorder. Both produce behavior that can appear similar or identical, such as the loud, argumentative conduct seen in drunks and people experiencing a manic episode, as well as the brooding mannerisms likewise seen in intoxicated people and bipolar individuals suffering a bout of depression. Consequently, it sometimes takes longer to distinguish the two conditions and diagnose the underlying mood disorder.
  
  

Treatment

• Alcohol abuse is not the only medically recognized condition that co-occurs with bipolar disorder. Others include drug abuse, obsessive-compulsive disorder and post-traumatic stress disorder, any and all of which can facilitate more extreme behavior, such as suicide attempts. Caregivers must therefore make sure to treat all of the related problems, in addition to the manic depression, either separately or together.
  
  

Considerations

• Although it frequently is an attempt to self-medicate, alcohol abuse doesn't always serve that purpose for someone suffering from bipolar disorder. For instance, individuals with bipolar disorders can also demonstrate an inability to control their alcohol intake when drinking heavily is a pre-existing customary routine that is subsequently exacerbated by a mood swing. In those cases, treating the mood disorder can automatically curtail the accompanying alcohol problem.
  
  

Warning

• Individuals who have bipolar disorder and drink alcohol excessively for whatever reason--not just self-medication--should keep in mind that alcohol and the pharmaceuticals prescribed to combat manic depression do not play well together. In fact, they don't play together at all, and mixing the two can result in dire consequences, including death.