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July 1, 2005

Alcohol Abuse Accompanies Bipolar Disorder

Bipolar disorder is often accompanied with a substance abuse disorder, very often it is alcohol abuse. Why these two disorders accompany one another has not been well researched, although there are several hypotheses as to why they are co morbid. Five of the most common theories were stated in this clinical update.

"(1) "kindling," or the neuronal sensitization created by one condition increasing susceptibility to the other; (2) a common genetic pathway for alcoholism and mood instability, resulting in shared neurochemical pathways that become dysfunctional; (3) long-term substance abuse, which may in fact cause bipolar disorder, although there is no clear-cut data to support this; (4) the belief that patients with bipolar disorder have thrill-seeking personalities drawn to high-risk behavior and are more likely to resort to alcohol and/or stimulant abuse; and (5) a form of self-medication where patients try to medicate themselves out of their depression and/or continue their mania or hypomania. Whatever the explanation, it is clear from the high rate of co-occurrence of these conditions that the association cannot be due to mere chance" (

Many of those who have an alcohol abuse problem are not screened for a mood disorder, although it is common for them to co-occur. Family physicians are usually the first to see the symptoms of either a substance abuse disorder or a mood disorder, but many have not received the education necessary to take action when such symptoms are present.

In one survey that was given to the patients and their families, it was discovered that it took an average of 7 to 10 years before they were diagnosed with bipolar disorder. Alcohol abuse is not commonly diagnosed in teens because abusing alcohol may sometimes be seen as part of growing up. General physicians may notice signs of depression, but not bipolar disorder because it is more difficult to diagnose. Unfortunately, many people that have a dual diagnosis often end up having a doctor that only focuses on one or the other problem. Dual diagnosis is when someone has both a psychiatric disorder and a substance abuse disorder. These two problems, although interrelated, need to be individually addressed if one is to receive successful treatment.

For more information on dual diagnosis go to:

Or you can go to this other great Dual Diagnosis site at:

The source of this story is Medscape.


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