Question: I have had problems with alcohol or substances of abuse. Is it possible that these are related to an underlying bipolar disorder diagnosis? How do I find out if this is the case?
Answer: The comorbidity of alcohol and bipolar disorder, or alcohol abuse and bipolar disorder, is extraordinarily high on the order of much more than half of people with bipolar disorder turn out to have a substance abuse issue as well.
Some understand this as being a self-medication, using alcohol or other drugs to try to manage the mood lability that's found in bipolar disorder. Often the history will be of people who are using alcohol to mask or to limit the effects of their mania or of their depression. The best way to find out whether depression is, or mania is, part of the story or not is to stop drinking and to see what happens. Complicating matters further is that heavy drinkers can end up with mood instability as well as a result of their drinking and thus the issue becomes again to tease out whether, after the drinking stops, the mood disorder remits or whether it becomes more clear.
In some, alcohol and bipolar disorder often confound one another and it's very hard to tease them apart and it will probably require expert care to sort that question out.
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