Booze, Drugs, and Bipolar Disorder

A dearth of research
It's been difficult to study the link between bipolar disorder and substance abuse because, traditionally, research on bipolar patients has screened out substance abusers, and vice versa, says Dr. Tolliver. He and other experts would like to see more research into treating patients with both problems; about 20% of people seeking treatment for a mood disorder are also substance abusers. In a 2004 study, 41% of alcohol abusers and 61% of drug abusers who sought treatment for their problem were also found to have a mood disorder such as bipolar.

Meanwhile, many bipolar patients, like Caroline, 25, may not be getting the treatment they need. Caroline has been hospitalized for a manic episode and sees a psychopharmacologist to manage her medications, which have included Seroquel, lorazepam (Ativan), divalproex (Depakote), lamotrigine (Lamictal), methylphenidate (Ritalin), Abilify, and Geodon. Currently unemployed and living in New York City, she has trouble sleeping and drinks heavily two to three nights a week.

"I can drink eight cocktails and be fine," Caroline says. However, her psychopharmacologist is not aware of her drinking, and Caroline doesn’t plan to address it, though she is vaguely aware that she's at risk—not only for potential drug and alcohol interactions, but also for unsafe situations.

Three years ago she was in a bar, nearly blacked out, when a stranger attempted to lead her out the door. One of her coworkers confronted the man, who claimed to be Caroline's brother. He left without her, but some rapes were later reported in the same area. "I dodged a bullet," Caroline says.