Alcohol & Bipolar Symptoms
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Q:  Alcohol & Bipolar Symptoms

Recently I have been seeking treatment for bipolar symptoms and depression.   I have been asked several times if drinking could be one of the problems.  However, sometimes I just can't stop thinking about anything and when I have a few beers (around 3) I feel so much better.  I don't worry about anything and I don't have constant thoughts running through my head.  I feel so relaxed when I get alcohol in my system and I am able to hold conversations, have fun, and even laugh.  Is this normal that alcohol makes me feel better, and never depressed?  Is a solution to feeling better to drink a few beers a day?

Dear Katherine -- 
Sounds like you're getting at least 2 benefits from alcohol: it treats your accelerated, incessant thinking; and it sounds like it might be treating a social anxiety as well.  So, you're right to ask whether there's any risk from this stuff that seems so helpful.  I notice that you were "seeking treatment for bipolar symptoms and depression"; so depression has been around.  Sounds like you just haven't seen a direct connection with the alcohol.  

So, what we need to wonder is if there might be an indirect connection between alcohol and your depression.  And the answer there is, "definitely possible".  Alcohol is very well recognized to induce cycling.   You might not see it the same evening or the next day.  But if you're having trouble getting your symptoms under control (and the fact that you'd need the alcohol for "constant thoughts running through your head" suggests that), then alcohol really could be making your whole situation worse -- despite being very helpful in some ways also. 

Thus the trick would be to find some other way to treat your racing thoughts other than alcohol, and that part is pretty easy -- that's what mood stabilizers are supposed to do, one of the things they do best.  Trickier will be the social anxiety, if I'm right in hearing that's an issue for you.  (It's a very common issue in bipolar II).  But there is a very good psychotherapy (so you don't have to add another medication to deal with it) for social phobia. Check out that link if that's an issue for you.  

Dr. Phelps

Published November, 2002


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