Wake up and smell the coffee- Bipolar and Alcoholism

Alcoholism/Substance abuse and bipolar disorder commonly co-occur.  Studies have indicated they co-occur at higher than expected rates which explains the epidemic of narcotic/illicit substance addiction, alcoholism, poly-pharm abuse, broken homes, increased unemployment statistics and overdose death rates.  

In my professional and personal encounters I have personally witnessed the devastation bi-polar disorder exacerbated by substance abuse brings to the life of the individual and their family.  I have found that the mood swings and poor impulse control leads the individual to find a pathway to modulate their dysfunctional brain chemistry.  One person that I am acquainted with personally, has chosen alcohol and illicit drugs in attempt to cope.  His alcohol use began at or around age 15 and has progressed to the present that finds most of his waking hours consumed with thoughts and actual use of alcohol.  His life is riddled with broken relationships, legal issues, poor employment history and numerous psychiatric hospitalizations.  I am most intrigued as to how the two disorders interact to completely blind him to the cumulative effect of each on the other and the direct cause and effect relationship to the many issues in his life. The overt function of his mental illness creates a delusional existence in which he is always the victim and he has formed elaborate falsehood justifications for every negative consequence in his life. 

   it's fairly obvious that the introduction of mind altering chemicals into the brain doesn't exactly help to sustain mental stability. With almost all recreational drugs there is some kind of "high" associated with experience. That's why people do it. But following any substance induced high, there's almost always the experience of coming down. And usually that translates into a "low" mood feeling.

   Drinking a beer or glass of wine has been scientific proven to present some positive health benefits and is not an issue if one is able to apply good judgment and adequate impulse control. The problem is that everyone with bipolar disorder intermittently becomes hypomanic or manic. It's what defines the diagnosis. And in these elevated mood states, bipolar individuals almost always experience some degree of impaired impulse control. During the elevated mood phase they're usually feeling up, energized, gregarious, cognitively accelerated and creative.  The problem is that once their mood extends above the mildly elevated range, they often lose the capacity to modulate or turn down their mood-related intensity. It's like the wheels of hypomania become lubricated and they keep picking up speed.  That's what's wrong with alcohol-related disinhibition. It further greases the wheels of elevated mood. The challenge faced by those with bipolar disorder is one of figuring out how to do the opposite. They've got to become skillful at applying the brakes and slowing back down to a healthy speed.  To do so however, they have to show some degree of desire to change and begins with not introducing alcohol or other mind-altering substances outside of their psychiatrist prescribed medication designed to assist them in obtaining stability.  Then the real work begins- re-integrating back into normal society and repairing all the damage done through their self-centeredness.