A new University of Michigan study challenges the belief that people with bipolar disorder use alcohol as “self-medication” for mood symptoms. Analyzing data from 600 individuals with bipolar disorder over ten years, researchers found that even small increases in drinking can lead to lasting depressive or manic symptoms, regardless of the amount consumed. However, the reverse wasn’t true; an increase in mood symptoms did not predict more drinking, which refutes the common assumption of self-medication.
Dr Sarah Sperry, a psychologist at Michigan Medicine, explains,
“Our study shows that when an individual with bipolar disorder drinks more than typical for them, regardless of how much more, they are more likely to show an increase in depressive and/or manic symptoms over the following six months.”
Despite high rates of alcohol use among those with bipolar disorder, few studies have examined the complex, bidirectional relationship between alcohol use and mood.
The study used data from the Prechter Longitudinal Study of Bipolar Disorder, which follows over 1,500 participants and tracks mood, life functioning, and alcohol use every two months. This data allowed Sperry and her team to observe that increased alcohol use correlates with impaired functioning, especially in work life, and is particularly impactful for those with bipolar II disorder.
Sperry notes that even moderate alcohol use can disrupt circadian rhythms and brain reward circuits, suggesting that people with bipolar disorder may be more sensitive to alcohol’s effects and slower to recover. She advises patients to maintain consistency in their alcohol consumption, as well as in sleep, medication, and eating habits. This approach could help individuals resist pressures to drink excessively in social situations and focus instead on harm-reduction strategies.
The team, including doctoral candidate Audrey Stromberg, plans further research into the neurophysiological impacts of alcohol in bipolar disorder using EEG and mobile tracking technologies. Sperry explains,
“The reasons behind our findings likely have more to do with what alcohol and social situations involving alcohol do to a person’s circadian rhythms and brain-based reward circuits”.
You can learn more about bipolar disorder here.