Why I Choose to Abstain from Alcohol as a Woman with Bipolar Disorder

By: Cassandra Stout

As a social lubricant, alcohol takes top billing.

But if you have a mental illness like bipolar disorder, alcohol and other substances tend to tank your mental health.

I’m not going to lie: alcohol temporarily helps decrease the suffering that comes from bipolar disorder. For many people, it feels great to drink, which is why studies show that there’s a 58% lifetime prevalence of co-occurring alcohol use disorders in individuals with bipolar I disorder.

But in the long run, alcohol is known to make bipolar mood episodes much, much worse. Drinking increases feelings of depression due to alcohol’s sedating effects and dramatically boosts the severity of manic symptoms.

I don’t drink. I’ve never had more than a sip of my husband’s Christmas-only chocolate martinis. There’s one main reason why I don’t:

I’m scared to lose control.

It’s a visceral reason, something on a gut level that all humans experience: fear.

I’m scared. I’m scared that the stability I’ve worked so hard to earn over the years will spiral down the drain if I drink. I’m scared that more than a sip of alcohol will have me dancing on tables and shoot me into a full-blown manic episode. I’m scared that I’ll never recover from the inevitable crash and I’ll end up taking my own life.

My family has a history of addiction. I am scared that I’ve inherited those addictive behaviors and won’t be able to stop drinking once I start.

So the most powerful reason for me to never start drinking is fear of loss of control.

This may be an irrational fear. I may be able to control my impulses. I may be able to drink one drink a day and stop, indulging only a little at a time.

But given that I have bipolar disorder, a disease marked by impulsivity and addictive behaviors, I don’t want to take the risk of drinking, even responsibly.

Yes, not drinking means that people look at me funny at parties. It means I’m always the designated driver. It means that I’m often the sole sober person in a room full of drunk people, which can be funny sometimes and astonishing at others.

Staying sober means that I don’t have the social lubricant available to me, nor do I have a chemical way to unwind at the end of the day, which sounds tempting while being as wired and restless as I usually am in the evenings.

But it also means I am less likely to spin out into a manic episode that damages me and my family. Not drinking means my medications stay effective and I am less likely to suffer fatal toxicity.

Because I’ve never drunk, it’s easier for me to abstain than someone with an alcohol use disorder. I can’t look at an addict and say, “Hey, you should stop drinking. It’s bad for you” with any results.

However, I can say that drinking alcohol if you have bipolar disorder is bad for you, especially if you take an antidepressant.

Alcohol counteracts the effects of your medication, which can lead to an increase in suicidal thoughts. Also, if you take MAOIs, a special kind of antidepressant, your blood pressure could rise quickly, and you could end up with a stroke. Also, sometimes fatal toxicity can happen because your liver just can’t handle the combination of alcohol and medications.

And that’s just the meds. Alcohol has been demonstrated in research to make bipolar disorder symptoms dramatically worse. And if you have a dual diagnosis of alcohol use disorder and bipolar disorder, each issue can worsen the other, making both difficult to treat.

So protecting your mental health, even out of fear, is a great reason not to drink, and for me, to never start.

You may not be afraid of alcohol like I am. That’s good! I’m glad you’re able to handle drinking responsibly. But be careful. Alcohol use disorder is an easy disease to slip into; like I said at the beginning of this post, 58% of people with bipolar I suffer from a drinking problem. That’s more than half of us.

If you’re struggling with controlling your drinking – you drink too fast or too often – then help is available. Most people with alcohol use disorder can benefit from treatment.

If you have a drinking problem, medications and behavioral treatments are available to help you conquer it. Twelve-step programs offer valuable peer support. Contact your general practitioner today to see what resources are available to you in your community.

Whether you drink alcohol is your choice. Be careful to make sure you don’t bear the cost of drinking too much.

I wish you well in your journey.