A huge problem for me has been wondering if my alcohol abuse caused the bi-polar or did having bi-polar mean that I abused alcohol. I think this will always be a case of chicken and egg. There are many articles on this and it would seem that whilst alcoholism/ alcohol abuse and bi-polar commonly occur, substance abuse is not considered a sole cause of bipolar disorder. However it can worsen the illness by interfering with recovery.

Although researchers have proposed explanations for the strong association between alcoholism and bipolar disorder, the exact relationship between these disorders is not well understood.
One proposed explanation is that certain psychiatric disorders (such as bipolar disorder) may be risk factors for substance use. Alternatively, symptoms of bipolar disorder may emerge during the course of chronic alcohol intoxication or withdrawal. For example, alcohol withdrawal may trigger bipolar symptoms.

My psychiatrist made sure I was sober for almost two years before she gave a final bi-polar diagnosis. This period of sobriety while, of course, essential in terms of no longer behaving recklessly when intoxicated, was hell because I did not actually feel better from giving up alcohol and did not understand why I was still ill and exhibiting both symptoms of mania and depression.¬† I now understand because it is a co-morbid condition, symptoms of depression and mania overlap so they have to be treated separately. So after treating the alcoholism first, she then gave the bi-polar diagnosis, which she had anyway thought from our first meeting. All those AA meetings and seeing people return to their normal selves did not make sense to me…

Sadly when anti-depressants were introduced with alcohol I would go from coherent to catastrophic within minutes.

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