bipolar and alcohol

While the association between a mood disorder and co-occurring alcoholism is well established, the most prevalent dual diagnosis is the one involving bipolar disorder and alcohol. Although the science behind this particular comorbidity isn’t yet clear, what is known is that alcohol abuse compounds the severity of the bipolar disorder and complicates treatment.

Bipolar disorder is a complex mental health condition that features extreme mood swings that vacillate between depressive and manic states, with some intermittent normal periods between these. There are four types of bipolar disorder, with bipolar I being the most serious. Individuals who suffer with bipolar disorder may gravitate toward alcohol use in an effort to soften the effects of the mental health disorder.

Gaining a better understanding of the relationship between bipolar and alcohol abuse allows us to improve the response time for getting someone much needed treatment for either or both of these conditions. Fortunately, both bipolar disorder and alcohol use disorder can be effectively managed through medication and psychotherapy.

What is Bipolar Disorder?

Mental illness can result in deep disturbances to all aspects of daily life, and bipolar disorder is particularly difficult to endure. Bipolar disorder, formerly referred to as manic-depression, features extreme mood swings. The characteristic shifts in mood and energy levels make it hard to complete basic tasks that others can so easily accomplish. According to the National Institute of Mental Health, bipolar disorder afflicts about 2.8% of the adult population in the U.S. Among those diagnosed with bipolar disorder, 82% are classified as severe.

The 4 types of bipolar disorder include:

Bipolar I Disorder. Bipolar I is the most common and most severe form of bipolar disorder, characterized by manic episodes that last for at least seven days or with manic symptoms so severe that acute stabilization in a hospital setting is often necessary.

Bipolar II Disorder. Bipolar II is defined by a pattern of manic and depressive episodes, but not to the same severity of Bipolar I.

Cyclothymic Disorder. Cyclothymic Disorder, or cyclothymia, is features repeated periods of manic symptoms and depressive symptoms lasting at least two years, however the symptoms do not reach the diagnostic criteria for manic or depressive episodes.

Unspecified Bipolar Disorders. This category includes those who experience bipolar disorder symptoms that do not fit into the above categories.

Symptoms of bipolar vary depending on the type of the disorder, but may include:

Depressive symptoms

  • Low mood that persists
  • Loss of interest in everyday life activities
  • Fatigue
  • Sleep problems
  • Inability to concentrate or make decisions
  • Feelings of guilt or worthlessness
  • Restlessness or slowed behaviors
  • Weight loss or gain that is unintended
  • Thoughts of suicide

Manic symptoms

  • Racing thoughts
  • Rapid speech, very talkative
  • Euphoric, hyperactive behavior
  • Increased activity and energy
  • Reduced sleep
  • Easily distracted, difficulty finishing tasks
  • Engages in high risk behavior
  • Poor decision-making

The Effects of Bipolar Disorder

Bipolar disorder can be dangerous to one’s physical health as well. Often the individual with bipolar will fixate on their own death, even obsessing about suicide. Also, many who struggle with bipolar disorder will engage in self-harming behaviors, such as the practice of “cutting” or other forms of self-mutilation, as an outlet for feelings of frustration and self-loathing.

Relationships are hard hit by bipolar disorder. People battling bipolar disorder often isolate themselves, withdrawing socially because they feel misunderstood. The isolating behaviors only worsen interpersonal relationships and can negatively impact employment stability.

Substance abuse is common among those with bipolar disorder, particularly alcohol abuse, further complicating the symptoms and exacerbating high-risk behaviors. Other comorbidities may include anxiety disorder, psychosis, eating disorders, and ADHD.

The Link Between Bipolar and Alcohol Use Disorder

The connection between bipolar disorder and alcohol use disorder has been the subject of research. It has been found that 46.2% of individuals with bipolar I disorder also have a comorbid alcohol use disorder, although it has yet to be discovered exactly why there is such a high prevalence of this dual diagnosis. Some of the possible causes for these comorbid disorders are posed in an article, “Bipolar Disorder and Alcoholism,” [Sonne and Brady]:

  • That bipolar disorder may be a risk factor for substance use
  • That symptoms of bipolar may emerge during alcohol withdrawals
  • That individuals with bipolar may use alcohol to mitigate mania
  • That bipolar disorder and alcoholism affect neurotransmitters the same way
  • That there is a genetic component with family history of both disorders

Unfortunately, alcohol abuse only enhances the symptoms of bipolar disorder. Although someone suffering from the relentless mood swings attempts to find relief in alcohol use, this strategy only worsens the disease and can lead to alcohol dependence or addiction.

The Warning Signs of Alcohol Use Disorder

The telltale signs and symptoms of alcohol use disorder (AUD) include behavioral, physical, and psychological elements. The DSM-5 established a list of criteria that helps to diagnose the severity of an alcohol problem. The more symptoms that are present, the higher the severity of the AUD. Mild AUD is indicated when 2-3 criteria are present, moderate AUD when 4-5 criteria are met, and severe AUD is diagnosed when 6 or more criteria are met.

The diagnostic criteria include:

  • Higher levels of alcohol consumption or drinking over a longer period of time than was intended
  • Persistent unsuccessful attempts to cut down or control alcohol use
  • Significant time spent obtaining, drinking, and recovering from the effects of alcohol.
  • Alcohol cravings
  • Recurrent alcohol use leading to failure to fulfill major role obligations at work, school, or home
  • Recurrent use of alcohol, despite having mounting interpersonal problems caused or worsened by alcohol
  • Giving up or missing important social, occupational, or recreational activities due to alcohol use
  • Recurrent alcohol use in high risk situations
  • Increased tolerance markedly increases levels of alcohol consumption to get desired effect
  • Withdrawal symptoms when alcohol is withheld

Dual Diagnosis Treatment for Bipolar and Alcoholism

According to statistics provided by the National Alliance on Mental Illness, approximately 9.2 million Americans struggle with a dual diagnosis, such as bipolar and alcohol addiction. When layering alcoholism over an existing mental health disorder, the individual’s condition becomes more serious. The resulting co-occurring disorders leaves individuals with mounting negative life consequences and deteriorating mental and physical health.

It is essential to seek help for comorbid disorders at a residential recovery program that specializes in treating a dual diagnosis. These programs are staffed appropriately with the psychiatric expertise necessary to prescribe medication, design a customized treatment plan for co-occurring disorders, and to effectively manage the unique mental health challenges that may emerge in the treatment setting.

It is essential that someone with both bipolar disorder and an AUD obtain treatment for both disorders simultaneously. Treatment will be multi-pronged, including medication, psychotherapy, holistic elements, and recovery support. These treatment elements include:

Detox and withdrawal.  Initially the individual must first eliminate the chemical toxins from the body through an alcohol detoxification process. This typically takes 5-7 days and is best undergone in an inpatient medically supervised detox program that is trained to identify dangerous withdrawal symptoms.

Medication: Mood stabilizing medications, such as antipsychotics and antidepressants, are the most commonly prescribed drugs for treating bipolar disorder. The specific type of bipolar disorder will dictate the medications. Lithium is the predominant medication prescribed for controlling bipolar disorder, in addition to anticonvulsants and SSRIs. Some may benefit from medication-assisted treatment for the alcoholism. Naltrexone is a non-narcotic drug that can help individuals maintain sobriety by reducing the cravings that lead to relapse.

Psychotherapy: Thoughts can influence behaviors, and negative thoughts can lead to self-destructive behaviors. Cognitive behavioral therapy (CBT) is the most commonly used form of psychotherapy for treating bipolar disorder. CBT therapists will guide the individual to identify thought distortions or triggers that lead to the disruptive behaviors, and help them change these destructive thought patterns. CBT is also effective for individuals in addiction recovery, providing them with essential coping skills.

Interpersonal and social rhythm therapy.  IPSRT provide life skills that helps the patient learn how to better predict and manage the bipolar episodes. This therapy focuses on the importance of maintaining a consistent daily routine, in addition to improving interpersonal relations and stress management.

Holistic: Experiential and holistic therapies can aid in regulating bipolar symptoms and promote overall wellness. These activities might include massage therapy, yoga, deep-breathing techniques, mindfulness meditation, art therapy, guided imagery, and aromatherapy.

Lifestyle: Because establishing a healthy routine is essential in managing bipolar disorder, residential programs will counsel patients on nutrition and exercise. Improving sleep quality, getting regular exercise, eating a nutritious diet, and managing stress are all intrinsic to achieving emotional stability and reducing the probability of a relapse.

Recovery support groups.  Success in recovery does not end with completion of a dual diagnosis program. Aftercare is an important aspect of recovery and should be included in the comprehensive dual diagnosis treatment planning. Aftercare includes regular participation in a recovery community, such as a 12-step or non 12-step program, ongoing outpatient group and individual counseling, and possibly transitional housing for a few months in sober living.

Elevation Behavioral Health Provides Dual Diagnosis Treatment

Elevation Behavioral Health is an upscale private residential mental health program in Los Angeles. Elevation is committed to providing leading dual diagnosis treatment for individuals who struggle with both bipolar disorder and alcohol use disorder. Our expert staff ensures that each individual in our care receives compassionate and respectful care, along with the most up to date evidence-based treatment measures. Our beautiful, serene setting provides a soothing and supportive environment for healing and new beginnings. For more information, please reach out to the Elevation team at (888) 561-0868.

alcohol drinking and coronavirus

In the early days of the coronavirus stay-at-home orders, it kind of took on a sense of one big vacation party. People were suddenly thrust into isolation with little time to prepare psychologically—or practically—for the adventure that could become a much more enduring situation than anyone had anticipated. At the outset, back in mid-March, there was a frenzied sense of gathering the basics before the stores ran out. But it wasn’t until it became clear that the lockdowns were going to last months, not days, that a spike in more alcohol drinking and coronavirus case counts became simpatico.

It isn’t hard to grasp why people in quarantine might gravitate toward the bottle. Tensions were high, as we sat glued to our sets watching the global map light up in deep shades of red and burgundy. The feeling of having no sense of control over something so scary and so huge naturally resulted in more alcohol drinking, and coronavirus fear escalated in kind.

Whether the boost in alcohol consumption started due to fear of the unknown, or just a good excuse to party, the end result of excessive drinking may be devastating. To one degree or another most of the nation has been stuck at home with little to keep themselves occupied outside of binge watching and beer. Newly established patterns of increased alcohol consumption during coronavirus may result in newly diagnosed alcohol use disorders at the other side of this.

Awareness is your friend, when looking for ways to set boundaries and avoid acquiring a drinking problem during the pandemic. Being cognizant of drinking behaviors, aware of what triggers them, and admitting if you are displaying the signs of an alcohol use disorder can make the difference between experiencing a short-lived uptick in alcohol use, or ending the quarantine with an alcohol addiction.

Problems Caused by Excessive Drinking During the Coronavirus

Whether it’s Zoom “quarantini” hours or sitting in the dark sipping whiskey, people who are stuck at home are engaging in higher levels of alcohol drinking, and coronavirus offers them a good excuse. With few other options on a Friday night, it’s easy to see why the living room becomes the new speak easy.

However, there is one reality that cannot be escaped, no matter how much of a buzz a person gets on, and that is that alcohol is extremely bad for us. The substance itself actually acts like a poison in our bloodstream, injuring our livers and causing myriad health issues. Mostly, though, the fact is that alcohol is extremely addictive, and alcohol addiction is a deadly progressive disease.

Some of the very real problems stemming from excessive drinking during the pandemic include:

  • Aggression, domestic violence
  • Accidents and injuries
  • Mood swings
  • Impulsive or high risk behaviors
  • Neglecting to complete work-at-home assignments
  • Decreases the body’s immune system and the ability to fight Covid-19

Why do People Turn to Alcohol?

Because of alcohols relaxing effects, it makes perfect sense that it would be an attractive panacea during times of stress. Alcohol use disorder often co-occurs with mental health disorders, especially depression, anxiety, and bipolar disorder. The quieting effects of alcohol can become a source of self-medicating the discomforts of a mental health issue.

But there are other reasons, some still not clearly understood, as to why some individuals gravitate toward alcohol abuse. Some of these factors include:

  • Genetics. Some individuals have a family history of addiction, indicating a genetic predisposition towards developing the problem.
  • Began using alcohol, drugs or nicotine at an early age
  • History of physical or sexual abuse, trauma exposure, or growing up in a home where family members engaged in substance abuse
  • Brain chemistry
  • Personality traits, such as gravitating toward high-risk behaviors, impulsivity, or having a mental health disorder

There are also new scientific discoveries that are beginning to shed more light on the role of specific genes in determining who will develop an alcohol problem. A study out of Sweden sheds light on how a certain group of rats gravitated toward alcohol instead of following the majority of rats towards the artificial sweetener, Saccharine. The study found that the rats that opted for the alcohol had a reduced expression of a particular gene, called GAT-3, which controls the neurotransmitter GABA and influenced the attraction to alcohol.

In humans, postmortem tissue of individuals who were alcoholic, it was discovered that they had less GAT-3 in the amygdala area that the brains of people who were not addicted to alcohol.

“This is one of the relatively rare cases where we find an interesting change in our animal models and the same change in the brains of people with alcohol addiction,” stated Dayne Mayfield, one of the researchers out of University of Texas that worked with the Swedish team.

What is an Alcohol Use Disorder?

Alcohol use disorder (AUD) covers the diverse spectrum of alcohol abuse—from binge drinking in early years to excessive drinking that causes negative consequences in daily life to full-blown alcohol dependency. Compulsive drinking that results in alcoholism has significant negative consequences for the individual and their families.

For a diagnosis of AUD an individual must have any two of the eleven criteria present within a 12-month period. The number of the criteria met will determine the severity of the AUD. The DSM-5 diagnostic criteria include:

In the past year have you:

  1. Had times when you ended up drinking more, or longer than you intended?
  2. More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  3. Spent a lot of time drinking, being sick, or getting over a hangover?
  4. Experienced cravings to drink?
  5. Found that drinking—or being sick from drinking—often interfered with taking care of your home or family?
  6. Continued to drink even though it was causing trouble with your family or friends?
  7. Given up or cut back on activities that were important to you in order to drink?
  8. More than once gotten into situations while or after drinking that increased your risk of injury?
  9. Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Have you had a memory blackout?
  10. Had to drink much more than you once did to get the effect your want, or found that your usual number of drinks had less effect than before?
  11. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating?

Answering yes to 2-3 of these items is considered a mild AUD, 4-5 is considered a moderate AUD, and 6 or more yes answers indicates a severe AUD.

Quarantine Increases Risk of Co-Occurring Alcoholism and Depression

Co-occurring substance use disorders with mood disorders are very common in normal times, but becoming more prevalent during the coronavirus crisis. Alcohol addiction when coupled with depression can be particularly challenging to treat.  According to data reported in the 2010 National Survey on Drug Use and Health, it is estimated that about 9.2 million of the 20 million adults who had a substance use disorder also had a major depressive episode.  Of that group, the most prevalent substance used was alcohol. Of that segment, only 7.7% of those with a dual diagnosis of major depression and alcohol use disorder received specialized dual diagnosis treatment.

It is crucial that someone battling both alcoholism and depression get the appropriate dual diagnosis treatment. Increased alcohol drinking and the coronavirus stressors have significantly ramped up the need for dual diagnosis interventions. The Substance Abuse and Mental Health Services Administration found that in 30% of suicides, blood alcohol levels were above the legal limit and that 50% of those suicide deaths also involved major depression. Alcohol is, after all, a depressant, and will only compound the effects of a major depressive episode.

Getting Help for an Alcohol Use Disorder During the Pandemic

Residential treatment provides the most intensive approach to alcohol recovery treatment. During the pandemic, addiction treatment facilities were designated as essential services, allowing residential programs to continue to operate. Guidelines published by the American Society of Addiction Medicine provide safety precautions that are tailored to residential rehab facilities.

To maintain safe treatment facilities, rehabs have adopted these precautions:

  • Screening (or testing) for COVID-19
  • Do thorough cleaning and sterilization procedures multiple times per day
  • Isolate clients who may later show symptoms of COVID-19
  • Limit or prohibit visitors and have them use PPE
  • Provide PPE for staff

With these measures in place, residential rehabs are able to continue providing essential services to individuals in need of timely treatment for an alcohol use disorder.

Fortunately, online A.A. meetings, free for those who utilize them, are available now using Zoom Internet technology. Now, those in recovery who desire to connect with a recovery community can do that without even getting into a car. While online A.A. meetings are not new, during the pandemic the Zoom platform is making them available far and wide, along with other recovery groups like SMART Recovery.

Elevation Behavioral Health Leading Provider of Dual Diagnosis Treatment

Elevation Behavioral Health provides comprehensive dual diagnosis treatment for individuals struggling with alcohol use disorder and a co-occurring substance use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. Our campus has been completely configured for safe distancing and cleanliness through the pandemic. Client safety is our top priority. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.

effects of alcohol on the heart

When speculating about the damage that alcohol does to the body, the kidneys are usually the first organ that comes to mind. Alcohol does greatly reduce kidney functionality, but there are more than 200 alcohol-induced diseases, and many of them primarily involve the heart. There are also additional ways that alcohol withdrawal can be harmful on the body. Here are just four of the countless ways alcohol can negatively affect the heart.

    1. Alcoholic Cardiomyopathy

Cardiomyopathy is the medical term for disease of the heart muscle. This is a progressive disease with several different causes, but heavy drinking in particular has a toxic effect on the muscle cells of the heart. This is referred to as alcoholic cardiomyopathy.

When a person develops cardiomyopathy, the heart becomes abnormally large due to the thickening of the muscle tissue. As the walls of the heart stiffen, it becomes difficult for blood to pump effectively. Blood backs up, causing further stress on the pulmonary system, and eventually the heart fails.

    1. Cardiac Arrhythmias

Cardiac arrhythmia means the heart beats abnormally. There are two common forms of arrhythmias associated with alcoholism:

Supraventricular tachycardia – Rapid heart rate originating from the atrioventricular node
Atrial fibrillation – Rapid and irregular beating that gets progressively worse, usually associated with binge drinking.

Both types of arrhythmias are potentially life-threatening and require medical treatment, especially if symptoms are persistent, recur for more than seven days or are permanent.

    1. Hypertension

Alcohol abuse is one of the most common causes of secondary hypertension, or high blood pressure. Secondary hypertension is high blood pressure caused by an underlying medical condition, in this case, drinking alcohol in excess.

    1. High blood pressure has a long-term effect on:
      • Arteries
      • Heart
      • Endocrine System
      • Kidneys

Left untreated, high blood pressure can lead to kidney failure, heart disease and stroke. High blood pressure is sometimes called the silent killer because there are often no symptoms.
Secondary high blood pressure will not respond to traditional treatments. The underlying cause, alcoholism, must be managed in order to lower blood pressure and prevent further damage to vital organs.

    1. Stroke

The high blood pressure resulting from alcoholism increases the risk of different types of strokes, including an embolic stoke. The risks are magnified for those who already have an underlying circulatory problem, such as pre-existing heart disease.

A study conducted by researchers at the Oulu University Central Hospital looked at 212 patients between the ages of 16 and 60 who had ischemic strokes, a stroke caused by a blood clot in the brain. They found that heavy drinking was a contributing factor to clot formation, but those who quit drinking were at a significantly lower risk of developing further health issues.

These are just four of the potentially life-threatening conditions that affect the heart and circulatory system as a result of long-term alcohol abuse. When you receive the help you need, you are not only helping your kidneys, you’re helping your heart and healing body as a whole.

depression and alcohol

There are many reasons why individuals suffer from alcoholism, and genetics, environmental factors and mental health issues are just a few explanations. Co-occurring disorders occur when an individual suffers from both a mental health issue and an addiction such as depression and alcohol. Though they are completely treatable, co-occurring disorders are especially delicate and require integrated clinical therapy to achieve lasting results. >/p>

Depression Statistics

Nearly a third of individuals who suffer from major depressive disorder also suffer from alcoholism. Though it can be hard to determine with certainty, in many cases the depression is present before the addiction takes place.

These numbers are compounded by the fact that 10 percent of Americans experience depression, yet more than 80 percent of those who deal with depression go undiagnosed and untreated. In the absence of professional treatment, it’s not uncommon for those suffering in silence to deepen their relationship with alcohol.

Negative Feedback Loops

Whether alcoholism is caused by depression or vice versa varies on a case-by-case scenario, but what remains the same is the impact that the two have on one another. For an individual struggling with alcoholism and depression, the negative feedback loop is self-perpetuating.

A person drinks in an attempt to feel better, only to find that the relief is merely temporary, if at all. This may lead to further attempts to self-medicate by drinking larger amounts with more frequency. Through this process, depression compounds these factors, leading the individual to quickly descend into addiction.

Social Consequences

The seemingly endless cycle of addiction has residual social repercussions as well. Many times people find themselves not caring about anything outside of their addiction. They may be unwilling to speak with others, show up at work or do anything that might interfere with their drinking routine. The inability to listen to reason, combined with disconnection from the world around them, produces a potent fertilizer in which depression, anxiety and addiction can grow.

Dual Diagnosis Treatment

Quitting cold turkey can not only be ineffective, it can be dangerous. Receiving help from certified professionals through a medically supervised detox program will greatly increase chances of recovery and decrease the dangers that come along with detoxing.

Trained specialists look at the root of the addiction and mental health issue and treat them both from the very start—healing both mind and body. Peoplecan learn new ways to cope with their mental health issues and begin to discover the potential that they may have thought was gone forever.

Types of Therapy

Many dual-diagnosis treatment facilities go beyond conventional individual and group therapy, giving individuals the chance to get to know themselves again through activities like art, yoga, exercise and music. When administered effectively and adhered to, therapy can help resolve co-occurring disorders and give people suffering from addiction the tools they need to overcome obstacles in a healthy and positive way.

Anyone who is suffering from alcoholism or who may be developing a drinking problem shouldn’t wait to treat these issues. The more time that passes, the more difficult it will be to break the negative feedback loop.

How Alcohol Affects the Brain

Alcohol has a powerful physical effect on the body. It alters more than just mood, though—alcohol abuse is capable of physically changing how the brain functions. If exposed to alcohol repeatedly, the brain will rewire itself, altering how it produces and utilizes the chemicals responsible for feelings such as pleasure or reward. As a first step to recovery, it is crucial to understand what is happening in the brain when alcohol is introduced to the body and why overcoming alcoholism can be so challenging.

Alcohol and Brain Chemistry

When a person consumes alcohol regularly, it affects the levels of neurotransmitters in the brain. These chemical messengers transmit signals through the body that control behavior, emotion and thought processes. Some parts of the brain that are affected include:

Excitatory Neurotransmitters: These neurotransmitters regulate activity and energy levels. Upon consumption of alcohol, they immediately slow down the connections in the brain—shortening response times, creating cognition issues and slurring speech.

Cerebellum: The cerebellum is the center of movement and balance in the body. Alcohol triggers it to malfunction, causing people to stagger, walk off-balance and even fall down.
Medulla: The medulla controls bodily functions such as body temperature, breathing and consciousness. Alcohol can slow down the medulla’s functions and cause a person to feel sleepy and lethargic.

Dopamine Levels: Dopamine is the “feel good” hormone that rewards pleasurable activities. Because alcohol releases more dopamine, the brain believes that it is being rewarded when alcohol is present. After a while, though, a person will be unable to experience happiness without the help of alcohol—sending them into a deep depression.

Effects of Alcohol Dependency

So there are changes in the brain, but how do they affect a person as a whole? The list of effects of dependency is staggering. Symptoms can come in waves across various periods of time, but here are a few effects to watch out for:

Short-Term: Short-term memory lapses, known as blackouts, as well as problems with balance, speech, cognition and reaction time.

Medium-Term: Decreased effects of dopamine, causing your brain to lose the ability to feel happy without alcohol and causing you to fall into depression.

Long-Term: Permanent brain damage—physical shrinking of the brain, deficiencies in the fibers that carry information between brain cells and a permanent altering of the brain’s chemistry. This can lead to more severe mental illnesses, such as dementia.

The longer the brain is exposed to alcohol, the more intense these symptoms will be and the harder it will be to overcome the dependency. Once the brain is permanently damaged, some of the cognitive problems associated with alcohol exposure may not be reversible.

No One is In This Alone

Millions of people across the country struggle with alcoholism every day, but there is hope in the darkness. There are highly qualified treatment centers that specialize in helping people overcome addiction. It is important to find a facility and a program that matches individual needs and is capable of providing the personalized treatment necessary.

add and alcohol

When we hear the term attention deficiency disorder (ADD) the first thing that usually comes to mind is a hyperactive 6-year-old boy struggling to focus on his schoolwork. ADD has been on the radar since the 1980s when formal diagnosis and the introduction of using drugs to help manage it. ADD diagnoses continue to rise, increasing by 43% since 2010.

What is not well known is that adult ADD is fairly commonplace. In fact, according to an article published by Cambridge University Press, about 50%-75% of children with ADD will carry the disorder into adulthood. As an adult struggles with the effects of this mental health condition, certain comorbidities can develop. In fact, there is a strong link between adult ADD and alcohol addiction. This dual diagnosis can be found among adults with undiagnosed and untreated ADD, where the individual is using the alcohol as a form of self-medication to help them relax.

For those with both ADD and alcohol addiction, a more challenging treatment picture results. Dual diagnosis treatment requires a specialized approach to assisting recovery, where both psychiatric expertise and addiction treatment team up to address both co-occurring disorders at the same time. With this customized protocol, individuals struggling with ADD and alcohol addiction can indeed overcome the challenges posed by the coexisting disorders and enjoy a productive and fulfilling life.

About ADD

In the U.S. ADD affects about 8 million adults, or 4% of the adult population. In adults, the hyperactivity that is so prevalent in childhood ADHD may not be the problems. Instead the disorder can lead to a series of symptoms that can disrupt daily functioning. Effects of adult ADD can range from declining job performance due to an inability to stay on task until completion, to disruptions in relationships, to impulsive behaviors.

While many adults with ADD may have also had the issue as kids, some have learned to compensate for the traits of ADD and never received treatment. Coping with ADD as an adult can include relying on making daily to-do lists to stay on task and to not forget important commitments, using reminders on the phone so meetings or appointments are not missed, to accessing apps that help with task management. For example, there are dictation apps that can help the adult with ADD to remember important information or to organize tasks.

The cause of ADD is still a mystery, although there are certain factors that may be involved. These include:

  • Genetics. Sometimes ADD will run in families. ADD is a risk if there is a family history of other mental health disorders as well, such as depression or anxiety disorder.
  • Toxin exposure. There is some evidence that points to the possibility that lead exposure, such as in pain or old pipes, during childhood may be a risk factor for ADD. Also, exposure to pesticides or PCBs may play a role. It is thought that these toxins may interfere with brain development.
  • Being born prematurely, or the mother had a difficult pregnancy.
  • If the mother drank alcohol, used drugs, or smoked during pregnancy
  • Developmental impairment with the central nervous system

Symptoms of ADD in Adults

Many of the adults who grapple with the symptoms of ADD in daily life are not even aware that they have this mental health disorder. They may feel overwhelmed in trying to manage the many demands in daily life, and wonder why they seem to be so ill-equipped compared to their peers. These individuals don’t know that they have a brain disorder that is basically scrambling their thoughts and interrupting concentration and cognitive functioning. All adults with ADD also had it as a child, although in many cases it was never clinically diagnosed. For this reason, some adults with ADD may assume it is a newly emerging problem.

Common symptoms of ADHD in adults:

  • Chronically late to work or for appointments. Being late to appointments, events, or meetings is a hallmark symptom of adult ADD.
  • Poor organizational skills. Individuals struggle to keep things in order, leading to increased stress and anxiety.
  • Trouble multitasking. Someone with ADD has difficulty focusing on or managing more than one task at a time. Given more tasks to juggle can lead to confusion and anxiety.
  • Mood swings. Mood swings, irritability, and temperamental behavior are common
  • Poor listening skills. Wandering thoughts and difficulty concentrating make paying attention difficult for the adult with ADD.
  • Chronic boredom. Job hopping due to boredom, jumping from relationship to relationship are typical in the need to seek constant gratification and excitement.
  • Forgetful. Someone with ADD may have a difficult time remembering data or information, which can make it difficult when training on the job, as it may come across as carelessness or lack of intelligence.
  • Difficulty controlling anger. Individuals with ADD can be prone to explosive angry outbursts, usually stemming from frustration.
  • Low tolerance for frustration. Become easily upset when something frustrates or annoys them.
  • Impulsive behaviors. This can manifest in a variety of ways, such as impulsive shopping habits, sexual impulsiveness, reckless driving, or any impulsive acts that have negative consequences. Difficulty delaying gratification.
  • Difficulty managing stress. The chaotic symptoms that accompany ADD can lead to stress overload, and the individual struggles to manage the stress.
  • Anxiety. Many with ADD experience anxiety as chronic worrying is common.
  • Depression. Depression is a common co-occurring mental health disorder with ADD, as the negative consequences
  • Disorganized. The person with ADD often feels overwhelmed with stimuli and then cannot stay focused enough to sort things out. This can cause difficulty completing tasks or projects at work, paying bills on time, or keeping up with family obligations.
  • Low motivation. The individual with ADD struggles between a desire to tackle multiple tasks at once and complete lack of motivation.
  • Trouble in relationships. Poor listening skills, trouble making or keep commitments, being bored with the relationship, and not attending to a relationship can lead to marital strife and relationship discord.
  • Substance abuse or addiction. Alcohol or drugs may be accessed as a means to improve sleep or relaxation, or they may be indicative of the impulsive nature of the person with ADD.

Adults with ADD may have trouble staying at a job for very long, resulting in job-hopping and lower income potential and career satisfaction. The inability to control impulsive behaviors can lead to alcohol abuse, accidents, unsafe sexual practices, and multiple marriages.

Co-occurring ADD and Alcohol Addiction 

A dual diagnosis exists when there is a mental health disorder, such as ADD, and a co-occurring substance use disorder. In many instances, the individual develops a substance use disorder in response to the mental health issue. They may begin to use alcohol as a means of reducing the effects of the ADD by its relaxant properties.

Unfortunately, some individuals may find their tolerance to alcohol increasing, leading to higher consumption of the substance in hopes of experiencing the initial calming effects. As consumption increases, the possibility for developing an alcohol use disorder increases as well.

Adults with ADD and alcohol addiction will find they have increased the suffering, as alcoholism has its own set of highly impairing features. The co-occurring disorders have the potential to cause serious disruption in daily functioning, and mounting consequences can result in the addition of an addition mental health disorder developing, such as depression or anxiety. For these reasons it is imperative that someone struggling with Add and alcohol addiction seek out the professional help that a dual diagnosis recovery program can provide.

Treatment for ADD and Alcohol Addiction Co-Occurring Disorders

Recovery will begin with a thorough evaluation of both the alcohol use disorder and the ADD, from which a customized treatment plan will emerge. Comprehensive dual diagnosis treatment involves combining several therapeutic elements that will address both disorders simultaneously. These include:

  • Medical detox. The first step in recovery is a medically supervised detox and withdrawal period. This will allow the individual to rid the body of the ethyl alcohol while under the close supervision of an expert detox team. Alcohol detox can be unpredictable, so for this reason detox and withdrawal should be monitored by a detox professional.
  • Cognitive behavioral therapy. CBT can help modify irrational thinking that is common with individuals with ADD. These irrational thoughts may include may include black-or-white thinking, catastrophic thinking, personalization, and an over-emphasis on negative thoughts. By making adjustments in the cognitive thought process, the negative behaviors are reduced. CBT can also help the individual respond differently to triggers that formerly resulted in alcohol misuse.
  • Group therapy. Small group settings led by a therapist can help encourage participants to share their experiences and personal stories, which can engender mutual peer support while in treatment.
  • Medication. Pharmacotherapy is typically part of the treatment plan for managing symptoms of ADD.  The medications for adults with ADD may include Adderall, Vivanse, Focalin, Dexedrine, Concerta or Ritalin. Non-stimulant medications include Intuniv, Kapvay, and Strattera.
  • Addiction education. Learning about the impact of alcohol on brain chemistry and structure can be a deterrent to relapse, and includes guiding the individual with relapse prevention strategies and new coping skills.
  • Holistic therapies. Learning effective methods to enhance relaxation can benefit both of these disorders. These activities might include deep breathing exercises, meditation, yoga, and massage therapy.

Individuals with a dual diagnosis of ADD and alcoholism can learn to manage these conditions and improve the quality of life through targeted treatment at a high quality residential dual diagnosis program.

Elevation Behavioral Health Offers Residential Mental Health Treatment in Los Angeles

Elevation Behavioral Health provides comprehensive dual diagnosis treatment for individuals struggling with ADD and a co-occurring substance use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.

 

alcohol withdrawal and blood pressure

Alcohol dependency creeps in stealthily, like a thief in the night. What might have begun as an evening relaxation ritual slowly encroached into your daily life. As tolerance to the effects of the alcohol increased, higher consumption seemed to follow. Over time, what started out as a panacea for stress or emotional issues became its own serious problem.

When facing the prospect of getting treatment for an alcohol use disorder, the thought of going through the detox and withdrawal stage may seem daunting. This initial hurdle, one that is essential to recovery, may be so dreaded that it becomes a serious barrier to treatment. In this event it is important to take the long view, to envision detox as just a short-lived challenge to overcome in order to enjoy a life free from the grip of alcohol.

Alcohol detox and withdrawal, however, does come with some risks. Although alcohol withdrawal symptoms can vary significantly from one individual to another, ranging from mild to severe, because of the unpredictable nature of these symptoms it is always advisable to obtain a medically monitored detox. Alcohol withdrawal and blood pressure elevation, or any one of several other serious symptoms, can evolve quickly into a medical emergency.

About Alcohol Use Disorder

Alcoholism is a chronic relapsing disease that impacts brain chemistry and the central nervous system. Once the body has become accustomed to the daily consumption of alcohol it will react when alcohol is withheld, initiating withdrawal symptoms that send you right back to the alcohol for relief. The symptoms of alcohol addiction or chemical dependence include:

  • Unable to stop drinking once started, never feeling sated
  • Being able to drink increasing levels of alcohol
  • Blacking out, having no memory of actions, whereabouts, or conversations
  • Lying about your level of drinking
  • Hiding alcohol from family members
  • Neglecting responsibilities at home or work
  • Relationship problems caused by excessive drinking
  • Attempting to stop drinking but cannot
  • Withdrawal symptoms emerge when attempting to stop

Alcohol use disorder has the potential to cause a slew of significant disruptions and negative consequences in one’s life. These might include:

  • Loss of employment
  • Damage to professional reputation
  • Legal problems, such as getting a DUI
  • Interpersonal problems, divorce
  • Social withdrawal and isolation
  • Financial problems
  • A co-occurring mental health disorder may develop

There are many reasons to take that first step toward sobriety. When facing down the detox and withdrawal phase of recovery, it is best to view it as a necessary first step to a new, healthy, and productive life.

The Importance of a Medically Monitored Detox

When someone with an alcohol use disorder decides to get sober there are some important things to consider. First, it is generally considered a bad idea to attempt to detox without a trained detox team supervising the process. The spectrum of withdrawal symptoms during alcohol detox is wide, from minor tremors and insomnia to the delirium tremens (DTs). Because of the potential for a serious medical emergency occurring during detox and withdrawal, it is usually recommended that the individual have a medically monitored detox.  This type of detox will provide the appropriate medical attention should alcohol withdrawal and blood pressure increases team up to cause a serious medical condition.

A medical detox provides the safest route to sobriety, where trained detox medical providers monitor the detox and withdrawal phase of early recovery. While supervising the process, the detox professional will utilize various medical and holistic interventions to help alleviate the painful withdrawal symptoms. Without this support, the difficulty experienced during detox can derail recovery right at the outset. The detox support team will provide medications, such as benzodiazepines, to assist with anxiety and insomnia, which can also help with alcohol withdrawal and blood pressure spikes, as these drugs are sedatives. In addition, they will access over-the-counter medications to help with fever and chills, nausea and vomiting, diarrhea, and other symptoms. The psychological support provided by a medical detox team is critical to helping the individual get through the challenging detox process and then safely transition to active treatment.

What to Expect During Alcohol Detox and Withdrawal

Upon entering the residential program a thorough intake interview will be conducted.  Health status, addiction history, and mental health history will be assessed in an effort for the provider to anticipate any potential risks during the detox process. The severity of symptoms is determined by various factors identified during the initial evaluation. These factors include:

  • The age of the individual
  • The general health status, if there are any medical conditions present
  • The length of history of the alcohol use disorder
  • The usual amount of alcohol consumed on a daily basis
  • The existence of another substance use disorder
  • The existence of a co-occurring mental health disorder

When an individual abruptly discontinues alcohol intake they will begin to experience withdrawal symptoms within 6-8 hours. Withdrawal symptoms are in response to the brain and central nervous system having made adjustments over time in response to the alcohol. Brain hyper-excitability ensues when the alcohol is withheld, leading to a range of highly uncomfortable symptoms.

Alcohol detox typically occurs in three stages. The first stage begins within 8 hours after the last alcoholic beverage and lasts about 24 hours. During this first stage, withdrawal symptoms include sweating, nausea, vomiting, hand tremors, irritability, and sleep difficulties. The second stage occurs on days 2-4 and involves the most intense symptoms, such as increased heart rate, elevated blood pressure and body temperature, mental confusion, mood swings, alcohol cravings, anxiety, and depression. The final stage, starting at day 4 and lasting 3-5 days, is the phase when symptoms begin to subside.

Alcohol withdrawal symptoms may include:

  • Shaky hands
  • Irritability
  • Nausea
  • Vomiting
  • Sweating
  • Headache
  • Agitation
  • Insomnia
  • Anxiety
  • Confusion
  • Hallucinations
  • Disorientation
  • Seizures

In some cases, unpredictable withdrawals symptoms can suddenly emerge on days 3-4, called the delirium tremens (DTs). For this reason, having medical personnel available who can manage the DTs is essential during the first 3 or 4 days of detox.

What Are the Delirium Tremens (DTs)?

In a small percentage of individuals, or 3%-5%, a medical emergency called the DTs can present a serious medical condition. The DTs might catch the individual completely off guard, which is why the development is so dangerous. In 5%-15% the DTs can lead to death. Alcohol withdrawal and blood pressure that rises dangerously, in addition to these symptoms, requires immediate medical intervention:

  • Grand mal seizures or convulsions
  • Delirium
  • Hallucinations
  • Hypertension
  • Very high fever
  • Cardiac arrhythmias
  • Hyperthermia

Getting help with DTs may mean a hospital stay to help stabilize the individual and improve the outcome. Treatment will involve benzodiazepines and/or barbiturates or phenobarbital, often using IV infusion for quick relief until symptoms stabilized and begin to subside. Dosing is determined by the specific withdrawal signs observed, such as delirium, and will incrementally be reduced over a period of several days once the severe symptoms have stabilized.

How is Alcohol Use Disorder Treated?

Alcohol addiction treatment immediately follows detox and withdrawal, and may involve an extended recovery program. The residential treatment setting provides the highest level of care, with 24-hour support and monitoring and a full schedule of daily treatment elements designed to help the individual overcome the alcohol addiction.

Alcohol recovery elements include:

  • Psychotherapy. Psychotherapy is the cornerstone of alcohol recovery, as it helps the individual examine underlying emotional issues or past traumas so these can be worked through. Cognitive behavioral therapy (CBT) provides a roadmap for making core changes in thought-behavior patterns that have kept a person trapped in addiction behaviors. The recovery skills learned in CBT help reframe disordered thinking into more positive, affirming thoughts.
  • Group sessions. Meeting with peers or family members to discuss topics related to recovery can help those in recovery learn how to communicate, and listen, more effectively.
  • Education. Learning about the impact of alcohol on brain chemistry and structure can be a deterrent to relapse, and includes guiding the individual with relapse prevention strategies and new coping skills.
  • Naltrexone. Naltrexone is a non-narcotic medication that can assist in reducing alcohol cravings and relapse for those who meet criteria for usage.
  • 12-step or similar programming. The meetings provide important peer support and the opportunity to share experiences, challenges, fears, and goals with others in recovery.
  • Adjunctive activities. Rounding out rehabilitation are several activities that augment the evidence-based therapies, including mindfulness training, yoga, massage, art therapy, acupuncture, recreational therapy, EMDR, equine therapy.

The Importance of Aftercare in Recovery

Consider addiction treatment and recovery as an ongoing continuum of care. The detox and withdrawal phase launches recovery, followed by therapy in a residential treatment program. But that is only the beginning of the therapeutic process. Aftercare, or continuing care, in addiction recovery involves ongoing interventions that can help to solidify and support recovery.

Through engagement in activities that reinforce sobriety, the chances of maintaining a sustained recovery are greatly improved. Individuals in early recovery are bound to encounter challenges to sobriety. These challenges may be emotionally overwhelming, possibly triggering a relapse. Aftercare options provide an added safety net where the individual will receive peer and professional support to help navigate these stressors as they occur. Aftercare efforts should include ongoing outpatient therapy, group therapy, and engagement in a recovery community.

Elevation Behavioral Health Provides Medical Detox for Alcohol Use Disorder

Elevation Behavioral Health is a Los Angeles-based residential recovery program that offers medical detox services and comprehensive addiction treatment for individuals with an alcohol use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.

alcohol withdrawal timeline

Alcohol Withdrawal Timeline, Symptoms and Treatment

Alcohol is a widely-used substance, and may create both psychological and physical dependence. When dependence develops, an individual will experience withdrawal symptoms upon removing alcohol from the body. Withdrawal from alcohol can be severely uncomfortable and even dangerous in some cases. It’s important to understand the risks of cold-turkey alcohol withdrawal and how to find appropriate help to keep yourself safe through the detoxification process.

Alcohol Consumption in the United States

Alcohol is consumed by a little over half of Americans age twelve and over, according to the Substance Abuse and Mental Health Services Administration. Alcohol is the most used substance in the United States, with over 55% of people 26 and over consuming alcohol in a given month. Although many people do not develop a problem with alcohol, an estimated 6.2% of American adults suffer from alcohol use disorder. According the same statistics on alcohol consumption, over a quarter of American adults engage in binge drinking behavior in a given month.

Alcohol Withdrawal Symptoms

The symptoms of alcohol withdrawal vary depending upon the individual’s case. The most common symptoms of alcohol withdrawal are:

  • Tremors and shaking
  • Fevers and sweating
  • Anxiety and irritation
  • Nausea and vomiting
  • Headache and muscle soreness
  • Insomnia
  • Appetite changes
  • Cravings for alcohol

Alcohol impacts the GABA receptors in the brain. GABA receptors are the main inhibitors of the central nervous system, the system in your body responsible for calming you and bringing you down. When you go through the detox process, your body essentially responds with agitation in the same system. Instead of calming, the body can become tense, irritated, anxious, and generally functioning poorly. In more severe cases, alcohol withdrawal can lead to seizures and coma, ultimate resulting in death.

Detox Timeline

Like the withdrawal from any other substance, alcohol detox happens in stages. the timeline of alcohol withdrawal symptoms may depend on your individual case, but it will follow a general path based on the half-life of alcohol in the body.

  • First 24 Hours

    During the first day after your drink, you’re likely to experience some anxiety, cravings for alcohol, and agitation. You may also experience intestinal discomfort and nausea. These may be symptoms very similar to a hangover, and may be worse than your normal hangover if you continue to not drink. The first day is difficult and a crucial period as many people seek alcohol out in order to manage symptoms of withdrawal.

  • First Couple Days

    After the first 24 hours, symptoms may worsen. During the first few days, additional symptoms may develop. You may experience things like increased blood pressure, sweating and fevering, depression and loss of energy, mood swings, and cognitive problems with memory and attention. During this period, individuals may develop physical symptoms that can be dangerous if unmanaged. It’s important to have trained physicians and clinicians observing you to manage the symptoms you are experiencing.

  • Alcohol Withdrawal Day 3 and 4

    People who go through alcohol detox often cite the third day of alcohol withdrawal as the worst. This is a time in which symptoms are likely to peak in severity, and many people relapse during this period. The good news is that if you can make it through this period, symptoms are likely to diminish.

  • 3 Days – 2 Weeks

    During the next week or so, symptoms will generally decrease. However, this is the period in which life-threatening withdrawal symptoms may arise in more severe cases of alcohol abuse. Users may experience delirium tremens, hallucinations, fever, mental confusion, and periods of intense agitation. Mood disturbances and fits of anger may occur.

Alcohol Addiction Treatment

Many people are able to drink alcohol normally, but those that develop an addiction may put themselves at risk. Alcoholism can be deadly, cause a lot of pain for individuals and their family members, and cause long-lasting effects on the mind and body. After going through the withdrawal process, it’s crucial to continue treatment for alcoholism. Moving on to a residential treatment center like Elevation Behavioral Health increases your chance at staying sober in the long-run.

It’s important to find the right help. You may want to consider if you need dual diagnosis treatment, medically-assisted detox, and/or long-term care. Although the medical and clinical communities have developed standards of care for alcohol addiction treatment, each person has an individual set of experiences and individual needs. As such, it’s crucial to find treatment that fits your specific needs in order to receive the best possible care and get the best chances at building a life in recovery.