Q:  Bipolar Disorder & Alcohol - Parallel Course?

It is my belief that I suffered from manic depression from an early age and used drugs and alcohol to self medicate. By the time I was finally diagnosed with bi-polar disorder at age 35 in 1988, I was already an alcoholic and had been for many years. I want to know if you can confirm my theory that manic depression and alcoholism run a parallel course.If you can I would appreciate any Information that you can send me to validate my case as I am presently seeking to tie these facts together for an ongoing appeal with the Veteran's Administration for benefits.

Sincerly
 

Dear Mr. P' -- 
Generally one sees rates of around 50% as the "comorbidity" of bipolar disorder and substance use, where alcohol is by far the most common (though certainly not the only) substance used.  However, since that means there are roughly 50% of people with bipolar disorder who do not have a severe concomitant substance use problem, I think it would be hard to make a case of "causality".  Related, definitely yes, in that the rate of substance use in the general population is no more than half this rate for those with bipolar disorder.  

Dr. Phelps

Published February, 2003