Should I get rid of alcohol or weed first?

I finally got the bipolar II diagnosis today. I'm happy with that, now I can relax more around my T and my psychiatrist. I have a drug problem, which I'm going to fix, but I was hoping someone had an answer to this question I have. Should I stop using alcohol or weed first? For me it seems logical to stop drinking alcohol now, because I feel the immediate depressing and destabilizing effects very clearly. However, I also know that weed has some serious longer term effects. I do experience some visual and auditory illusions, and I don't think the weed is making that any better (but it's not the only cause), I'm also often slightly paranoid. However, I'm sure I won't become psychotic.

I hope you will tell me your opinion on this matter, as I'm not 100% sure it's better to stop alcohol first. It would be easier for me to stop using alcohol than weed. I'm quite paranoid today so please write any criticism carefully. I know I need to quit both eventually, but I have to be realistic and if I can quit one of them and feel better, then that's a good thing.

Thank you!

I say maybe stop the alcohol first but also set a date to start tapering back on the weed as well. Do you have a support system to help you in stopping?

I agree you need to be realistic and it may be easier to do one at a time. I think that once you start getting rid of one, you'll start to feel healthier and the other will start to be easier. Also remember alcohol has long term effects to your body as well.

Good luck with this!

I'm sorry you're having problems with chemical addictions, but I honestly feel that it's best to stop them both at the same time. Your psychiatrist is going to medicate you in an effort to stabilize your brain chemistry. Both marijuana and alcohol are going to interfere with that process.

Placing yourself with a group such as Alcoholics Anonymous might enable you to manage giving them both up at the same time. Besides, your psychotropic medications will be far more effective, and your psychiatrist will be able to add an appropriate med to help with the withdrawal symptoms. (You may have been self-medicating with alcohol and marijuana for some time.)

I'd definitely talk to my psychiatrist about it before I determined to give up one and later the other. They both have strong long-term serious consequences.

At one time it was thought that marijuana could cause changes in DNA; now we're
hearing that the product is much more intense in its chemistry. There will come a
time when a major report will be published that will indicate the serious consequences of marijuana use; I think you can count on that.

As for alcohol, doctors now have medical tools to use to help with withdrawal and
this may be the best time to give it up. The long-term consequences of alcohol
dependency are devastating for many, and remission will involve major changes in your
personality for the better. I don't know that there are any meds that will help with withdrawal from marijuana use. There may be; I'm just not aware of it.

Under any circumstances you have your work cut out for you, and you are in an
excellent position to get the help you need to stop the addictions. Just get clean, please.

Sorry about the paranoia; that will clear up probably once the drugs are out of your
system. The truth is what really matters, though, and I think you'd agree that
it's best to have both alcohol and marijuana out of your system and be on the way
to recovery (and remission in alcoholism).

I'd also publish your message on the Addiction Forum. Those folks are really expert
on giving advice about what to do for addictions and how to go about stopping them.
"Thickntired" is one who has undergone giving up alcohol and marijuana; she will be
more helpful than I could ever be in regard to chemical addictions; others could give
you super advice, too. Our understanding is directed more to care in bipolar illness.

I wish you the best.

Thank you so much!

I posted it here because I'm very interested in hearing how people feel their bipolar cycling is affected by these drugs. I know I should quit both, I've tried hard and did well, but relapsed to my previous level of use recently because of uncertainty about my future and loss of motivation. I'm not up for quitting them both right now, but still want to make progress. Thank you for doing that.

I understand your feeling. Your newly prescribed medications for bipolar II illness are
going to make it unnecessary for you to self-medicate, however. It's from that point
only that I am able to speak, because I've never had problems with addiction to
alcohol or marijuana, but I understand that they both are really troublesome to get
rid of completely (initially).

Please do post on the Addiction Forum, too, because they can give you better
information than I, although there are many here who may be able to give you helpful advice about what to do.

You understand, I feel sure, that bipolar illness is, in part, a chemical imbalance in the brain. Some psychiatrists have called it an inflammation of the brain in which a portion of the brain fires too rapidly. Others have called it simply a chemical imbalance. Still others have indicated a far more complex state of brain-organ involvement. Go figure! At any rate, understanding that may help you to see the role that Marijuana (especially) plays in calming the brain, and the effects of
alcohol, of course, which involve the whole system, unfortunately. (I suspect that Marijuana does, too.)

Take care.

Yes marijuana functions like normal paracetamol in the body outside of the nervous system.

I have a thread there, I'll use that one. I've been on these meds before though.

I would stop drinking first. I don't think pot is a big problem personally but that's just me.

I am not so sure meds will make you wanna drop booze... I know too many who wash down their meds with beer or wine. At the best.

(also... many drink and smoke for "fun". YOu will not get the buzz from shrink prescribed med. Not all drinking and weed smoking is or started as "self-medication". If one smokes and drinks out of boredom, because attachment to said lifestyle... prescribed meds won't do nothing to your cravings of said substances).

I don't drink very much, like maybe once every 3-4 months, so I don't think it has too much effect on me.

Long, long ago I did smoke weed socially for about 6 months, and then very rarely over the next few years (also socially.) I remember clearly the first time I tried it, I was completely astonished at the effect. I looked at my friend and said, "I'm thinking one thing at a time." That's the effect it had on me. It slowed my thoughts. So, I'm not fully against testing to see if it helps with things like racing thoughts, but I know a lot of people are, so I don't talk about it much.

Well look at is this way. You're assumably taking medications to stabilize your mood.

Alcohol is a depressant. Being bp II you apparently experience more of the depressive side of manic depression. Therefore, the alcohol is working against the mood stabilizing drugs.

Most of these drugs are processed through the liver. So is alcohol. So when you drink on your meds you are making your liver work double time, and the risk of liver damage goes up considerably.

Weed affects everyone differently, but for me its a mood stabilizer, which is your ultimate treatment goal.

Cut out the alcohol for sure.

Well, here's the way I see it:

I think there is a drug called Naltrexone (or something similar) that is prescribed now for alcohol addiction. That might curb the craving for alcohol. You've got to get clean of the drugs before the psychotropic medications can target well the sites that need attention in the chemistry imbalance. Don't tell me, please, that Marijuana should be continued while you're taking psychotropic medications. That is just delaying the long-term effects of Marijuana dependence.

You will be in a very fragile condition for a while just from the adjustments that sometimes must be made in prescribed medications. You may even have to switch a couple of times to get to the right "cocktail" that stabilizes moods in bipolar illness.

You mentioned earlier that it was a "relief" of sorts to find out that you have bipolar illness, type II. Let me tell you that it is not an illness to play around with. You are going to have to change your diet, take the meds, and work to maintain your stability. If you don't do those things, the illness can get worse.

You need every bit of clarity and clean conditions in your brain for psychotropic medications to be of real benefit. Otherwise, you may just be cancelling out the effects of taking meds, and then you still have all the money you've put into psychotherapy to, hopefully, help you go into remission.

Man, I'm bipolar II, also, and I can tell you that I don't even eat wheat anymore because of the terrible things it does to feeling tone, the addiction it causes, and the weight problems associated with exorphins from grains containing gluten. You have no idea yet how sensitive your system is to anything that can cross the blood-brain barrier. The brain is a very reactive organ to things that can reach it!

It is not a simple illness, and you need to get yourself in the best condition you can be in for your illness to be stabilized and maintained in a healthy way for the rest of your life. It can go into remission for rare people, but they are extraordinary in their ability to manage their medications, severity of illness, diet, exercise, and stress in order to do that.

You have a lot to look forward to if you are willing to put your well-being first.

It can be made better as you age when you take care of yourself. Please do so.

Best wishes.

To answer your question I'd go with Mary and give up the booze.

I may have missed it, but what do your pdoc and t offer, or have you discussed it with them? If this is a change that you are committed to make, they will be your best source of help.
I don't smoke, but I have a brother who does daily, and even though he has been prescribed anti-depressants he will not take them-not sure if it is because of the pot.
As for alcohol, I do drink, but I know that this should only be a minor amount because alcohol does not allow the drugs to be effective.
Good luck!
Bluemountains

Naltrexone is working wonders for me to help control the urge to drink

I'm not going to lecture you,

You asked for opinions.... So... my personal opinion is if the alcohol is something you can tell is causing you problem then by all means you need to stop.

Marijuana... I don't think that it's an oh so terrible thing, maybe it's just as bad as medications? I don't know. I know it's used for chronic pain and during cancer treatments and many other illnesses.

Work on a plan of stopping whatever you feel you need to with your Pdoc/T.

Anyway just my opinion.

Good Luck

You know a psychiatrist really cannot properly diagnose you while your using alcohol and drugs. Alcohol will cause what looks to be "bipolar disorder". I wore that label "bipolar" for several years and used it to justify my drinking - when my real problem is that I'm an alcoholic and a drug addict. 7 years 7 months sober now thank God. Go check out aa, you may find that your solution "is" your problem. After I had been sober for some time, saw a psych and they told me "your not bipolar", good grief, that's after some 25 years of meds, shrinks, docs and torture. Med free now. Grateful to be a recovered alcoholic. There's a "test" from the Big Book of AA for quitting your drinking and drugs (the Marty Mann test), see if you're an alcoholic. You might not be bipolar.

Best of luck!

I am so glad that you finally found the real diagnosis, shikantaza. Seven plus years shows great strength, congratulations!

I would cast my vote for alcohol. It is so dangerous to combine alcohol with meds- increased risk of blackouts and it is murder on your liver. I know this and I am also struggling with the alcohol issue. The weed was something I have been forced to give up as I am looking for a job.. I can relate.

Please take care of yourself.

~J.

Alcohol is the first to go in my opinion. I worked 4 years in a addiction rehab. I can tell you those with psych meds felt a great deal better after being clean of alcohol and weed. It was like the meds were able to work. I agree with other's above that you are just working against your meds. Talk with doc an such about it.

Thank you for all of the great replies! That's really cool to get so many useful replies.

I appreciate the concern. I know it is a serious illness, but so is BPD. I'm relieved because I was right that my problems are not just a result of my personality, I was right that I wasn't just paranoid and they (therapists) did not believe me at first when I told them about my moods (my psychiatrist said so), and I was right that what I've been doing for so many years to "cure" myself (changing my personality and trying to create an identity) isn't going to fix all my problems and that's not just because I haven't tried hard enough.
I'm very comfortable with change. Change is good. I hope to be able to live without meds some time in the future.

I've had quite a bit of neurosciences in my studies, so I know I should be careful with my blood-brain barrier. I should probably consider my diet when I start my meds. Right now I'm just trying to eat enough and eat at all.

My psychiatrist has given me Lamictal and Zyprexa, which I was sort of stable on at one point before (but I took a lot more than I was comfortable with). She wants me to take 10mg Zyprexa because apparently she's worried that I might be going into a psychosis, but I doubt that's ever going to happen, and she said I could take only 2.5mg if I found I was stable enough on that. I see my T once a week and also go to group therapy for the BPD once a week, but I'm likely not going to be allowed to continue with that T and group (hence the loss of motivation and relapse). Pot could be the reason your brother isn't taking his pills, because of the paranoia, but that's highly unlikely I think. I'm not taking mine yet because I feel like I'm doing fine right now. I'm waiting until I'm not fine again, so probably not long at all unless something changes.

This is a really refreshing thing to hear!
Thanks a lot!

That depends on the level of consumption of drugs and which drugs you're consuming. They might tell us that we need to be completely clean for any diagnosis to be made, but that is a lie.

Yes, I've heard this once before, it's really strange! For me though I'm sure it's not the case, because I drink on average once or twice a week. Some months I don't drink anything at all, but my moods still cycle with about the same intensity. I don't think of myself as an alcoholic, but I know I would have been one if I hadn't discovered weed (I actually think I would have been much worse off without weed and the opportunities it gave me socially and psychologically, but it's time for a change now). Good job on your recovery, man! That's awesome.

Thanks!

Diagnosis of bipolar from Wikipedia:

"Diagnosis

Diagnosis is based on the self-reported experiences of an individual as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a psychiatrist, nurse, social worker, clinical psychologist or other clinician in a clinical assessment. There are lists of criteria for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. Assessment is usually done on an outpatient basis; admission to an inpatient facility is considered if there is a risk to oneself or others. The most widely used criteria for diagnosing bipolar disorder are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, the current version being DSM-IV-TR, and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, currently the ICD-10. The latter criteria are typically used in Europe and other regions while the DSM criteria are used in the USA and other regions, as well as prevailing in research studies. The DSM-V, to be published in 2013, will likely include further and more accurate sub-typing.[47]
An initial assessment may include a physical exam by a physician. Although there are no biological tests which confirm bipolar disorder, tests may be carried out to exclude medical illnesses such as hypo- or hyperthyroidism, metabolic disturbance, a systemic infection or chronic disease, and syphilis or HIV infection. An EEG may be used to exclude epilepsy, and a CT scan of the head to exclude brain lesions. Investigations are not generally repeated for relapse unless there is a specific medical indication.
Several rating scales for the screening and evaluation of bipolar disorder exist, such as the Bipolar spectrum diagnostic scale.[48] The use of evaluation scales can not substitute a full clinical interview but they serve to systematize the recollection of symptoms.[48] On the other hand instruments for the screening of bipolar disorder have low sensitivity[clarification needed] and limited diagnostic validity.[48]"

The part in bold is about differential diagnosis: what needs to be EXCLUDED.

Where do you see (in the above) that psychiatrists cannot diagnose a patient who is on alcohol and drugs?

The process of excluding other hypotheses is called Differential Diagnosis. When symptoms A, B, and C are present, there might be different causes of symptoms A, B, and C. Doctors form hypotheses about the causes and try to exclude them via a process of elimination (similar to what you would do on a standardized test).

alcohol and drug use is one of the many hypotheses that are alternatives to the hypothesis of bipolar, but just one of many, and to say that a patient needs to have zero level of use to be diagnosed is extreme.

So many bipolar people also use drugs and alcohol that if doctors start to refuse diagnosis and treatment until and unless the patients stop all use, the situation will become disastrous.

Well that answers your inquiry right there - go with the low hanging fruit.

If you need to rationalize it, weed is way safer because you cannot consume a deadly quantity of weed but you can consume a deadly quantity of alcohol. I do not think that you personally would consume a deadly quantity of alcohol, but at least in theory one CAN consume a deadly dose of alcohol but not of weed.

I do not think though that you must rationalize it - you can simply go with the low hanging fruit just because it is a low hanging fruit, period.