Expert: Ivan Goldberg, M.D. - 8/3/2008

Question
HI- I really need some insight on behaviors of Type I bipolarism. Three days ago, my fiancee to Washington DC (to go to a 1-year grad program) and I live in Philly- he's been taking Lithium and in the past month has changed to another medication to treat it...he has also started to drink more in the past month. Two days before he left, I found out that he had went on a personals ad in DC and e-mailed a woman about meeting up. He was drinking a lot that day and he claims that the switching of the medication and the heavy drinking caused him to send the e-mail and that he doesn't remember doing it.
I'm having a really hard time believing this story- is this something that people with Bipolar I disorder actually do? Also, if it is his disorder/alcohol, how can I help prevent it from happening again? He was incredibly upset when he lft and said he wants to marry me and promises to change. He is now in AA and is committed to being sober for the rest of his life.

Answer
Hi, Elizabeth . . .

One of the biggest problems with bipolar disorder is impulsive behavior. Impulsive sexual, financial, aggressive and antisocial behavior regularly gets people with bipolar disorder into trouble.

Lithium does a great job of reducing impulsivity. Alcohol increases impulsivity. The combination of less or no lithium + drinking too much may account for your fiancee's behavior.

I insist that my patients with bipolar disorder do not drink at all or use any street drugs.

I hope this helps clarify the situation.

Best regards . . .

Ivan
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