Alcohol and Meds for Mental Illness generally don’t mix well

In my blog bio, I listed the various meds that I take to treat my mental illness: Effexor, Welbutrin, Zyprexa, and Klonopin. Speaking broadly, these meds stave off depression, balance my moods, and quiet my mind. The Klonopin helps settle me down and also allows me to get sleep at nights, even if I’ve spent the entire day in bed.

When my doctor first prescribed my mental meds, I was given the usual alcohol warning: “Please be very careful consuming alcohol in excess with these pyschiatric drugs…”

NOTICE: The following is my personal experience with alcohol and mental meds, please consult your medical provider in depth before you attempt to mix your medication with other substances.

I also have to factor in my Type 1 Diabetes with my alcohol consumption. Alcohol is said to lower blood sugar. When this occurs unchecked, diabetics can have what is called “hypoglycemia”, or a reaction caused by an overabundance of insulin in the body. The result is usually confusion, shakiness, and irritability. In more serious cases, loss of consciousness, seizures, and comas can occur. If you see a diabetic having an insulin reaction, ask them if they are OK, and then offer then something with sugar in it.

As a result, I usually elect to have licquor mixed with a fruit juice: for example Vodka and orange juice (a “screwdriver”) or Vodka and cranberry (known on the East US coast as a “Cape Codder”). The sugar in the juice counteracts the sugar lowering effects of alcohol and keeps me on an even keel.

Alcohol and my psychiatric meds are a different story. Factors such as “food in stomach”, “weight”, and “frequency of consumption” aside, I find that I am a “cheap drunk” as a result of taking mental medications. My tolerance for alcohol is much lower than others, unless I “build it up” by drinking very frequently over a few months.

Also, I’ve found that if I drink to excess, I tend to get very disoriented and clumsy faster, and tend to “pass out” easier. I get very sleepy and will get annoyed if I can’t find a place to rest after drinking a lot.

Hangovers the next day are horrible: I nearly always have a ripping headache, unabated thrist, and general fatigue. When I have strong hangovers I am basically out of action for the entire day, and sleep for hours on end. The loss of productivity from losing a day’s work stresses me out, since I must make up for this loss of time. Also, sleeping all day nursing a hang over messes up my already shakey sleep pattern.

Worst of all is the onset of a brief period of depression. Alcohol is a depressant – this everyone knows – but factor in psychiatric medication, diabetes, and the effects of BPD, and I get a wicked, hopeless feeling in the hours and day or two following high alcohol consumption. I feel absolutely lousy, hopeless, and useless. I have no desire to do anything.

Here’s what I’ve found over the past few years, when considering the big picture of having BPD, Diabetes, and a social scene full of alcohol consumption:

  • If you’re going to drink, have food in your stomach. This slows down the speed at which alcohol enters your blood stream. If you can’t eat, or haven’t eaten all day, be careful drinking, since the alcohol will take effect much faster.
  • If you’re going to drink, drink on weekends when work schedules are light and you can afford to spend a day in bed if you have a bad hangover. Increasingly, people like to go out during the week, especially on Thursdays. For me, this usually means a wasted Friday.
  • Don’t binge drink – or drink very quickly, even if all your friends are doing shots and being competitive. Remember that eveyone’s body tolerates alcohol differently. Therefore, a 220 LB football linebacker will handle shots of whiskey much better than a 110 LB female on medication. This is a fact of life, so don’t get down if you’re not able to keep up with a heavy drinker.
  • BIGGEST TIP: For every drink, shot, or glass of wine you have, drink at least two glasses of water. Period. When the liver processes alcohol, it requires water. When you are drinking in excess, this causes rapid dehydration. Drink water between your alcoholic beverages. This will cause you to need the bathroom more often, but atleast you know you will be getting some of the booze out of your system. Also, water mitigates hangovers the next day, since most hangovers are caused by dehydration.
  • Don’t mix up various alcoholic beverages, ie. beer, wine, licquor, over the course of an evening. The hops and barley in beer, the grapes from wine, or the sugar cane from rum all make the alcohol absorbtion process much more complicated. I nearly always have a bad headache the next day if I drink Vodka drinks and Beer the night before.
  • Finally, if you’ve never had alcohol before, drink very lightly and slowly around friends and family just in case you have a bad reaction. Clubs and college parties are the worst places to experiment with your alcohol tolerance, because those around you generally don’t know that you’re also taking psychiatric medication. Instead, if you’re going to experiment, do so around people you know that will take care of you if an emergency arises.

Be careful and don’t complicate your BPD with substance abuse. It’s much easier said than done, but if you’re going to drink, do so with utmost caution and preparation. You’ll be glad the next day when you’re not vomitting, passed out, dehydrated, or wickedly depressed from heavy drinking the night before.