Addiction Treatment
Addiction Treatment

Bipolar Disorder and Addiction

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Medically reviewed: 06/07/2018
Last updated: 05/15/2019
Author: Addictions LLC

Reading Time: 4 minutes

What is Bipolar Disorder?

Bipolar disorder, formerly known as manic-depression, is a brain disorder that produces extreme shifts in energy levels, and mood, moving between emotional highs and lows. Bipolar disorder is associated with mood swings that can last for a long period of time and is defined by high highs and low lows.

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The high periods are known as manic episodes and the low periods as depressive episodes. Sometimes these highs and lows are severe enough to necessitate hospitalization, and sometimes the mania is milder, and may even be pleasant for the individual. This is known as hypomania, and while it is not always problematic on its own, any change in mood and energy level may indicate a problem that could become more severe over time.

What are the Signs and Symptoms of Bipolar Disorder?

Mania or hypomania can last from seven days to six months if left untreated. Individuals experiencing a manic episode will experience three or more of the following symptoms to the degree that interferes with the ability to socialize or work (otherwise the episode can be considered hypomanic):

  • Euphoria
  • Distractibility
  • Rapid non-stop speech
  • Racing thoughts
  • Excess involvement
  • Little need for sleep
  • Poor judgment
  • Irritable moods
  • Poor control of temper
  • Reckless behavior

The earlier an individual develops bipolar disorder; the more likely their first few bipolar episodes will be depressive. This can easily lead to misdiagnosis and inappropriate treatments. Unfortunately, many traditional antidepressants are counterproductive for bipolar disorder, potentially inducing mania and rapid cycling from one mood episode to another.

Depressive episodes can cause the following symptoms:

  • Daily low mood or sadness
  • Fatigue
  • Low energy and activity levels
  • Sleep problems
  • Loss of pleasure in activities once enjoyed
  • Loss of self-esteem
  • Problems concentrating
  • Forgetfulness
  • Worry and anxiety
  • Emptiness and hopelessness
  • Eating too much or too little
  • Feeling slowed down
  • Thoughts of death or suicide

Many of the manic and depressive symptoms of bipolar disorder are also associated with substance abuse. Those who binge on stimulants can often experience frequent bouts of highs and lows, and eventually, these issues can become very severe. Also, a person might abuse drugs to self-medicate depression, to try to level out mood swings or to cope with insomnia or other symptoms. However, these symptoms should eventually resolve once the substance abuse is stopped. To properly diagnose bipolar disorder, an individual should be frequently evaluated by a psychiatrist during treatment, as symptoms will change and evolve over time. Any individual who is experiencing psychiatric symptoms along with addiction should be treated at a facility that specializes in a dual diagnosis, or co-occurring disorders, to ensure the correct diagnosis and course of treatment.

There is often a strong relationship between addiction and bipolar disorder. Many individuals with bipolar disorder will choose to self-medicate troublesome symptoms with drugs or alcohol, and often, the effect of these substances on the individual’s brain chemistry will cause a shift to severe mania or depression, or to rapid cycling of mood episodes.

How Does Bipolar Disorder Interact with Addiction?

Suffering from both bipolar disorder and addiction is common, though the exact link between the two is not entirely known. Bipolar disorder and alcoholism are the most common co-occurring disorders. In particular, women with bipolar disorder experience up to seven times the rates of alcohol use disorder compared to the general public. However, any form of substance abuse can be associated with bipolar disorder.

It is generally accepted that both substance abuse and bipolar disorder can be caused by a combination of genetic and environmental factors. Furthermore, considering the fact that those who live with bipolar disorder may turn to drug or alcohol abuse as a coping mechanism, and that substance abuse can actually trigger bipolar disorder in individuals who did not previously have it, the two disorders are unsurprisingly often found in the same individual. The primary concern with the link between these two disorders is that substance abuse can sometimes mask the symptoms of bipolar disorder, making an accurate diagnosis and appropriate treatment more difficult.

Anyone who suffers from both disorders is dealing with two severe mental illnesses and therefore requires qualified, experienced help from professional treatment programs, as well as social support from loved ones. If someone you care about shows signs of both these disorders, it is important to encourage them to seek specialized treatment as soon as possible.

How are Bipolar Disorder and Addiction Treated?

Bipolar disorder is a serious mental illness that, in many cases, can be associated with addiction. Fortunately, there are treatment options that can be utilized for dual diagnosis patients to create a strong, healthy recovery.

The first, most important step is making a clear diagnosis. Any patient who is newly presenting with the symptoms of bipolar disorder must be closely supervised, assessed, and evaluated throughout the detoxification phase of treatment. Only after the worst symptoms of withdrawal have passed can a doctor accurately diagnose bipolar disorder and safely prescribe drug therapy to level out the patient’s moods. Both bipolar and substance use disorders can be treated with psychotherapy and cognitive behavioral therapy, but pharmacological treatments will also be necessary to control the symptoms of bipolar disorder that can greatly increase the chance of relapse if left uncontrolled.

All co-occurring disorders must be treated simultaneously in order for the individual to safely recover. Without simultaneous care, the untreated illness will continue unabated and can often derail one’s progress with the other disorder. Therefore, it is extremely important to find a rehab program that can treat both issues at the same time.

Though there is no cure for bipolar disorder, those who seek treatment will often be able to learn to manage it the way they manage their addiction. Cognitive-behavioral therapy, in particular, can help to teach a patient how to:

  • Cope with cravings and stress
  • Understand and respond healthfully to their moods
  • Recognize and avoid triggers
  • Replace destructive patterns of thought and behavior with positive ones
  • Practice better life skills, including good self-care