Bipolar disorder is a mental health condition that causes unusual and extreme mood swings, ranging from extreme highs (mania or “manic” episodes) to lows (depression or “depressive” episodes).
A “manic” episode may include:
- Intense feelings of euphoria, excitement, or happiness
- Appearing abnormally jumpy or wired
- Having excessive energy and feeling very productive
- Insomnia or restlessness (a decreased need for sleep)
- Speaking fast or being unusually talkative
- Racing or jumbled thoughts
- Distractibility
- Inflated self-esteem and a feeling of invincibility
- Doing impulsive, uncharacteristic, or risky things - like unsafe sex or spending uncontrollably
- Increased agitation and irritability
- Hypomania
A “depressive” episode may include:
- Feeling down, sad, worried, worthless, anxious, guilty, empty, or hopeless
- Loss of interest in activities
- Avoiding friends and family
- Feeling tired, having low energy
- Forgetfulness
- Indecisiveness
- Difficulty concentrating
- Changes in sleep, either sleeping too much or too little
- Changes in appetite, either eating too much or too little
- Thoughts of death and/or suicide
A severe manic or depressive episode may also feature psychotic symptoms, such as delusions or hallucinations.
A person who has bipolar disorder also experiences changes in their energy, thinking, behavior, and sleep. During bipolar mood episodes, it can be difficult for individuals to carry out day-to-day tasks, go to work or school, and maintain relationships.
Co-occurring Bipolar Disorder and Addiction
When bipolar disorder and substance abuse occur together, this is known as comorbidity - the existence of two or more diseases or medical conditions in a patient at the same time. In such circumstances, a dual diagnosis is made. NIDA (National Institute on Drug Abuse) explains that three different situations can contribute to the comorbidity between bipolar disorder and substance use disorders (SUDs), or bipolar and alcohol abuse. These are:
- Common risk factors, such as childhood trauma and stress, can make people more susceptible to both bipolar and substance use disorders. There are also genetic factors that might make a person predisposed to both conditions.
- Mental health conditions - in this case, bipolar disorder- may contribute to substance use and addiction.
- On the flip side, substance use and addiction can contribute to the development of mental illness. This is known as substance-induced bipolar disorder, where the substance use disorder precedes the bipolar disorder.
Regarding these last two factors, research shows that people with bipolar disorder are at an increased risk of developing a SUD (substance use disorder), and people with SUDs are more likely to have bipolar disorder than the general population.
Relationship Between Bipolar and Substance Abuse:
There are a number of reasons why bipolar disorder and drug abuse are linked. Some of these reasons include:
- Self-medication: People with bipolar disorder may use drugs or alcohol to relieve the negative symptoms of bipolar or the side effects of the medications they use to treat it. For example, they may use stimulants to boost their energy during depressive episodes or depressants to calm down during manic episodes.
- Cope with stress and trauma. People with bipolar disorder are at an increased risk of experiencing trauma and stress, which can trigger mood episodes. Drugs and alcohol can be used as a way to cope with these difficult emotions.
- Impulsivity: People with bipolar disorder often have difficulty controlling their impulses. This can make them more likely to start using drugs or alcohol – even though they know how harmful it is - and less likely to stop once they are addicted.
Why Co-Occurring Bipolar Disorder and Substance Abuse is Harmful:
Drug abuse can have a number of negative consequences for people with bipolar disorder. These repercussions include:
- Worsened symptoms: Although drugs and alcohol may temporarily reduce negative bipolar symptoms, in the long run, they can alter the brain’s chemistry and worsen the symptoms of bipolar disorder, both during manic and depressive episodes. This can make it difficult for people to manage their condition and function in their daily lives.
- Worse effects from drugs: Changes in brain activity from bipolar (or any other mental illness) can enhance the drug’s rewarding effects and reduce awareness of their negative effects. This obliviousness to the harmful effects of drugs can make a person more vulnerable to drug misuse.
- Reduced treatment effectiveness: Drug abuse can also reduce the effectiveness of treatment for bipolar disorder. This is because drugs and alcohol can interfere with the way that medications work. Lithium is a drug commonly used to treat bipolar disorder. If other drugs increase lithium levels in the blood, this can lead to lithium toxicity, which can be dangerous and even fatal. If drugs decrease lithium levels in the blood, this can make lithium less effective, which can lead to a return of bipolar symptoms.
- Increased risk of relapse: People with bipolar disorder who abuse drugs and alcohol are more likely to relapse. Patients with comorbid disorders demonstrate poorer treatment adherence and higher rates of treatment dropout than those without mental illness.
- Increased risk of suicide: Drug abuse and alcohol abuse are both risk factors for suicide. This is especially true for people with bipolar disorder, who are already at an increased risk of suicide.
Treatment Options for Addiction and Bipolar:
People wonder how to deal with a bipolar drug addict. One of the first steps of treatment will involve working with a specialist to distinguish what symptoms are the result of bipolar and which are the result of drug abuse or withdrawal. At times, these two disorders can manifest similar characteristics. The chronic use of central nervous system stimulants, such as cocaine and Adderall, can produce manic-like symptoms, whereas withdrawal can produce depression-like symptoms.
There are a number of treatment options available for people with bipolar disorder who are also struggling with drug abuse.
These treatment options include:
- Integrated treatment: Integrated treatment programs address both bipolar disorder and drug abuse at the same time rather than the individual having separate treatment for each diagnosis. This type of treatment is often the most effective for people with co-occurring disorders.
- Medication management: Medication management is an important part of treatment for both bipolar disorder and drug abuse. Being on the right medication for bipolar disorder can help stabilize a person’s mood and make them feel more level-headed and able to think more clearly. This allows them to be more in control of their condition and reduces their need to turn to drugs and alcohol.
- Therapy: Therapy can help people understand their bipolar condition better and learn coping skills for managing it. It can help individuals discover which aspects of bipolar they struggle with the most, as well as what things trigger them and make them feel as though they need to take drugs.
Dealing with both bipolar disorder and substance use disorder at the same time can be incredibly challenging and overwhelming, but know that you’re not alone. If you or someone you know has bipolar disorder and is struggling with drug abuse, don’t hesitate to contact Avenues Recovery. Our professional and highly trained staff will work with you every step of the way, in a caring and sensitive manner, to help you regain control of your life. Our staff are experts in the fields of mental health and addiction, and they will not stop at anything until you have reached a place where you can manage your bipolar disorder and live a fulfilling life of sobriety. Contact us today to take your first giant step towards recovery.