Bipolar Disorder and Addiction

Bipolar disorder is a mental health disorder characterized by chronic mood swings, frequently causing shifts between manic highs and depressive lows.^{3, 6} While bipolar disorder is serious enough on its own, when it appears alongside a substance use disorder (SUD) it can cause many negative medical and socioeconomic outcomes. When bipolar disorder or another type of mental health disorder appears alongside a substance use disorder (SUD), they are known as co-occurring disorders.¹

Co-occurring disorders impact many people, with an estimated 7.7 million people in the United States meeting the criteria for both a mental health and substance use disorder.² The prevalence of certain mental health disorders occurring alongside addiction varies. However, research suggests that SUD co-occurrence tends to be higher among those with bipolar disorder than among people with any other mental health disorders.³

Fortunately, treatment programs exist that address both addiction and bipolar disorder. Co-occurring treatment programs also known as dual diagnosis treatment programs are programs that simultaneously treat both bipolar disorder and substance use disorder and can lead to positive results.⁵ Understanding what bipolar disorder is, how it interacts with substance use disorders, and where to find dual diagnosis treatment can help you find effective treatment for the conditions. Other forms of co-occurring disorders can include depression, anxiety, and ADHD.

Understanding Bipolar Disorder

The general characteristics associated with bipolar disorder revolve around changes in mood generally causing an individual to experience manic periods of increased energy and elevated mood and depressive episodes of decreased energy and deflated mood.⁶ While symptoms can vary from person to person, bipolar disorder can lead to changes in the following:⁴

• Thinking, cognitive functions, and judgment.
• Behavior.
• Sleep.
• Ability to carry out daily tasks at school and at work.
• Ability to maintain healthy relationships.

Variations of Bipolar Disorder

There are 3 main types of bipolar disorder: ⁴

• Bipolar I. This type of bipolar disorder is characterized by chronic mood swings that alternate between severe mania and severe depressive episodes.⁶
• Bipolar II. This type of bipolar disorder is when one struggles with a hypomanic episode and a major depressive episode.⁶ Manic highs may be less extreme than in Bipolar I, but the depressive episodes in Bipolar II may be as severe.
• Cyclothymic disorder. Cyclothymic disorder is characterized by numerous hypomanic symptoms and mood swings. Symptoms are usually not as severe as in Bipolar I and II.⁶

While they all share similar manic periods (highs and lows as well as depression), the main differences between these three variations are the length of the mood swings and the severity of symptoms.⁴

Symptoms and Effects of Bipolar Disorder

While the symptoms of manic and depressive episodes vary from person to person, there are a few general symptoms one can watch out for. Some common symptoms of a manic episode may include:^{4, 6}

• Having excess energy.
• Feeling or presenting as abnormally jumpy.
• Expressing intense feelings of excitement, happiness, or euphoria.
• Becoming easily distracted.
• Being hyperverbal (speaking fast or talking a lot).
• Feeling restless and having difficulty sleeping as well as a decreased need for sleep.
• Engaging in risky and impulsive behaviors, such as excessive spending and having unsafe sex.
• Experiencing increased irritability and agitation.
• Having exaggerated self-esteem.

Symptoms of a depressive episode can include: ^{4, 6}

• Forgetfulness.
• Having low energy and feeling fatigued.
• Difficulty making decisions.
• Sleep disruptions, including sleeping too much or too little.
• Thoughts of suicide or thoughts of death.
• Anhedonia or loss of interest in activities that were once enjoyable.
• Feeling sad, worried, worthless, guilty, or hopeless.
• Changes in appetite such as not eating enough or over-eating.
• Problems with focus and concentration.

The Strong Relationship Between Bipolar and Substance Use Disorder

Many people who experience bipolar disorder also struggle with addiction. Studies show that between 22 and 59% of people who are diagnosed with a bipolar disorder may also experience a substance use disorder.³ The existence of a mental health and substance use disorder together doesn’t mean that one caused the other; however, they can mutually impact one another and exacerbate symptoms of one another.²

It is hard to pinpoint the cause of the connection between SUD and bipolar disorder. However, researchers theorize that:³

• People with bipolar disorder use substances as a way to self-medicate from the symptoms of bipolar disorder.
• Both SUD and bipolar disorder involve problems in the functioning of the brain, which impacts motivation, behavior and impulsivity, and the feeling of reward.
• Both SUD and bipolar share a genetic vulnerability to one another.

Researchers have ascertained that an SUD can worsen, precede, precipitate, be a result of, and have separate causes from bipolar disorder.³ Furthermore, individuals who struggle with a SUD and a co-occurring bipolar disorder may face additional difficulties in attaining positive treatment outcomes.³

Treating Bipolar Disorder and Addiction

When left untreated, co-occurring mental health disorders can provide significant barriers and challenges during substance use disorder treatment and recovery.⁵ It’s important to choose a treatment facility that specializes in dual diagnosis treatment. These dual diagnosis programs are often specialized to provide integrated treatment for co-occurring disorders.

Treatment options for bipolar and addiction include: ⁵

• Cognitive-behavioral therapy (CBT).⁵
• Integrated therapy.⁵
• Relapse prevention techniques.⁵
• Medications such as mood stabilizers, antidepressants, and antipsychotics.⁴

Finding Bipolar Disorder and Addiction Rehab Near Me

If you’re struggling with bipolar disorder and substance misuse, it’s important to understand the resources that are available to you. If you’re considering treatment, a doctor can help determine your medical needs and offer referrals to appropriate treatment centers suitable to you. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides an online directory where you can find treatment centers near you.

Addiction helplines can also help answer questions and provide resources to help you identify an appropriate treatment center. American Addiction Centers (AAC) offers assistance 24 hours a day, 7 days a week. AAC has trained and compassionate admissions navigators available to help answer questions about co-occurring disorders and can even help direct you to an appropriate rehab. You can speak to an admissions navigator by calling , and you can rest assured that your call will remain completely confidential.