Co-Occurring Addictions

Bipolar Disorder and Substance Abuse

Bipolar disorder is a mental health illness that causes a patient to cycle between periods of joyfulness (mania) and sadness (depression). How often, and how severely, a patient will cycle between the emotions varies from patient to patient. In some cases of bipolar disorder the symptoms will be so severe as to cause the patient to be unable to function in day-to-day life. It is one of the most debilitating mental health illnesses and has no known cure. Although medications can ease symptoms and reduce the severity of mood swings, bipolar patients are always at risk of relapse.

Unfortunately, bipolar disorder can manifest in conjunction with another mental disorder, such as substance abuse. In fact, of all psychiatric disorders, substance abuse is the condition most likely to co-occur with bipolar disorder. Because either one of these illnesses, by itself, can wreak havoc in a patient’s life, the combination of substance abuse and bipolar disorder is a dire situation indeed. Research has shown that over 60 percent of bipolar patients are also alcoholics. As such, medical practitioners who care for substance abusers must first rule out other types of mental illness, such as bipolar disorder, in order to effectively treat the patient.

Researchers have been unable to determine why bipolar disorder and substance abuse occur together, but suspect that bipolar disorder leads to substance abuse rather than the other way around. One theory behind the co-occurrence is that patients may be attempting to self-medicate with alcohol or drugs in order alleviate some of the more severe bipolar symptoms. Alcohol, opiates, and pot have been shown to temporarily lessen the severity of mood swings and bipolar patients have been shown to be very sensitive to the effects alcohol or drugs. Of all bipolar patients, those who also abuse substances have been shown to be the least likely to cooperate with treatment plans and take their medications as prescribed.

When a manic-depressive uses methamphetamine (meth) or cocaine, however, he or she could actually trigger a manic episode followed by a deep depression. Further, the excessiveness associated with mania can make a patient drink too much.

Bipolar patients who suffer from “mixed” states (symptoms of both mania and depression at the same time) or rapid cycling between mania and depression are in the most danger of abusing drugs and alcohol as some patients will try almost anything to find relief.

Sadly, substance abuse is extremely common among manic-depressives, especially young people. In one study conducted at Massachusetts General Hospital, scientists found that patients with bipolar disorder were at vastly greater risk of developing substance abuse than teens with conduct disorders. The risk was so great that the researchers recommend that all teens who are diagnosed with bipolar disorder should undergo intensive counseling regarding the dangers inherent in using drugs and alcohol. Conversely, all those who are being for substance abuse should be screened for bipolar disorder. On a positive note, Lithium (the most common mood stabilizing medication) has been shown to be effective at reducing or eliminating substance abuse in 75 percent of bipolar teens that are abusing drugs or alcohol.