Understanding Bipolar Disorder

Many people with an addiction have a co-existing mental health condition such as bipolar disorder. Once known as “manic depression,” bipolar disorder causes mood swings between intense emotional highs and lows.

In a study of people with bipolar disorder, approximately 60% had some history of substance abuse.

Although it’s not fully understood why, bipolar disorder makes people more likely to abuse drugs and alcohol. Drugs and alcohol often make the symptoms of bipolar disorder worse. People with no history of mental health issues may also develop bipolar disorder as a result of drug abuse.

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Co-Occurring Bipolar Disorder And Addiction

People with bipolar disorder experience radical shifts in mood. These episodes can last for days or weeks at a time. Episodes may happen as often as several times a week or as little as a few times a year. Bipolar disorder also causes major changes in energy and concentration.

Both genetics and imbalanced chemicals in the brain can cause bipolar disorder. A traumatic environment is also a risk factor for bipolar disorder. This disorder can lead to financial and legal troubles, addiction, relationship issues, and suicide. Many people with bipolar disorder are tempted to abuse drugs to relieve the troubles caused by their condition.

There are 4 types of episodes people with bipolar disorder may experience. These include:

  • Manic Episodes

    During a manic episode, someone with bipolar disorder may be excessively cheerful or hostile. These episodes last a week or more and may require hospitalization.

  • Hypomanic Episodes

    There are only subtle differences between hypomanic and manic episodes. The main difference is that hypomanic episodes are shorter, lasting at least 4 days, and are less severe.

  • Major Depressive Episodes

    These episodes leave people depressed and/or uninterested in activities. A person’s depressed mood has to last at least 2 weeks to meet the clinical definition of an episode.

  • Mixed Episodes

    Some people with bipolar disorder have mixed episodes. These episodes include traits of manic, hypomanic, and major depressive episodes.

The Diagnostic and Statistical Manual of Mental Disorders provides 2 categories for bipolar disorder, bipolar I and bipolar II.

People with bipolar I experience 1 or more manic/mixed episodes followed by major depressive episodes or hypomanic episodes. Those with bipolar II have 1 or more major depressive episodes followed by a hypomanic episode. Bipolar I is more severe than bipolar II.

It’s common for people with bipolar disorder to self-medicate with drugs and alcohol. These substances seem to ease the symptoms of manic and depressive episodes at first, which partially explains why many people with bipolar disorder have an addiction.

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Substance-Induced Bipolar Disorder

Frequent drug use causes physical changes in the brain. The most obvious change is to the brain’s reward system, which makes using drugs feel pleasurable. However, changes in the brain’s reward system lead to compulsive and drug-seeking behavior. Drugs can rewire other parts of the brain that affect mood and behavior. Drug abuse and addiction can cause changes in the brain that lead to bipolar disorder.

Even people who were mentally healthy before their addiction can develop bipolar disorder.

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Symptoms And Effects Of Bipolar Disorder

The symptoms of bipolar disorder vary from person to person. There are also different symptoms for manic and depressive episodes. Those who also suffer from addiction usually have heightened bipolar symptoms.

Manic Episode Symptoms

  • Hyperactivity
  • Inflated sense of self-confidence
  • Decreased need for sleep
  • Extreme talkativenes
  • Racing thoughts
  • Short attention span
  • Risky behavior
  • Preoccupation with a specific goal

Some people experience manic episodes so severe that they are unable to function in a social or occupational setting. People having these episodes may require hospitalization. A typical manic episode is not caused by drug abuse. This makes it hard to diagnose bipolar disorder if an addiction also exists.

Major Depressive Episode Symptoms

  • Feeling depressed or hopeless most of the day
  • Having a sense of worthlessness
  • Weight loss or gain
  • Restlessness
  • Insomnia or feeling the need to oversleep
  • Loss of interest or pleasure in once enjoyable activities
  • Feeling fatigued nearly every day
  • Excessive feelings of guilt
  • Lack of concentration
  • Thoughts of death or suicide

Major depressive episodes leave people unable to function in social or occupational settings. A person’s depressed mood has to last at least 2 weeks to meet the clinical definition of an episode. Like manic episodes, a true major depressive episode is not the result of drug abuse.

Diagnosing Bipolar Disorder

Diagnosing bipolar disorder in a person with an addiction is difficult. The symptoms of the episodes experienced by people with bipolar disorder mirror many symptoms of drug abuse and addiction. Doctors diagnose bipolar disorder through several tests to help distinguish between a bipolar disorder and addiction.

Diagnostic Tests for Bipolar Disorder
Psychological tests A doctor evaluates the thoughts and feelings of the patient. The doctor looks for evidence of any manic or depressive behavior. Doctors may interview friends and family to learn more about the patient’s behavior.
Physical exams The doctor performs a physical exam to determine if there is anything causing imbalances in the brain. He or she also reviews the patient’s medical history and drug use. Pinpointing the cause of bipolar disorder can help treat the condition.
Mood charts The doctor may ask the patient to chart his or her mood. Mood charts help determine the frequency and length of episodes. Having a distinct record of a patient’s episodes and how long they last help make an accurate diagnosis.
Making comparisons Doctors compare the symptoms of bipolar disorder against other conditions. Symptoms of bipolar disorder are common to other conditions. For instance, some people have major depressive episodes without having bipolar disorder. The signs of intoxication can also mimic some symptoms of bipolar disorder.

Drug Abuse, Bipolar Disorder, or Both?

The symptoms of bipolar disorder often resemble the signs of drug use and addiction. Someone going through a manic episode can look and act like someone on Cocaine. Both experience an elevated mood and energy. Those having a major depressive episode can also have the same symptoms as someone in withdrawal.

If someone with an addiction has a co-occurring bipolar disorder, they need the help of someone trained in making a dual diagnosis. Because symptoms of both conditions can overlap, it’s important to see an experienced specialist. Someone with experience can distinguish between symptoms of addiction and bipolar disorder.

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Treating Bipolar Disorder And Addiction

Treating co-occurring disorders involves tackling both problems at once. Doctors use medications and therapy to treat these conditions. A person struggling with an addiction and bipolar disorder can get treatment through an inpatient or outpatient rehab.

Medications For Bipolar Disorder And Addiction

Medication can help people with bipolar disorder and addiction. Addiction treatment medications stifle cravings and ease withdrawal symptoms. The type of addiction medication prescribed depends on the patient’s drug of abuse.

Medications for bipolar disorder can calm mood shifts and bring equilibrium to a person’s life. Some medications for bipolar disorder include:

  • Anticonvulsants
  • Antipsychotics
  • Lithium
  • Benzodiazepines

Each of these medications helps with either a manic or depressive episode. Doctors may be careful to prescribe Benzodiazepines because they are addictive. But Benzos may simultaneously help with manic episodes and withdrawal symptoms.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) helps people with addiction and co-occurring bipolar disorder. CBT addresses the thoughts and feelings that people with these conditions face.

By examining the thoughts and feelings that lead to manic and depressive behaviors, addicted people with bipolar disorder can better understand their actions. This helps them prepare for cravings and episodes, so they can manage their behavior.

Get Help For Bipolar Disorder Dual Diagnosis

By comparison, it is easier to diagnose an addiction than it is to diagnose bipolar disorder. People who have a history of episodes prior to their drug use are more likely to recognize the underlying mental health issue. However, if the disorder developed as a result of an addiction, it can be harder to tell. If you think there is more to your addiction than drug use, you should gather more research on dual diagnosis. Click here to learn more about online therapy options for bipolar disorder and addiction.

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Published:

Author

Jeffrey Juergens

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  • Jeffrey Juergens earned his Bachelor’s and Juris Doctor from the University of Florida. Jeffrey’s desire to help others led him to focus on economic and social development and policy making. After graduation, he decided to pursue his passion of writing and editing. Jeffrey’s mission is to educate and inform the public on addiction issues and help those in need of treatment find the best option for them.

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Reviewed by Certified Addiction Professional:

David Hampton

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  • A survivor of addiction himself, David Hampton is a Certified Professional Recovery Coach (CPRC) and a member of the National Association of Alcohol and Drug Abuse Counselors (NAADAC).

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