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 percent 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 can 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.
Imbalanced chemicals in the brain and genetics 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 four types of episodes people with bipolar disorder may experience. They include:
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.
There are only subtle differences between a hypomanic and manic episode. The main difference is that hypomanic episodes are shorter, lasting at least four 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 two weeks to meet the clinical definition of an episode.
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 defines bipolar disorder in two categories. These categories are bipolar I and bipolar II disorder.
People with bipolar I disorder experience one or more manic/mixed episodes followed by a major depressive episode. Those with bipolar II disorder have one or more major depressive episodes followed by a hypomanic episode. Bipolar I disorder is more severe than bipolar II disorder.
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.
Substance-Induced Bipolar Disorder
Frequent drug use causes physical changes in the brain. The most obvious change is to the brain reward system, which makes using drugs feel pleasurable. However, changes in the brain reward system lead to compulsive, drug-seeking behavior.
Even people who were mentally healthy before their addiction can develop bipolar disorder.
Drugs can also 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.
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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
- 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
- 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 two 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. Addicted people with 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:
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 a Dual Diagnosis
By comparison, it is easier to diagnose an addiction than bipolar disorder. People who had a history of episodes prior to their drug use are more likely to recognize the underlying issue. But if bipolar disorder developed as a result of an addiction, it can be harder to tell.
The best treatment centers in the country have expertise making dual diagnoses. If you think there is more to your addiction than drug use, you should see an expert in dual diagnosis.
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