Bipolar and Addiction Treatment at Crestone
Effective treatment for people with bipolar disorder and co-occurring substance abuse issues requires a comprehensive approach that addresses both conditions simultaneously. Bipolar disorder, characterized by extreme mood swings from manic highs to depressive lows, often coexists with substance abuse, as people may self-medicate to manage their symptoms.[1]
Treatment typically involves a combination of medication, therapy, and support groups tailored to stabilize mood fluctuations while addressing addictive behaviors, promoting long-term recovery and improved quality of life. Integrated treatment approaches offer personalized strategies to manage both conditions concurrently.
- Bipolar disorder involves extreme mood swings between highs (mania or hypomania) and lows (depression), impacting daily functioning with symptoms like heightened energy or sadness.
- People with bipolar disorder have a higher risk of substance abuse due to self-medication attempts, impulsivity, and shared genetic/environmental factors. Substance abuse can worsen bipolar symptoms and treatment effectiveness.
- Supporting someone with both disorders requires empathy, understanding, and encouragement for professional help. Treatment options include various therapies to address both disorders concurrently.
What Is Bipolar Disorder?
Bipolar disorder, previously known as manic depression, is a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). These mood shifts can be intense and disruptive, affecting your ability to function in daily life.[2] Manic episodes may involve heightened energy and impulsive behavior, while depressive episodes can lead to feelings of sadness, hopelessness, and low energy.[3]
In addition to manic and depressive episodes, people with bipolar disorder may experience other symptoms that impact their mood, behavior, and cognition. These can include changes in sleep patterns, such as insomnia or oversleeping, changes in appetite or weight, difficulty concentrating, irritability, agitation, and feelings of guilt or worthlessness.[4] Some people may also experience psychosis, which involves experiencing delusions or hallucinations during severe manic or depressive episodes.[5]
It’s important to note that the severity and frequency of symptoms can vary widely among those with bipolar disorder, and not everyone will experience the same combination of symptoms.
How Bipolar Disorder and Drug Abuse Can Interact
People with bipolar disorder are at an increased risk of developing substance abuse issues compared to the general population.[6] This heightened vulnerability stems from several factors, including attempts to self-medicate mood swings, impulsivity during manic episodes leading to risky behaviors like substance abuse, and shared genetic and environmental risk factors between bipolar disorder and addiction.
The relationship between substance abuse and bipolar disorder is complex: on the one hand, substance abuse can exacerbate symptoms of bipolar disorder, triggering mood episodes and making it more challenging to manage the condition effectively. On the other hand, the presence of bipolar disorder (or other mood disorders) can also contribute to an increased likelihood of developing substance abuse problems as people may turn to drugs or alcohol as a way to cope with the intense mood swings and emotional distress associated with the disorder.
Additionally, substance abuse can complicate the course of treatment for bipolar disorder by interfering with the effectiveness of medications and therapy. Drugs and alcohol can interact with mood-stabilizing medications, leading to unpredictable reactions or reducing their efficacy.[7] This can result in difficulties achieving mood stability and increasing the risk of relapse or worsening symptoms.
Dual Diagnosis Addiction
Can Drugs Cause Bipolar Disorder?
While drugs themselves do not directly cause bipolar disorder, substance abuse can sometimes trigger the onset of bipolar symptoms in those who are predisposed to the disorder due to genetic or environmental factors. Some research suggests that certain substances, particularly stimulants like cocaine or amphetamines, can induce manic or hypomanic episodes in people with or without a predisposition to bipolar disorder.[8] These substances can disrupt the balance of neurotransmitters in the brain, leading to mood disturbances characteristic of bipolar disorder.
Furthermore, substance abuse can exacerbate underlying mood instability and increase the severity and frequency of mood episodes in people already diagnosed with bipolar disorder.[9] Drugs and alcohol can interfere with the effectiveness of mood-stabilizing medications and disrupt the delicate balance of neurotransmitters involved in mood regulation, making it more challenging to manage the symptoms of bipolar disorder effectively.
How To Help Someone With Drug Addiction and Bipolar Disorder
Supporting a loved one grappling with both bipolar disorder and addiction can feel challenging. Try to take the initiative to better understand the complexities of these co-occurring conditions, their unique obstacles, and the available treatment modalities. Approach your loved one with empathy, demonstrating understanding and compassion rather than resorting to criticism or lectures, which may only push them away. Express genuine concern for their well-being and encourage them to seek professional treatment that addresses both their addiction and bipolar disorder concurrently.
While providing support is crucial, it’s also important to recognize the toll it can take on your own mental and emotional well-being. Enlist the help of others, establish boundaries when necessary, and prioritize self-care to maintain your own resilience. Acknowledge that recovery is an ongoing process, and setbacks are a natural part of the journey. With your own support network in place, you can play a vital role in guiding your loved one toward healing.
What Are the Treatments Available for Bipolar Disorder and Substance Abuse Issues?
If you’re struggling with the symptoms of bipolar disorder and addiction, there are numerous treatment programs and evidence-based modalities that can provide enduring support and facilitate healing:
Frequently Asked Questions About Bipolar and Substance Use Disorders
Are there different kinds of bipolar disorder?
Yes, there are several types of bipolar disorder, each characterized by distinct patterns of mood episodes. The primary types include:
- Bipolar I Disorder: This type involves manic episodes that last at least seven days or are severe enough to require immediate hospital care. Depressive episodes often occur as well, typically lasting at least two weeks. Some people may experience mixed episodes, where symptoms of both mania and depression occur simultaneously.
- Bipolar II Disorder: In this type, people experience both depressive and hypomanic episodes. Hypomanic episodes are similar to manic episodes but less severe. While they may not cause significant impairment in functioning, they are still noticeable to others. Depressive episodes are similar to those seen in Bipolar I disorder.
- Cyclothymic Disorder (Cyclothymia): Cyclothymia is characterized by numerous periods of hypomanic symptoms as well as numerous periods of depressive symptoms lasting for at least two years (one year in children and adolescents). However, the symptoms do not meet the criteria for a hypomanic episode and a depressive episode.
How does substance abuse affect the course and severity of bipolar disorder symptoms?
Substance abuse can exacerbate the symptoms of bipolar disorder, leading to more frequent and intense mood swings. It can also interfere with the effectiveness of medication and make it harder to stabilize mood fluctuations. Additionally, substance abuse may increase the risk of experiencing psychotic episodes and suicidal thoughts in individuals with bipolar disorder.
Is there a higher risk of relapse in individuals with bipolar disorder and addiction compared to those with just one condition?
Yes, individuals with co-occurring bipolar disorder and addiction often face a higher risk of relapse compared to those with only one condition. The complexities of managing both disorders simultaneously, along with the potential for substance abuse to trigger mood episodes, contribute to this increased risk. Ongoing support and comprehensive treatment strategies are crucial to reducing the likelihood of relapse in this population.
How long does treatment typically last for someone with co-occurring bipolar disorder and addiction?
The duration of treatment for co-occurring bipolar disorder and addiction varies depending on individual needs and treatment response. While some people may require short-term intensive treatment, others may benefit from longer-term care and ongoing support to maintain recovery and manage symptoms effectively.
Sources
[1] National Institute of Mental Health. (2024, February). Bipolar Disorder. National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/bipolar-disorder#:~:text=Bipolar%20disorder%20 on June 10, 2024
[2] Mayo Clinic. (2022, December 13). Bipolar Disorder. Mayo Clinic; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955 on June 10, 2024
[3] Cleveland Clinic. (2022, April 12). Bipolar Disorder (Manic-Depressive Disorder) | Cleveland Clinic. Cleveland Clinic; Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9294-bipolar-disorder on June 10, 2024
[4] SAMHSA. (2023, April 24). Bipolar disorder. Www.samhsa.gov. https://www.samhsa.gov/mental-health/bipolar on June 10, 2024
[5] Chakrabarti, S., & Singh, N. (2022). Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World Journal of Psychiatry, 12(9), 1204–1232. https://doi.org/10.5498/wjp.v12.i9.1204 on June 10, 2024
[6] Preuss, U. W., Schaefer, M., Born, C., & Grunze, H. (2021). Bipolar Disorder and Comorbid Use of Illicit Substances. Medicina, 57(11), 1256. https://doi.org/10.3390/medicina57111256 on June 10, 2024
[7] Treating Substance Use Disorder in Older Adults UPDATED 2020 TREATMENT IMPROVEMENT PROTOCOL TIP 26. (n.d.). https://store.samhsa.gov/sites/default/files/tip-26-pep20-02-01-011.pdf on June 10, 2024
[8] Young, J. W., & Dulcis, D. (2015). Investigating the mechanism(s) underlying switching between states in bipolar disorder. European Journal of Pharmacology, 759, 151–162. https://doi.org/10.1016/j.ejphar.2015.03.019 on June 10, 2024
[9] Quello, S. B., Brady, K. T., & Sonne, S. C. (2005). Mood disorders and substance use disorder: a complex comorbidity. Science & Practice Perspectives, 3(1), 13–21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/ on June 10, 2024
