Bipolar Disorder
Bipolar Disorder and Addiction
Bipolar disorder is of interest when discussing alcohol and drug abuse because bipolar disorder and alcoholism are present in the same person at a much higher rate than would be expected by chance. In general, people with psychiatric disorders commonly engage in substance abuse. Many studies show that those with bipolar disorder are the most likely to also suffer from substance abuse.
It is estimated that between 30 and 70 percent of the individuals who suffer from this disorder also are affected by substance use disorder. The term dual diagnosis, also referred to as co-occurring disorders, refers to when someone simultaneously has a mental illness and substance use disorder. Therefore, dual diagnosis is a term used when someone has bipolar disorder and suffers from addiction or alcoholism.
What Is Bipolar Disorder?
Bipolar disorder is a mood disorder. It used to be referred to as manic depression. As the name indicates, individuals affected most often have mood swings that range from severe depression to mania (excitability, euphoria). These periods can last from days to weeks to months. There may also be periods when a person’s mood is normal. Both men and women are affected by bipolar disorder symptoms. Age can vary, but the disorder often first appears when the individual is between 15 and 25 years of age.
A Person Who is Bipolar May Exhibit Some or All of the Following Symptoms:
During Mania:
- Rapid speech, excessively talkative
- More energetic than usual; increased mental and physical activity
- Difficulty controlling fast, continuous thought processes
- Sudden ambitions or plans that are quite grand and may exceed expectation and ability
- The ability to sleep fewer hours without feeling tired
- Extremes of agitated moods from overly happy to overly angry or irritable
- Unusually comfortable or interested in excessive risk-taking
- Unusually impulsive. This may be exhibited in many different ways, such as through shopping, sex, alcohol, drugs, etc.
On the other hand, during periods of depression, a person may exhibit some or all of the following symptoms:
- Overly tired, less energy
- Less active
- Less talkative
- Sadness that lasts longer than normal
- Excessive anxiety, overly worried
- Decreased or increased appetite
- Feelings of hopelessness, thoughts of suicide
- Difficulty concentrating, inability to make decisions
- Loss of interest in normal activities
- Restless, irritable
- Feelings of guilt
- Sleeping too much, sleeping too little
The precise cause of bipolar disorder is unknown, but there appears to be a genetic link in many individuals.
Two types of bipolar disorder have been identified:
(1) Type 1 – characterized by at least one manic episode and periods of severe depression.
(2) Type 2 – periods of what is known as hypomania, increased energy, and impulsiveness, but not to the extreme as that of true mania. This is interspersed with periods of major depression.
Sometimes an additional category called cyclothymia is included. Cyclothymia is a mild form of bipolar disorder and is different from Type 2 only in that the individual suffers from mild depression, not severe depression.
It often occurs that Type 2 individuals and those with cyclothymia are misdiagnosed as having just depression.
So Why Is There a Link Between Bipolar Disorder and Alcohol/Drug Abuse?
Various theories have been put forward to explain this relationship. These theories generally fall into one of 3 categories:
(1) The two disorders just happen to coexist in the same person without a causative relationship between them. This is generally based on the theory that there is a genetic link. The two disorders occur at the same time in the same individual due to genetics.
(2) Substance abuse is the result of underlying mental illness, and drugs and alcohol are used as an attempt to self-medicate.
(3) Substance abuse may cause the mental illness.
Having bipolar disorder symptoms can be a lonely and isolating place, especially during times of depression. It is not a surprise then that a person with bipolar disorder symptoms may turn to alcohol and drugs to help cope with their intense feelings and pain. It is SO important that an individual with bipolar disorder AND a substance abuse problem get a proper diagnosis. Treating one without treating the other has exceptionally high failure rates. Therefore, if you or a loved one seek treatment for either, please be honest with your medical/psychiatric professionals.
It is equally important for medical/substance abuse professionals to get a very detailed history from their patients and be aware that substance use disorders and mental illnesses often present in the same person. Those with drug addiction or alcoholism are reluctant to tell someone they have a problem. Often, they have not even come to terms with it themselves.
It is also possible for the effects of drugs and alcohol to produce symptoms that look like mental disorders. Drugs and alcohol can also mask mental illness symptoms, making it difficult for a professional to properly diagnose someone using drugs or alcohol. Additionally, drug and alcohol abuse can cause or bring out mental disorders or worsen existing conditions. That’s why a medical professional needs to get a detailed history of the patient.
Regarding bipolar disorder specifically, drugs and alcohol can bring about its emergence at an earlier age, make already diagnosed people worse, and bring about rapid cycling. Substance abuse also increases the resistance of the disorder to treatment. An increased sensitivity to alcohol and drugs is also a characteristic of bipolar disorder. Mood can be affected with relatively low to moderate amounts of either.
Dual diagnosis treatment usually addresses the substance abuse problem first or more intensely. That’s because alcohol and drugs can have very negative interactions with the medications used to treat bipolar disease and can exacerbate bipolar disorder symptoms.
Also, individuals with substance abuse problems sometimes refuse to take their medication or forget to take their medication, so treatment for their bipolar disorder is not very successful until the substance abuse problem is addressed.
In Summary
Millions of people are affected by bipolar disorder. Many of these same individuals are also addicted to drugs and/or alcohol. Both of these disorders can make the other more severe, more challenging to diagnose, and more difficult to treat.
It’s difficult enough to recover from drug addiction and/or alcohol dependency, but to face bipolar disorder AND addiction is much more difficult. It is rare to overcome one without treating the other. The only way to effectively treat both conditions is through dual diagnosis treatment approach. Diagnosing both disorders and treating both disorders offers the only real solution.