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Bipolar Disorder and Addiction: Signs Symptoms and Treatment

Co-occurring disorders are extremely common when it comes to addiction. One of the most common mental health conditions to co-occur with addiction is bipolar disorder. According to research, among individuals with bipolar disorder, about 60% had a lifetime prevalence of substance abuse.[1]

Bipolar disorder is a mental health condition that causes emotional highs (mania or hypomania) and lows (depression). These highs and lows can be extreme, with episodes often lasting for a few days to several months. This can severely affect a person’s ability to think clearly, behave normally, and complete daily tasks.

While the exact cause of substance abuse among bipolar individuals is unknown, several theories surround the topic. Understanding how addiction can be triggered by bipolar disorder can help people prevent themselves from suffering from this comorbidity.

What are the Symptoms of Bipolar Disorder?

There are a few different types of bipolar disorder, each causing a variety of symptoms. 

Individuals with Bipolar I disorder have had at least one episode of mania followed by hypomania or a depressive episode. The mania experienced in Bipolar I is often accompanied by psychosis. 

Bipolar II disorder is a less severe form of Bipolar I. These individuals have never had a manic episode, but have experienced hypomania and a depressive episode. 

Lastly, Cyclothymic disorder is a form of bipolar that is characterized by intermittent highs and lows that have occurred over a period of two years in adults or at least one year in children and teenagers. 

Understanding the types of bipolar disorder requires being aware of the symptoms of mania, hypomania, and depressive episodes. The symptoms of mania or hypomania may include:

  • Being abnormally upbeat or jumpy 
  • Increased activity, energy, or agitation
  • Euphoria and exaggerated sense of self-confidence 
  • Decreased need for sleep 
  • Unusual talkativeness 
  • Racing thoughts 
  • Being easily distracted 
  • Poor decision-making that includes impulsivity, such as spending too much money, substance abuse, or being overly sexual 
  • Episodes of psychosis 

The symptoms of a depressive episode may include:

  • Feeling depressed or hopeless most of the time 
  • Feeling worthless 
  • Losing or gaining weight 
  • Restlessness
  • Insomnia or oversleeping 
  • Loss of interest or pleasure 
  • Feeling tired and fatigued most of the time 
  • Excessive feelings of guilt 
  • Lack of concentration 
  • Thoughts of death or suicide  

How is Bipolar Disorder Connected to Addiction?

The symptoms caused by bipolar disorder often lead to impulsive behaviors. During mania or hypomania, people tend to make quick and impulsive decisions based on how they are feeling at the moment. This can be extremely dangerous for them, as their uncomfortable emotions can lead them to engage in risky behaviors such as unsafe sex or substance abuse.

While mania can cause substance abuse, it can also cause individuals to become addicted to substances faster. This is because mania often leads to an inflated sense of self, making individuals believe that they cannot become addicted like other people around them. This causes them to overindulge in drugs or alcohol, leading to the quick development of addiction. 

Research has also found that bipolar disorder reduces the amount of gray matter in a person’s brain.[2] The areas of the brain with the greatest amounts of gray matter are responsible for impulse control and decision-making skills. When someone does not have enough gray matter, they become more susceptible to making impulsive decisions and becoming addicted to drugs or alcohol. 

How are Co-Occurring Substance Abuse and Bipolar Disorder Treated?

When treating any co-occurring disorders, both conditions must be addressed at the same time. If someone only received treatment for their addiction, the unmanaged symptoms of their bipolar disorder could cause them to relapse in the future.

Because both bipolar disorder and addiction are treated simultaneously, the first step is medical detox. Individuals must rid their bodies of substances and overcome withdrawal symptoms with the help of medications and evidence-based treatments before they can focus on the therapeutic aspects of recovery. 

Once medically detoxed, patients can begin medication management for their bipolar disorder. The types of medication used to treat this condition include:

  • Anticonvulsants
  • Antipsychotics
  • Mood stabilizers
  • Lithium 

While medication can help soothe the uncomfortable symptoms of bipolar disorder, it does not cure the condition. Patients still need to attend individual therapy and group counseling to learn to manage their symptoms and live their life free of substances. 

Some of the most common therapies used to treat bipolar disorder include:[3]

  • Cognitive-behavioral therapy (CBT)
  • Family-focused therapy (FFT)
  • Interpersonal and social rhythm therapy 
  • Dialectical behavior therapy (DBT)
  • Group psychoeducation 

In addition to therapy for bipolar disorder, patients will receive therapy for their substance use disorder. Common therapies that help treat addiction include:

  • Cognitive-behavioral therapy (CBT)
  • Contingency management (CM)
  • Motivational interviewing (MI)
  • The matrix model 
  • 12-step facilitation therapy 
  • Family behavior therapy 
  • Community reinforcement approach plus vouchers 

With the combination of medical detox, medical management, individual therapy, and group counseling, recovery from comorbid bipolar disorder and addiction is possible. 

Finding Help for Bipolar Disorder and Addiction 

If you or a loved one suffer from comorbid addiction and bipolar disorder, help is available. Dealing with the effects of these co-occurring disorders on your own is never easy. That is why Mandala Healing Center embraces individualized treatment planning and dual diagnosis recovery so we can help you or your loved one gain the tools you need to successfully recover from both conditions. 

Contact the Mandala Healing Center today to get started.