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Bipolar Disorder and Drug Addiction: Where Does One End and the Other Begin?

Bipolar disorder, which used to be called manic depression, is a serious psychological disorder characterized by sudden and intense shifts in mood, behavior as well as energy levels.

There are four major types of mood episodes that constitute bipolar disorder: mania, hypomania, depression and mixed episodes; each has its own set of symptoms:

Symptoms of Mania

  • Moments of tremendous optimism and significant pessimism
  • Grandiose feelings
  • Rapid talking
  • Little sleep
  • Impaired judgment, irrational behavior
  • Delusional behavior
  • Hallucinations

Symptoms of Hypomania

  • Higher than usual levels of happiness, irritability or energy
  • A feeling that you’re capable of taking on more responsibility
  • Feeling like you need less sleep
  • You seem more talkative or sociable to others
  • You are prone to engage in risk-taking behaviors, like substance abuse

Symptoms of Depression

  • Feelings of hopelessness
  • Loss of interest in things that used to make you happy
  • Fatigue
  • Changes in appetite – eating more or eating less
  • Self-loathing
  • Suicidal thoughts

Description of Mixed Episodes

When it comes to bipolar disorder, the medical term mixed episode refers to a situation in which the individual experiences and displays behaviors of both mania and depression, in tandem. An example of a mixed episode is when someone with bipolar disorder might be experiencing suicidal feelings and a loss of interest in daily activities or hobbies (signs of depression), while at the same time have racing thoughts, rapid speech, and a lack of sleep (symptoms of mania).

Bipolar Disorder and Drug Addiction: Where Does One End and the Other Begin?

Substance abuse and bipolar disorder pose risks to a person’s physical and emotional well-being. People with bipolar disorder tend to have a higher incidence of relationship turmoil, financial problems and instability, suffer accidental injuries more often, and have a higher rate of suicide than the general population. And, they are also considerably more likely to acquire an alcohol addiction or other drug addiction.

According to statistics presented by the American Journal of Managed Care:

  • Approximately 56% of participants with bipolar in a national study reported having experienced drug addiction during their lifetime.
  • About 46% of that group had abused alcohol, specifically, or were alcohol-addicted.
  • And 41% had abused other drugs or were actually addicted.
  • Alcohol is the most common substance of abuse among people with bipolar.

Bipolar Disorder and Drug Addiction: Co-Occurring Disorders

There explanation for the high rate of substance abuse and chemical dependence among bipolar individuals is a complicated, multi-layered one.


The symptoms of bipolar disorder such as anxiety, pain, depression and sleeplessness are so uncomfortable and pervasive that many people with bipolar disorder turn to drugs and alcohol as a means of self-soothing and to ease their discomfort, if only temporarily.

Ironically, as the National Institute of Mental Health notes, alcohol use and other drug use may actually trigger depressed or manic moods in people with bipolar disorder.

Age and gender

A person’s age and gender are now thought to play a part when it comes to bipolar disorder and addiction. The journal Bipolar Disorder reports that substance abuse is more prevalent in young males than in any other population. That is, young men are more likely to take risks or to act on self-destructive impulses than their female or older male counterparts.

Brain Chemistry

Clinical researchers also believe that brain chemistry can influence the development of both bipolar disorder and substance abuse. People with bipolar disorder often have abnormal levels of serotonin, dopamine and norepinephrine when compared to their healthy cohorts. These brain chemicals are responsible for mood and emotions and heavy drug use can interfere with the way your brain processes them, leading to emotional instability, inconsistent energy levels, and depression. Again, people with bipolar disorder may turn to drugs and alcohol as a way to self-treat and stabilize their moods, even if on a subconscious level. And, again, this has the unfortunate and ironic effect of making their symptoms of bipolar disorder worse.

Bipolar Disorder and Drug Addiction: Dual Diagnosis Treatment

In the past, bipolar disorder and substance use disorder, such as chemical dependence and addiction, were addressed as separate medical conditions and therefore required treatment at separate facilities. So, for example, people who were diagnosed with a mental illness, such as bipolar disorder, were referred to psych wards or mental health treatment centers, while those who were in active substance abuse or addiction were sent to drug and alcohol rehab.

Today, addiction professionals as well as many mental health professionals realize the need, importance, and benefit of treating mental illness and substance abuse at the same time in a process called “integrated treatment.” Integrated treatment programs are known as dual diagnosis treatment facilities and they focus on treating the individual as a whole, making sure to treat all medical conditions – physical and psychological – simultaneously for the best treatment outcomes.

Are you struggling with mental illness and substance abuse? You’re not alone. Many people struggle with both and it’s important for you to realize that, although mental illness isn’t as easy to detect as say a physical ailment, it’s just as real, and just as serious. The Orchid Recovery Center is an alcohol and drug rehab center that specializes in dual diagnosis treatment of women. Please call us today at toll-free 1-800-777-9588.

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