Bipolar Disorder and Substance Abuse

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Bipolar Disorder and Substance Abuse
Statistics show that rates of substance abuse are higher among people with bipolar disorder than among the general population. Data from recent surveys show that about 40 percent of people with bipolar disorder have a co-occurring substance use disorder as well. When left untreated, bipolar disorder can increase the risk of poor life outcomes and injury. When combined with a co-occurring substance use disorder, these problems are exacerbated.


Let’s have a look at how substance abuse can affect bipolar disorder, what causes them to co-occur, and potential treatment options like inpatient treatment.

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Substance Abuse on Bipolar Disorder

Effects of Substance Abuse on Bipolar Disorder

During a manic episode, you experience elevated mood, due to which you feel haphazardly enthusiastic and make spur-of-the-moment decisions. Because of these symptoms, people with bipolar disorder have a higher likelihood of abusing alcohol and illicit substances. And because these substances can lower inhibition, they can worsen the symptoms of a manic episode.

Substance-Induced Bipolar Disorder

The category of bipolar and related disorders also includes a diagnosis of substance-induced bipolar disorder. It’s characterized by a persistently elevated, expansive, or irritable mood. In this case, there is evidence that the mood disturbance developed due to substance intoxication or withdrawal and that the involved substance is capable of causing the symptoms.


According to the fifth edition of the APA’s Diagnostic Statistical Manual of Mental Disorders, there are specifiers to determine whether the symptoms are caused by alcohol, sedatives, cocaine, amphetamine, or other substances. However, this is a different diagnosis from bipolar I or II, which don’t occur as a result of substance abuse.


When evaluating symptoms, practitioners at URP Behavioral Health determine whether symptoms occur exclusively due to the effects of substance intoxication or withdrawal. If they occur consistently, regardless of substance abuse, you can receive a dual diagnosis for co-occurring bipolar disorder and substance use disorder.

Substance Abuse as a Risk Factor for Bipolar Disorder

A research review involving 22 studies shows that substance use is a risk factor for developing bipolar disorder. Moreover, studies indicate that alcohol and illicit substances such as methamphetamine, cocaine, and heroin alter the prefrontal cortex. Substance abuse also reduces grey matter volume in key brain areas.


A similar finding was reported in a study involving clients with bipolar disorder. Therefore, researchers suspect that resulting changes in the brain’s chemistry and structure increase the risk of developing bipolar disorder.

Why Bipolar Disorder and Substance Use Disorder Co-Occur

One of the possible explanations for the co-occurrence is the self-medication hypothesis. It proposes that people with bipolar disorder use alcohol and illicit substances to alleviate emotional suffering. Also, the type of substance they take is specific to the emotional suffering they experience. Another theory is that they co-occur due to shared genetic factors that influence the risk for bipolar disorder and substance use disorder.

Treatment For Bipolar Disorder

Dual Diagnosis Treatment For Bipolar Disorder and Use Disorder

When you have a co-occurring bipolar disorder and substance use disorder, some symptoms can overlap. This makes it difficult to differentiate between the two disorders and determine which one you have. So, you’ll need to see a mental health practitioner who specializes in dual diagnoses. If you do receive a dual diagnosis for both conditions, you’ll need to seek treatment for bipolar disorder and substance use disorder. Ideally, you can enroll in a residential treatment program to recover from both disorders.


Before you can start the treatment process, you need to stop using the addictive substance with a detox. During the detox period, your healthcare providers will monitor you throughout the day for a whole week so you can wean off the substance and alleviate the effects of withdrawal.


Your mental healthcare provider will prescribe you medication to alleviate the effects of withdrawal and addiction. Medication for addiction treatment will reduce the intensity of cravings and subsequent withdrawal symptoms. The medication you’ll be prescribed will vary depending on the substance you’ve been taking.


Your psychiatrist will also prescribe mood stabilizers for your bipolar disorder. These can prevent mood disturbances, so you feel calmer and are more receptive to therapy. If you experience psychotic symptoms during manic episodes, your doctor will recommend antipsychotics as well.


Also known as talk therapy, this involves identifying and changing unhelpful thoughts and behaviors with help from a licensed practitioner. Over the course of these sessions, your therapist can adopt different approaches.


The most common is cognitive behavioral therapy, which is based on the concept that your thoughts, feelings, and behaviors are interconnected. That means certain thoughts and subsequent feelings result in manic symptoms and substance abuse. Therefore, changing the way you think can ultimately improve your behavior.


During these sessions, you’ll work with your therapist to identify what triggers your manic and depressive episodes. These could be certain events or situations, and how you feel about those events is what causes your behavior. Your therapist will help you develop coping strategies so you can respond to these feelings in a healthy way. They’ll also work on techniques that alleviate your manic symptoms and improve your functioning.

Inpatient Treatment

Inpatient treatment facilities offer holistic care for people with co-occurring bipolar disorder and substance use disorder. So, in addition to offering pharmacotherapy and psychotherapy, they also provide wellness treatments like meditation, therapeutic massage, and animal-assisted therapy. The purpose of such treatments is to promote relaxation and enhance a sense of well-being.


At the same time, you’ll stay in a comfortable facility equipped with various amenities, away from stressful situations and potential triggers. Amenities include balanced meals, private accommodation, fitness equipment, and recreational activities. After all, inpatient plans aren’t just designed to treat your disorder but to help you recover and improve your quality of life.


Bipolar disorder and substance use disorder can co-occur due to various reasons like self-medication or a genetic risk factor. Nevertheless, early diagnosis and treatment can increase your chances of positive outcomes. To make sure that you have a dual diagnosis, your mental health practitioner will determine whether you meet the criteria for both disorders. And with the right course of treatment, like an inpatient program, you heal in a calm environment that’s conducive to recovery.

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