Bipolar and Addiction

By May 18, 2018 No Comments

Mental health is a complex and often overlooked area of medicine and psychiatry which can have enormous ripple effects on the individual and their families. This blog looks at the interaction and treatment of bipolar conditions and addiction to drugs and alcohol.

However, please be under no illusion, this information is no substitute for professional diagnosis and treatment. This is a complex area of dual diagnosis where the symptoms of addiction and those of bipolar frequently mirror each other or are easily confused. Diagnosis and treatment is often a process.

If you suspect that you or one of your loved ones are suffering from addiction or bipolar, either together or separately, call in the experts. A solution starts with a proper diagnosis followed by a well-rounded and holistic treatment plan.


Dual Diagnosis

A dual diagnosis is the existence of two or more medical conditions diagnosed in a person at the same time. Consequently, in the field of drug and alcohol addiction treatment this can mean one of several things:

1) A substance abuse issue as well as a mental health condition

2) A problem with drugs or alcohol and a physical health condition

3) Drug and alcohol addiction and another addiction

Sometimes this area of medicine is also called co-morbidity or the client is referred to as having a co-occurring disorder. One of the most common mental health conditions which occur alongside addiction is bipolar disorder.

According to the National Alliance on Mental Illness in America, over 56 percent of people diagnosed with bipolar have a history of illicit drug abuse, while 44 percent have abused or are dependent on alcohol.


What is Bipolar Disorder?

Bipolar disorder is characterised by extreme changing moods and used to be referred to as manic depression. The client can display different forms of mania followed by periods of deep depression, there may also be significant changes in energy levels and the person’s ability to function may be significantly impaired.

There are different forms of bipolar. In brief, these are divided up as follows:

Bipolar I

This form of bipolar is the most extreme and people can experience rapid and severe mood swings from mania to depression. Typically the periods of depression last for at least two weeks. Additionally, the manic phases often leave the sufferer functionally impaired so that they must be hospitalised for their own safety.

Bipolar II

Bipolar II is characterized by less severe fluctuations between the polar emotional states. Depressive episodes sometimes last longer and are then replaced with periods of hypomania. Hypomania is a milder form of mania. While it is easier for the client to function with this disorder it can interfere with the normal activities of daily living.


This mood disorder manifests as milder depressive episodes and phases of hypomania.

Bipolar with mixed features

This form of bipolar means that the person experiences the mania and the depression at the same time or in quick succession. This often presents as elevated energy levels, sleeplessness, and appetite loss combined with feelings of despair, low self-worth, and sadness.

Rapid-cycling bipolar

This manifestation of the disorder is characterized by multiple, rapidly alternating episodes of mania and depression, usually at last four within a 12-month period.

All of these sorts of mood disturbance can be caused by different drugs or their subsequent withdrawal symptoms.

Defining a Substance misuse disorder

The gold standard when it comes to looking at diagnostic criteria for mental health is a weighty tomb called The “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition,” often called the DSM-V. As well as addressing bipolar it also lays out criteria for substance abuse which can, in reality, span a variety of degrees of severity.

These are some of the criteria listed:

  • Taking the substance in larger amounts or for longer than you’re meant to.
  • Wanting to cut down or stop using the substance but not managing to.
  • Spending a lot of time getting, using, or recovering from use of the substance.
  • Cravings and urges to use the substance.
  • Not managing to do what you should at work, home, or school because of substance use.
  • Continuing to use, even when it causes problems in relationships.
  • Giving up important social, occupational, or recreational activities because of substance use.
  • Using substances again and again, even when it puts you in danger.
  • Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.


Treatment for Addiction and Bipolar disorder

A stint in inpatient drug and alcohol rehab is the best way to address these co-occurring disorders. The first step is to detox from the drugs and alcohol because any diagnosis and treatment for suspected bipolar are not going to be accurate until this point. Any medicines prescribed for an already diagnosed bipolar condition will need constant review and adjustment to prevent the emergence of bipolar symptoms.

Having staff who monitor the client 24 hours a day really helps to assist in catching the symptoms early. Once clients are detoxed, doctors can better pinpoint which symptoms are drug induced and which ones result from a person’s bipolar condition. Likewise, this makes it easier for doctors to determine which medications will best treat a person’s bipolar condition.

As well as the use of medications, many of the holistic and therapeutic techniques used in drug and alcohol rehab also benefit bipolar. The idea is to heal the mind, body and spirit through a regular balanced daily schedule of group and individual therapy and other wellness activities.

One commonly used therapy is CBT which helps the client gain a new outlook on the situation by directly challenging negative thoughts and fears and teaching the individual how to control or get rid of them. Other very effective therapies include mindfulness-based cognitive behavioural therapy, behaviour activation therapy and interpersonal and social rhythms therapy.

There is no reason that with the right sort of help, these clients can achieve a sense of inner balance and create more satisfying, productive lives.


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