Bipolar disorder, once commonly known as manic depression, is a serious mental disorder that is characterized by sudden and intense shifts in mood, behavior and energy levels.
Like substance abuse, bipolar disorder poses a risk to the individual’s physical and emotional well-being. Those afflicted with bipolar disorder have a higher rate of relationship problems, economic instability, accidental injuries and suicide than the general population. They are also significantly more likely to develop an addiction to drugs or alcohol.
According to statistics presented by the American Journal of Managed Care:
- About 56 percent of individuals with bipolar who participated in a national study had experienced drug or alcohol addiction during their lifetime.
- Approximately 46 percent of that group had abused alcohol or were addicted to alcohol.
- About 41 percent had abused drugs or were addicted to drugs.
- Alcohol is the most commonly abused substance among bipolar individuals.
If you are struggling with bipolar disorder and with a drug or alcohol problem, you may have a Dual Diagnosis of bipolar disorder and substance abuse. Having a Dual Diagnosis, or a co-occurring disorder, can make recovery more challenging. Bipolar individuals may experience periods of intense depression alternating with episodes of heightened activity and an exaggerated sense of self-importance. This emotional instability can interfere with your recovery program, making it difficult to comply with the guidelines of your treatment plan.
Dual Diagnosis rehabilitation programs are designed to meet the needs of clients who are faced with this complex psychiatric condition. Staffed by specially trained and credentialed mental health professionals and addiction specialists, these centers offer care that integrates the best treatment strategies for bipolar disorder with the most effective treatments for addiction.
How Are Bipolar and Addiction Related?
There is no easy explanation for the high rate of substance abuse and chemical dependence among bipolar individuals. One reason for this phenomenon is that a large percentage of individuals attempt to self-medicate with drugs and alcohol in an effort to numb the painful symptoms of their bipolar disorder.
Symptoms of bipolar disorder such as anxiety, pain, depression and sleeplessness are so alarming, that many individuals will turn to drugs and alcohol as a means for offsetting the discomfort, if only for a little while. On the other hand, the National Institute of Mental Health notes that drinking and using drugs may trigger depressed or manic moods in someone with bipolar disorder.
Age and gender may play a part in the relationship between bipolar and addiction. According to the journal Bipolar Disorder, substance abuse is more common in young males than in other population groups. Young men are more likely than females or older men to take dangerous risks or to act on serious self-destructive impulses. In elderly individuals with bipolar disorder, the incidence of substance abuse is much lower.
Clinical researchers believe that brain chemistry may influence both bipolar disorder and substance abuse. People with bipolar disorder often have abnormal levels of serotonin, dopamine and norepinephrine, according to WebMD. These chemicals affect vital functions like appetite, metabolism, sleep and your body’s response to stress. They also affect mood and emotions.
Heavy use of drugs or alcohol can interfere with the way your brain processes these chemicals, causing emotional instability, erratic energy levels and depression.
Symptoms of Bipolar Disorder
We all go through intense episodes of sadness, elation, anger or despair. But for someone who meets the diagnostic criteria for bipolar disorder, these episodes are all-consuming and uncontrollable. There are four major types of mood episodes that characterize bipolar disorder: mania, hypomania, depression and mixed episodes — each of which has a set of unique symptoms:
Treatment for Bipolar and Addiction
In the past, bipolar disorder and chemical dependence were addressed as separate conditions and treated at separate facilities. People who were diagnosed with bipolar disorder were referred to mental health treatment centers or psychiatric hospitals, while those who were actively abusing drugs and alcohol were sent to rehab.
Today, addiction professionals recognize the importance of treating bipolar disorder and substance abuse at the same time through a process called “integrated treatment.”
Integrated treatment encompasses a number of different treatment strategies. Your treatment plan might include one-on-one psychotherapy with a mental health professional, counseling sessions with addiction specialists, Dual Diagnosis support groups, family counseling and holistic therapy.
Features of an integrated program for bipolar disorder and addiction include:
- Centralized care provided in a single rehabilitation facility
- A collaborative treatment team that includes psychologists, addiction counselors, and other professionals trained in Dual Diagnosis care
- Individual psychotherapy that focuses on managing your emotions and minimizing the risk of substance abuse
- Psychiatric medication to help you handle the ups and downs of bipolar disorder
- Peer group support from others who are battling addiction and a mood disorder
It’s not enough to treat bipolar disorder without addressing the problem of substance abuse, and vice versa. Unless you receive comprehensive care for both conditions, your chances of relapse are high. Relapse prevention strategies for an individual with bipolar disorder must include coping skills for managing the psychological and emotional triggers for substance abuse.
Therapeutic approaches like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) have proven useful in teaching Dual Diagnosis patients how to regulate their emotions and avoid being overwhelmed by dramatic mood changes.
Group support is crucial to recovery when you have a Dual Diagnosis of bipolar disorder and a substance use disorder. In peer group support meetings and counseling sessions, you’ll learn about the common triggers and risk factors that people with bipolar disorder face in recovery. You’ll have the opportunity to share your experiences with others and to acquire new coping strategies from your peers.
In dual diagnosis treatment centers, the importance of psychotherapeutic medication in treating bipolar disorder is widely acknowledged. Mood-stabilizing medications may be used in combination with antipsychotic drugs or antidepressants to provide complete support for your recovery goals.
Challenges to Recovery
Addiction professionals face a number of challenges when it comes to treating bipolar patients with addiction issues. For one thing, many of the symptoms of bipolar disorder are similar to those of drug and alcohol abuse. Therefore, if a person does seek out professional help, it is difficult to see where the mental disorder stops and the addiction begins.
Also, even the most well-meaning drug rehab programs are likely to be unable to identify the concurrent bipolar disorder that a patient is experiencing. Many do not get the help they need and are asked to leave the rehab program because they are not responding to the traditional forms of treatment.
During a depressive episode, for instance, a lack of motivation or low energy levels can interfere with treatment plans. In a manic state, rehab clients may appear to be unfocused, overly talkative, impatient, aggressive or grandiose.
The U.S. Department of Health and Human Services emphasizes that treatment for co-occurring disorders should proceed at the individual’s own pace, and that the treatment plan must be evaluated and modified to meet the Dual Diagnosis patient’s unique needs.
Facilities that specialize in Dual Diagnosis treatment understand the overlapping nature of bipolar disorder and substance abuse. These dedicated treatment centers can provide appropriate treatment at a pace better suited for the person with bipolar disorder.
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