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Addressing Bipolar and Drug or Alcohol Abuse

Unfortunately, there is not a single explanation as to why substance abuse is so high among people who have bipolar disorder. A single idea for this phenomenon is that many turn to drugs and alcohol as a means for offsetting the discomfort. 

The National Institute of Mental Health explains that drinking and using drugs may trigger depressed or manic moods in someone with bipolar disorder. Studies also point to age and gender playing a role between bipolar and addiction. Substance abuse is commonly found in young males than in other population groups, and young men are more likely than their female counterparts to take dangerous risks or act on self-destructive impulses.

One in four adults with a mental illness also struggle with a substance use disorder, and clinical researchers believe that brain chemistry may influence both bipolar disorders and substance abuse. Bipolar disorder is the result of abnormal levels of serotonin, dopamine, and norepinephrine in the brain. These chemicals regulate vital functions such as appetite, metabolism, and how the body responds to stress. They also contribute to mood and emotion. People who have bipolar disorder may turn to drugs or alcohol out of an unconscious need to stabilize their moods. Over time, however, substance abuse will have the opposite effect making the symptoms much worse.

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What Is Bipolar Disorder?

Bipolar disorder is a severe illness that affects the brain. It has other names such as manic-depressive illness or manic depression. Those who struggle with bipolar disorder go through unusual and intense mood changes. There are days they will feel delighted and “up,” and are much more energetic and active than usual. This is defined as a manic episode, and sometimes people with bipolar will feel very sad and “down,” have low energy and are much less active. The depressed episode they experience is characterized as a depressive episode.

While everyday life is filled with routine ups and downs, people with bipolar deal with mood swings that are much more severe and extreme. The mood swings are often accompanied by changes in sleep, energy levels, and the ability to think or reason clearly. The symptoms are often so severe that they can damage relationships and make it extremely difficult to hold a job or go to school. Even worse, the symptoms have the potential to be dangerous. Some who struggle with the disorder will inflict self-harm, or attempt suicide. 

Types of Bipolar Disorder

  • Bipolar I – This is the classic type of bipolar, and it used to be known as manic depression. Patients would typically alternate between full-blown mania and depression, which causes a severe behavioral shift
  • Bipolar II – It is the less extreme, but more common version of the disorder. Depressive episodes alternate with hypomania, a milder version of manic. Those with hypomania are sometimes highly productive and function well.

Bipolar and DSM-5

People with bipolar disorder go through intense emotional changes that are very different from usual mood and behavior. In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), bipolar and related disorders are given a chapter on their own, between depressive disorders and schizophrenia spectrum disorders. These include bipolar I disorder, bipolar II, and cyclothymic disorder. The DSM-5 seems to concur with the idea that there has been an under-recognition of bipolar in our communities. 

Common Signs of Bipolar Disorder

It’s often difficult to pinpoint a mental illness because of the wide variety that exists, and bipolar is no exception to that observation. Here are some of the most common signs associated with bipolar disorder.:

Bipolar is characterized by its up-and-down episodes of mania and depression. During a manic phase, some people can break away from reality. Hypomania is a symptom of the disorder and is a high-energy state where the individual feels upbeat and hasn’t lost their grip on reality. It can be an enjoyable and creative state, and some view this as the upside of the disorder.

Having various half-completed projects is a staple of bipolar disorder. Those who harness their energy in a hypomanic phase can be productive, but those who can’t will jump from task to task never completing their grand ideas they thought up.

A person in a bipolar depressive state is going to appear in a way similar to someone with regular depression. Their energy, appetite, and sleep resemble someone with clinical depression, but antidepressants will not work well in those who are bipolar. The medications can make people cycle more often and worsen their conditions.

Many people will drink when they are in a manic phase to slow themselves down and use alcohol to improve their mood when they are down. Unfortunately, this is why such a high rate who are bipolar turn to drugs or alcohol as a means to self-medicate.

Causes of Mental Illness

Mental health professionals think there are many contributing factors to the onset of mental illness, and studies have shown that physical, social, environmental, and psychological issues are all present.

Biological Factors

Each genetic makeup can contribute to the risk of developing a mental health disorder. Trauma to the brain has been successfully correlated to the development of mental illness, which can lead to changes in the personality which trigger symptoms. Drug and alcohol abuse has also been shown to cause deficiencies of certain vitamins that are important in your diet.

Environmental Factors

When someone is living in conditions of extreme poverty, it can all cause high stress and put pressure on your mental health. These stresses can push someone into a mental breakdown and thus exacerbate mental illness and make symptoms worse.

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Treatment for Bipolar and Addiction

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 use disorder. Having a co-occurring disorder can present its own set of challenges when overcoming addiction.

People who have bipolar disorder can experience crippling bouts of depression, and emotional instability can interfere with the recovery program. Someone who cannot focus on their recovery because of their disorder will have a much more difficult time overcoming the obstacle, but that does not mean it is impossible.

Addiction professionals see the importance of treating both disorders together and call this integrated treatment. Integrated treatment implements many different strategies that help support your mental state.

The plan could include one-on-one psychotherapy with a mental health professional, counseling sessions with addiction specialists, dual diagnosis support groups, and family counseling. Treating your bipolar on its own is not enough if substance abuse is present. The only way to give you a chance to avoid relapse is to receive comprehensive care for both conditions. Cognitive behavioral therapy is a powerful and useful tool in dual diagnosis treatment because it teaches clients how to regulate their emotions and avoid being overwhelmed by dramatic mood changes. This is also a handy tool for treating addiction because it can change habits to pick up drugs or alcohol when you feel an urge.

Sources

National Alliance on Mental Health. (2017 August) Dual Diagnosis. How Is Dual Diagnosis Treated? Retrieved from https://www.nami.org/learn-more/mental-health-conditions/related-conditions/dual-diagnosis

National Institute on Mental Health. (2020 January) Bipolar Disorder. Retrieved from https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml

Psycom. (2019, November 25) Bipolar Definition and DSM-5 Diagnostic Criteria. Truschel, J. Retrieved from https://www.psycom.net/bipolar-definition-dsm-5/

PsychCentral. (2019 October 11) Hypomanic Episode Symptoms. Grohol, J. PsyD. Retrieved from https://psychcentral.com/disorders/hypomanic-episode-symptoms/

Psychiatric Times. (2018, September 27) Understanding and Treating Co-Occurring Bipolar Disorder and Substance Use Disorders. Ma, M., Coles, S. George, T. MD Retrieved from https://www.psychiatrictimes.com/bipolar-disorder/understanding-and-treating-co-occurring-bipolar-disorder-and-substance-use-disorders

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