Bipolar and Addiction

Bipolar and Addiction

Bipolar disorder is a psychological illness that affects the way you think, feel and behave. Also known as “manic depression,” bipolar is characterized by fluctuations in mood and energy levels. While it’s normal to experience changes in your emotional states, a person with bipolar disorder suffers from unmanageable mood swings that can affect his or her relationships, career and physical health. Mania, a high-energy state, may increase risk-taking behavior, while depression can inspire suicidal thoughts. Substance abuse affects up to 60 percent of people who have bipolar disorder, according to the journal Bipolar Disorders.

In order for you to achieve a full, rewarding life in recovery, both bipolar disorder and substance abuse must be addressed in rehab. Co-occurring disorders require a multi-disciplinary approach to treatment that helps you achieve stability and health in mind and body.

Warning Signs

The patterns of bipolar disorder vary from one person to another, and it’s not always easy to recognize this condition. You may have milder high-energy states, known as “hypomania,” alternating with occasional bouts of depression. Or you may have intense, dangerous manic episodes followed by a crash into deep despair. You may go for weeks or months without having any bipolar symptoms, or you may be afflicted with strong mood swings several times a day. Bipolar disorder may also be accompanied by generalized anxiety disorder, attention deficit disorder or obsessive-compulsive disorder, or by physical conditions like obesity or asthma. Symptoms of mania include:

  • An extended period of feeling unusually happy, emotionally high or energetic
  • A long period of feeling overly irritable, agitated or jumpy
  • Restlessness
  • Loss of appetite
  • Inability to sleep
  • Impulsive behavior, such as going on a shopping spree
  • Risk-taking behavior, such as unprotected sex, drug or alcohol abuse

Hypomania is often characterized by a higher than usual level of energy or activity. When you’re manic or hypomanic, you may feel that you’re functioning very well and getting a lot done; in fact, you may not feel that you have a problem at all.

According to the National Association for Mental Illness (NAMI), about 50 percent of people who develop bipolar disorder start with a depressive episode, and for most bipolar individuals, depression lasts longer and is more frequent than manic or hypomanic periods. Watch for these warning signs of a depressive state:

  • Feelings of hopelessness, worthlessness or despair
  • Absence of pleasure in activities you usually enjoy
  • Sleeping too much or too little
  • Unwanted weight loss or gain
  • Suicidal thoughts or attempted suicide
  • Drinking or using drugs to relieve sadness

The National Institute of Mental Health (NIMH) cautions that you may be having a bipolar episode if you have symptoms of mania or depression daily or almost daily for seven to 14 days. But not all treatment centers offer specialized treatment for bipolar disorder as well as substance abuse. If you have frequent mood swings or you feel that your emotional states are driving your substance abuse, it’s crucial to seek help from a treatment center that specializes in co-occurring conditions.

Substance Abuse

Addiction and bipolar disorder often overlap; in fact, many of the symptoms of chemical dependence resemble bipolar disorder, and vice versa. If you have bipolar disorder and you haven’t been diagnosed or effectively treated, you may use drugs or alcohol to try to regulate your own moods. When you’re feeling agitated, irritable or jubilantly energetic, you may use alcohol to calm yourself down. When you’re depressed, you may drink to mask feelings of hopelessness or take stimulants like meth or cocaine to bring yourself back to an energy level that allows you to function. Ultimately, these drugs only worsen the unpredictable emotional states of bipolar disorder and make it harder to function in your daily life.

The Journal of Clinical Psychiatry reports that people who suffer from bipolar disorder and a substance use issue may have more extreme symptoms and may experience those symptoms earlier in life than people who don’t abuse drugs or alcohol. If you have a Dual Diagnosis of bipolar disorder and an addiction, you may be more likely to experience symptoms such as:

  • Irritable or agitated moods
  • Depressed (“dysphoric”) moods
  • Resistance to therapeutic help
  • A more frequent need for hospitalization

Suicide attempts and intentional self-injury are common in bipolar individuals during episodes of depression, especially if a low mood is accompanied by alcohol or drug use. During a manic period, high-risk behaviors like using illicit drugs, driving under the influence and participating in drug-related crimes are more common.


If you have a Dual Diagnosis, you may feel that your moods and your chemical dependence are controlling your life. No matter how much you may want to achieve a stable, sober state of mind, your co-occurring conditions may make it seem impossible. At an integrated drug rehab program, therapists or psychiatrists are available to help you manage your moods with intensive counseling, group therapy and medication. At the same time, addiction specialists can help you identify the emotional patterns and negative behaviors that keep you stuck in a cycle of substance abuse.

Bipolar disorder can make recovery from drug or alcohol addiction even more challenging. Some of the hurdles that bipolar patients face during drug rehab include:

  • Low motivation to participate during depressive episodes
  • Edginess and irritability during manic periods
  • Resistance to complying with prescription medications
  • Lack of financial resources or transportation due to underemployment

The National Institute on Alcohol Abuse and Alcoholism notes that bipolar patients who go through drug rehab need individualized counseling and education about the relationship between bipolar disorder and substance abuse. They may need pharmacotherapy to manage cravings for drugs or alcohol, along with mood-stabilizing medications to regulate emotional states. Family members require therapy and counseling to help them understand the complicated, destructive relationship between substance abuse and bipolar disorder.

Bipolar disorder is a complex illness that often goes hand in hand with other medical or psychological disorders. Identifying the best way to treat your psychological symptoms and your chemical dependence requires experience, sensitivity and compassion. The Canyon specializes in providing integrated, holistic recovery solutions for those who suffer from co-occurring conditions like bipolar disorder. Contact our intake counselors for information about how you can start looking forward to a healthy, rewarding future.

Further Reading