Recovering from addiction is challenging enough without having to deal with the symptoms of another mental health diagnosis. Unfortunately, this is the reality for many people living with addiction. One mental health condition that is especially prevalent in individuals with substance use disorder (SUD) is bipolar disorder. 

The Symptoms of Bipolar Disorder

Bipolar disorder is characterized by extreme changes in mood and energy. These changes fall into the two categories of depression and mania. Bipolar disorder was previously known as manic depression because of this. Distinct symptoms characterize mania and depression.

Manic Symptoms

Mania is a high-energy state that exists on one end of the bipolar spectrum. It presents with the following symptoms:

  • Feelings of extreme happiness or irritability
  • Having more energy
  • Able to get by on less sleep
  • Taking on multiple tasks or projects at once
  • Having a sudden sense of being very important or powerful
  • Demonstrating hypersexuality
  • Engaging in more substance use
  • Speaking excessively and quickly
  • Feeling like your thoughts are racing
  • Spending significant amounts of money unnecessarily
  • Engaging in risky or impulsive behavior

Depressive Symptoms

Depression, on the other hand, is a low-energy state. It presents with the following symptoms:

  • Experiencing sadness or apathy
  • Difficulties with sleep that can involve excessive sleeping or trouble getting to and staying asleep
  • Inability to perform everyday tasks
  • Having a sense of worthlessness, hopelessness, or guilt
  • Losing interest in activities that were once enjoyable
  • Difficulty with concentrating or focusing
  • Issues with memory
  • Feeling like you are moving and talking slowly

There are different forms of bipolar disorder that have different presentations of mania and depression. You might be more familiar with bipolar I disorder. In this condition, a period of at least seven days of mania is followed by about two weeks of depression. For an episode of mania to be identified, symptoms need to be present the majority of each day during that period. Sometimes hospitalization is necessary during mania because of risky behavior creating dangerous situations. Mania generally impairs a person’s functioning at work and school and in their relationships. 

Another form of bipolar disorder is bipolar II disorder. This is different from bipolar II disorder because of the presence of hypomania instead of mania. Hypomania has similar symptoms to mania, but it is less severe and generally does not require hospitalization. It might not even cause any impairment in functioning. This can actually look closer to an elevated mood and increased productivity that is then disrupted by depression. The depression in bipolar II disorder is very similar to that of bipolar I disorder.

Why Does Bipolar Disorder Occur Alongside Addiction?

It is common to experience substance abuse alongside other mental health conditions, like depression or anxiety. These conditions share similar risk factors, origins, and symptoms. One condition that is especially common as a comorbid disorder is bipolar disorder. Between 30 to 50% of individuals living with bipolar disorder will develop an addiction at some point in their lives. 

One theory that connects these two conditions has to do with the idea of self-medicating. Bipolar disorder causes extreme highs and lows that create incredible disruption in a person’s life. Using drugs and alcohol can provide temporary relief from these symptoms. When someone is in the midst of a depressive episode, some substances can elevate mood and provide more energy. On the other hand, during a manic episode, certain substances can bring a person’s energy down and provide a calming effect. This self-medicating only provides temporary relief and creates severe issues in the long run as a person becomes dependent on the substances for everyday functioning. 

Substance use may also exacerbate symptoms for some people, creating more intense depression or mania. If someone struggles with addiction alongside bipolar disorder, they are more likely to experience suicide attempts and hospitalization than their peers with only bipolar disorder. This can create a cycle that is hard to escape from. Other theories posit that substance abuse and bipolar disorder are commonly comorbid because of shared neurological and genetic origins. While bipolar disorder often leads to substance abuse, substance abuse can also precede bipolar disorder.

Treating Co-occurring Disorders

Recovery can be challenging when someone has comorbid addiction and bipolar disorder because this population tends to have lower adherence to treatment. This does not mean that it is impossible, however. Finding a licensed clinician who is equipped to treat both SUD and bipolar disorder is crucial to recovery. These two conditions are serious and often exacerbate each other. It might not be possible to treat one and then move to the next. Due to this, seeking treatment with an integrated approach can help to address both sets of symptoms. 

Bipolar disorder and SUD are both chronic conditions. They can be treated, but they cannot necessarily be “cured.” This means that they require consistent management to keep symptoms under control. People with co-occurring addiction and bipolar disorder can live fulfilling lives with the appropriate support from a qualified treatment team. Intervention that is started early and remains consistent offers the best opportunity for sustained recovery and wellness. 

It is often the case that someone living with addiction will also experience at least one other mental health condition. This can lead to complications in recovery that require providers experienced in the nuances of treating comorbid conditions. One common comorbid condition that accompanies substance use disorder is bipolar disorder. Fortunately, help is available. Family-Centered Services has a team of licensed clinicians who are experts in addiction and mental health treatment. We will work with your family throughout the treatment process, and we are proud to offer an extensive array of services, including a family recovery program, individual and family therapy, comprehensive case management, treatment placement consultation, intervention education and preparation, and sober accountability. Call (509) 991-5822 to learn more.