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Bipolar Disorder and Addiction

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Bipolar disorder and substance use disorders (SUDs) commonly occur together. When a person has one or more mental health disorders as well as a substance use disorder, this is called co-occurring disorders, or dual diagnosis.

If you or someone you care about is dealing with co-occurring addiction and bipolar disorder, you’re not alone. Studies estimate that between 30% and more than 50% of people with bipolar disorder will develop a substance use at some point in their lives.1 This article will help you understand the relationship between bipolar disorder and substance abuse and how to find treatment.

What Is Bipolar Disorder?

Bipolar disorder—also sometimes called manic depression or manic-depressive disorder—is a serious mental illness (SMI) that involves extreme mood swings and changes in activity and energy levels.1 People with bipolar disorder go through periods of mania (“up” or high moods) and depression (“down” or low moods) that are different from the regular ups and downs most people feel.2,3

A manic episode can look like:1,2

  • Having a lot of energy.
  • Not sleeping much.
  • Having a lot of confidence.
  • Acting jumpy or “wired.”
  • Talking really fast.
  • Having racing thoughts.

In some people, mania can instead look like being very irritable or “touchy,” especially if the person also uses substances.1

A depressive episode may look like:1,2

  • Feeling very sad and hopeless.
  • Having low energy.
  • Sleeping too much.
  • Talking very slowly.
  • Having concentration problems.

Bipolar disorder has 3 main subtypes:2,4

  • Bipolar I disorder, where manic episodes last 7 days or more or are bad enough that a person needs to be hospitalized, and depressive episodes tend to last about 2 weeks.
  • Bipolar II, where there is a pattern of depressive episodes and less severe manic episodes (hypomania).
  • Cyclothymic disorder (cyclothymia), where periods of hypomania and depressive episodes last for 2 years, but symptoms aren’t as severe as those of bipolar I or II.

Bipolar disorder can also be triggered by substance abuse, including a drug-induced manic episode, in which case it is diagnosed as “substance-induced bipolar disorder.”4

The Link Between Bipolar Disorder and Addiction

Studies show that people with bipolar disorder have a higher rate of co-occurring substance use disorders (SUDs) than any other mental health disorder, with some studies putting the lifetime risk as high as 65%.1,8

One theory for why these two disorders are so closely linked is that people with co-occurring addiction and bipolar disorder may use drugs or alcohol to self-treat or ease their symptoms. In fact, one study found that around 41% of all people with bipolar I disorder and 34.7% of people with bipolar II disorder self-medicated with drugs or alcohol.9

Other reasons why bipolar disorder and addiction co-occur may be common genetic factors between the two disorders, as well as shared personality traits.10,11 For example, poor impulse control is a trait of both addiction and bipolar.10,11

Bipolar Disorder and Alcohol Use Disorder

Some studies show that as many as 54% of people with bipolar disorder will develop an alcohol use disorder (AUD) in their lifetime.1 Drinking alcohol can be dangerous if you have bipolar disorder. Not only can AUD and bipolar worsen each other, but in people with bipolar disorder, alcohol abuse is associated with:8,12

  • A higher risk of suicidal thoughts and behaviors.
  • Longer withdrawal period from alcohol.
  • Increased severity of mania and depressive symptoms
  • Poor treatment outcomes.
  • Overall decreased functioning.

How to Treat Bipolar Disorder and Addiction

Co-occurring treatment, also known as dual diagnosis treatment or integrated treatment, involves substance abuse and mental health care teams working together on a whole person approach to treat both disorders.1,8,13 Integrated treatment often involves a combination of behavioral therapies and medication, such as:8,13

  • Cognitive behavioral therapy (CBT), which helps you identify and change negative thoughts and behaviors.
  • Dialectical behavior therapy (DBT), which focuses on reducing self-harm.
  • Contingency management (CM), which offers vouchers and other positive reinforcement in exchange for healthy behaviors.
  • Prescription medicines, which can vary depending on the substance you use.

How to Get Help for Addiction and Bipolar Disorder

Your disorders don’t define you. Recovery is possible, and we can help. American Addiction Centers is a leading provider of integrated treatment for co-occurring bipolar and addiction treatment in both Nevada and nationwide. We offer personalized treatment plans designed to address the symptoms and problems that are caused by both bipolar disorder and addiction. Our highly-skilled and compassionate staff know what you are going through and will help you every step of the way. If you’d like to learn more about your rehab options or if you have any questions about treatment, please call our free, confidential helpline any time of day or night at .


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