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bipolar disorder

Bipolar Disorder

Bipolar Disorder

Bipolar disorder is a mental illness that causes a person to have extreme shifts in moods. It affects roughly 1.5% to 2.5% of the population. 

These extreme shifts are caused by chemical imbalances in the brain. This could be due to genetics or even a traumatic event in someone’s life. Often, they are referred to as “episodes” and can last for days or even weeks.

Depending on the individual, episodes can occur several times a week or only a few times a year. Due to the extreme nature of these imbalances in moods, it greatly affects a person’s level of energy and ability to focus. Substance abuse can make these imbalances even more severe.

Let’s take a look at the four types of episodes a person with bipolar disorder may experience

  • Depression or depressive episodes – These symptoms are similar to the clinical definition of depression. A person will feel sad, low energy, and low self-esteem. They will also withdraw away from interests as they have little ability to concentrate. They may also eat very little or another extreme is over-eating. 
  • Mania or manic episodes – Someone who is experiencing a manic episode will have extremely high levels of energy, racing thoughts, and overall restlessness. Their excitement and enthusiasm levels will also be elevated. This is dangerous as it can cause them to be reckless and risky due to their careless attitude. 
  • Hypomania or Hypomanic episodes – These symptoms are similar to mania; however, the individual is not acting as extremely as in a manic episode. These episodes also typically last only a few days. 
  • Other Mixed Episodes – Some individuals will suffer from a blend of these episodes. It is usually due to the use of alcohol and drugs that could be triggering more chemical imbalances. 

Bipolar disorder can even be brought on from substance abuse. Drug use changes chemical balances in the brain, most notably, the reward center that makes using drugs feel good. Because of continued or excessive use of a substance, it can actually have the ability to rewire parts of the brain that affect your overall mood and actions. Sadly, even a person that had no previous issues with a mental illness can develop bipolar disorder due to drug use.

Bipolar Disorder and Substance Abuse: A Common Dual Diagnosis

Unfortunately, it is very common for people suffering from bipolar disorder to become victims of substance abuse. It has been found that around 42% seek out alcohol and 20% will abuse marijuana. 

Typically, people with bipolar disorder are genetically pre dispositioned to alcohol use disorder at somewhere between 47%-57%. This means that the disorders are in some way genetically related. 

Also, because of the traits that a person with bipolar disorder develops it elevates the chances, they will engage in substance abuse. 

These traits include:

  • Inability to cope with stress, or stressful situations
  • Engaging in excessive reward-seeking activities that occur with mania
  • Impulsive behaviors
  • Searching for release from depressive episodes

A basic explanation of why a person suffering from bipolar disorder would look for relief in drugs or alcohol is because they are simply looking to alleviate the symptoms of mental illness. However, people engaging in this behavior may be causing more chemical imbalances by trying to self-medicate. 

It is often difficult to diagnose someone with bipolar disorder and substance abuse. Many individuals are not forthcoming about their substance use and family and friends may only see the depressive episodes. Therefore, the individual only gets treated for depression. 

Getting a Proper Diagnosis

Dual diagnosis is the very first challenge in caring for people suffering this co-occurring condition. Next is finding an effective treatment for each individual bipolar and substance abuse conditions. It is important that a medical specialist is evaluating to make a thorough assessment. 

When Diagnosing some of the following conditions are considered:

  • When did the symptoms of bipolar disorder become noticeable?
  • How long does the person typically suffer from manic episodes?
  • How long does the person typically suffer from depressed episodes?
  • What type of reckless or self-harming behaviors has the individual initiated?
  • What type of substances has the individual used to self-medicate?
  • How long has the person been using these substances?

An experienced specialist will take into consideration all factors and take a multi-faceted treatment approach. Everyone who suffers from this dual diagnosis is very different. Many symptoms of substance abuse and bipolar disorder overlap, only a professional will know what to look for. 

How to Treat Bipolar Disorder and Substance Abuse

In any dual diagnosis situation, it is important to treat both conditions at the same time. It should be noted that bipolar disorder is a lifelong condition, so treatment will be aimed at managing the symptoms. Addiction therapy will be done through either inpatient or outpatient rehab.  

Medication Treatment

Medication is typically recommended for someone suffering from bipolar disorder. A comprehensive treatment plan often encompasses several medications. Due to substance abuse, doctors are reluctant to prescribe certain medications like benzodiazepines for anti-anxiety due to the risk of abuse. 

Typical medications may include:

  • Antidepressants: This medication will help manage the depressive episodes. 
  • Mood stabilizer: Used to control manic episodes. 
  • Antipsychotics: In the event that depression or mania continues, the doctor may prescribe these. 
  • Anti-Anxiety: known as benzodiazepines, these will help with anxiety and sleep issues, but carry a high risk for addiction and are typically given to individuals suffering from bipolar disorder and substance abuse. However, certain situations may warrant a prescription.

Psychotherapy Treatment 

Therapy is the biggest part of any outpatient or inpatient program at Discovery Institute. They spend the bulk of their day in different types of therapy address individual concerns. We provide our clients with a variety of recovery techniques to make sure all needs are met. 

Group Therapy

Group therapy is very important because it lets everyone know that they are not alone in their struggle. They also have the opportunity to learn from someone else’s experiences. Everyone comes together in small groups to discuss the topics that are relevant to their recovery. This could include a discussion of their mental illness or substance use or even both. 

Family Therapy

Family Therapy seeks to minimize the conflict and tension between the recovering addict and their family. The idea is that through analyzing the patterns associated with the former problems, a trained therapist can help the family readjust those patterns so that there are no longer problems. Families generally hold some resentment toward the person in recovery because of past instances where they were unable to control their bipolar episodes or substance abuse behavior. Family therapy works to bring families together and work towards forgiveness for everyone involved. 

Individual Therapy

Individual therapy is part of both inpatient and outpatient treatment for substance abuse. It is a critical part of recovery and starts immediately once someone has begun the program. In this setting, the client has the opportunity to discuss details of their struggles that may be difficult to disclose to family or in a group therapy setting. This is truly an opportunity for the individual to get impartial feedback, release emotions and process feelings to learn more about what lead to their addiction.

Depending on the individual assessments, they may receive some specialized therapy such as dialectical behavioral therapy or trauma processing. 

Dialectical behavioral therapy (DBT) is often used to help individuals learn how to cope with their bipolar disorder and predisposition to substance abuse. This method of therapy is closely related to Cognitive behavioral therapy (CBT). CBT generally focuses more on individuals who are suffering from substance abuse, whereas DBT is geared more towards dual diagnosis patients.

Dialectical behavioral therapy works by teaching patients coping skills and behaviors to better understand the extreme emotions that are often associated with bipolar disorder. Professionals work with patients to help them learn how to replace destructive thoughts and behaviors with positive actions and mindfulness exercises. Through this therapy, individuals learn how to handle intense emotions in a more productive manner. With repetition, they retrain their brain with healthy coping methods and slowly unlearn negative ones. 

Trauma processing is also a useful therapeutic tool for individuals suffering from bipolar disorder and substance abuse. There are instances where a traumatic event may have led to the onset of bipolar disorder, or it is the reason for substance abuse or even both. Therapists are trained in guiding these clients through painful memories and emotions. Targeting triggers of traumatic moments helps clients learn what they are, and how to navigate those feelings outside of a therapy setting. 

Getting the Help You Need at Discovery Institute

At Discovery Institute our mission is to provide high-quality habilitation and rehabilitation services to all individuals suffering from substance abuse and mental health-related illnesses. Whatever type of program you are looking for, we can find something that can work for you. We know that living with co-occurring conditions like bipolar disorder and substance abuse can feel like it’s impossible to overcome. But you can, and we can help. 

Contact us today or call (844) 478-6563 to speak to one of knowledgeable addiction treatment specialists. Find the freedom you truly deserve! 

Article Reviewed by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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