Treatment For Bipolar and Addiction Disorders

How Are Addiction and Bipolar Disorder Related?

Bipolar disorder and addiction are related in several significant ways, primarily through their overlapping symptoms, potential for comorbidity, and the impact each can have on the course and treatment of the other:

Comorbidity and Prevalence

• High comorbidity rates: Studies show a high rate of comorbidity between bipolar disorder and substance use disorders (SUDs).[2] People with bipolar disorder are significantly more likely to develop an addiction compared to the general population. For instance, individuals with bipolar disorder are at increased risk for alcohol, drug, and other substance use disorders.
• Bidirectional influence: The presence of one disorder increases the risk of developing the other. For example, substance use can trigger or worsen the symptoms of bipolar disorder, and the manic or depressive episodes in bipolar disorder can lead people to self-medicate with substances, thereby increasing the risk of addiction.[3]

Biological and Psychological Factors

• Genetic predisposition: There is evidence suggesting that genetic factors may contribute to the susceptibility to both bipolar disorder and substance use disorders.[4] Shared genetic vulnerabilities may partially explain the high comorbidity.
• Neurochemical factors: Imbalances in neurotransmitters such as dopamine and serotonin may be implicated in both bipolar disorder and addiction.[5] These neurochemical changes can influence mood regulation and reward pathways, contributing to the development and maintenance of both conditions.

Psychosocial Aspects

• Stress: Both bipolar disorder and addiction can be triggered or worsened by stress and traumatic experiences.[6] Individuals with bipolar disorder may use substances as a way to cope with the emotional distress associated with their mood swings.
• Social and environmental factors: Environmental factors, such as peer pressure, availability of substances, and social networks, can play a significant role in the development of both bipolar disorder and substance use disorders. Social isolation or lack of support can exacerbate both conditions.

Symptom Overlap and Misdiagnosis

• Overlapping symptoms: Many symptoms of bipolar disorder, such as impulsivity, risk-taking behaviors, and periods of elevated mood, can also be associated with substance use. This overlap can complicate the diagnosis and treatment, as substance use can mask or mimic the symptoms of bipolar disorder.
• Misdiagnosis: Due to overlapping symptoms, individuals with bipolar disorder might be misdiagnosed with a substance-induced mood disorder or another mental health condition. Accurate diagnosis requires careful assessment by healthcare providers to distinguish between the effects of substance use and the underlying bipolar disorder.

What Are the Symptoms of Bipolar Disorder and Co-Occurring Issues?

Bipolar disorder is a mental health condition characterized by significant mood swings, including episodes of mania (or hypomania) and depression. When it co-occurs with other issues (e.g. bipolar depression and alcohol abuse), these additional conditions can complicate the clinical picture and affect the overall management of your condition.

The following are Symptoms of Bipolar Disorder: [7]

Manic Episode

A manic episode is a period of abnormally elevated mood and high energy, often accompanied by other symptoms. To be classified as a manic episode, your symptoms must last at least one week (or less if hospitalization is required) and significantly impact your overall functioning:

• Increased energy or activity: Excessive involvement in activities, often leading to exhaustion.
• Euphoric or irritable mood: Feeling overly happy or irritable.
• Grandiosity: Inflated self-esteem or unrealistic beliefs in one’s abilities.
• Decreased need for sleep: Feeling rested after only a few hours of sleep.
• Talkativeness: Rapid, pressured speech that is hard to interrupt.
• Racing thoughts: Fast-moving ideas that are difficult to follow.
• Distractibility: Inability to focus, easily diverted by irrelevant stimuli.
• Impulsive behavior: Engaging in risky activities such as spending sprees, sexual indiscretions, or reckless driving.

Hypomanic Episode

Hypomania is a milder form of mania with similar symptoms but less severe and without significant impairment in social or occupational functioning. It lasts for at least four consecutive days.

Depressive Episode

A depressive episode involves a period of at least two weeks with symptoms such as:

• Depressed mood: Feeling sad, empty, or hopeless most of the day.
• Anhedonia: Loss of interest or pleasure in almost all activities.
• Weight changes: Significant weight loss or gain or changes in appetite.
• Sleep disturbances: Insomnia or hypersomnia (excessive sleeping).
• Fatigue: Persistent lack of energy or fatigue.
• Psychomotor changes: Either agitation or retardation that is noticeable to others.
• Feelings of worthlessness or guilt: Excessive or inappropriate guilt.
• Cognitive impairment: Difficulty concentrating, thinking, or making decisions.
• Suicidal thoughts: Recurrent thoughts of death or suicide, or suicide attempts.

Co-Occurring Issues

Many individuals with bipolar disorder also struggle with substance use, using substances to self-medicate or manage their symptoms:

• Types of substances: Commonly misused substances can include alcohol, cannabis, cocaine, and prescription medications. Alcohol and illicit drugs are particularly prevalent. The choice of substance often varies, with some individuals preferring stimulants to counteract depressive symptoms while others might use depressants to manage manic episodes.
• Self-medication: People with bipolar disorder may use substances to self-medicate and manage their mood symptoms. For instance, they might use stimulants during depressive episodes to feel more energetic or use depressants like alcohol to calm manic symptoms.
• Exacerbation of current symptoms: Substance use disorder can worsen the symptoms of bipolar disorder. Drug and alcohol use can lead to more severe and more frequent mood swings and can also interfere with the effectiveness of prescribed medications.

Statistics About Bipolar Disorder and Substance Use Disorder

Substance use disorders frequently co-occur with mental health conditions such as depression and bipolar disorder at a rate much higher than that of the general population.[8] About 42% of people with bipolar depression also struggle with alcohol use—the highest rate in the general population—compared to around 8% of people without a co-occurring mental health condition.[9] Additionally, the prevalence of substance use disorders in people with bipolar disorder ranges from 20-30% for substances like cannabis and cocaine.

This comorbidity leads to increased hospitalization rates, with individuals facing more frequent emergency room visits and inpatient admissions.[10] The risk of suicide attempts is also significantly higher, with substance use disorders potentially increasing the risk by two to three times.[11]

Treatment for Bipolar Disorder and Dual Diagnosis at Wellbridge

Dual diagnosis treatment at Wellbridge for bipolar and addiction offers a comprehensive range of evidence-based treatments and therapeutic modalities aimed at addressing both conditions at the same time: