Co-Occurring Bipolar Disorder & Drug or Alcohol Addiction

Bipolar disorder affects an estimated 2.8% of adults and 2.9% of adolescents in the U.S. annually, and 45 million people worldwide.^1,2 Recent data suggests around 50% of people with bipolar disorder have at least one substance use disorder.³

Read on to learn more about bipolar disorder, its link to addiction, and how to get help if you or someone you know is suffering with a dual diagnosis, such as co-occurring bipolar and substance use disorders.

What Is Bipolar Disorder?

Bipolar disorder is a mental illness characterized by shifting moods of major depression, hypomania, or manic episodes that are more severe than the “ups and downs” most experience.¹

Symptoms of Bipolar Disorder: Manic & Depressive Episodes

Mood shifts are a part of life for everyone, but a person with bipolar disorder has mood swings that are extreme, affect daily functioning, and outside the range of normal behavior.¹

Episodes of mania are identified by elevated moods, energy levels, irritability, impulsivity, erratic decision making and sometimes even by psychosis.¹ Full-blown mania may last for at least a week, and is often accompanied by little or no sleep.^1,4 During an episode of mania, a person with bipolar disorder may appear to be more talkative or agitated and easily distracted.^1,4

Hypomania is a milder form of mania where psychosis isn’t present and there’s less functional impairment.⁴

Depressive episodes in people with bipolar disorder are recognized by fatigue, sadness, suicidal ideations, and hopelessness.¹ Little interest is displayed in most activities, and speech may be slowed.¹ Depression may also be characterized by weight gain, trouble falling asleep or sleeping too much, and trouble concentrating.¹

It’s possible to have a “mixed mood episode” as well. These are episodes containing simultaneous depressive and manic features.^1,4

Types of Bipolar Disorder

There are three types of bipolar disorder:¹

• Bipolar I disorder is characterized by episodes of mania lasting at least 7 days, with symptoms so severe a person needs immediate hospital care.
• Bipolar II disorder is defined by a pattern of alternating episodes of depression and hypomania that are less severe than those with bipolar I.
• Cyclothymic disorder is characterized by periods of hypomania and periods of depression lasting for at least two years, with symptoms that don’t meet the diagnostic requirements for episodes of depression or hypomania.

Co-Occurring Bipolar and Substance Use Disorder

Research indicates that about 65%–95% of individuals suffering from bipolar disorder have at least one co-occurring mental health disorder.⁵

Individuals with bipolar disorder are more likely than the general population to battle addiction.³ Studies estimate 40%–60% of those with bipolar disorder have a co-occurring substance use disorder, and more than half specifically have an alcohol use disorder.^4,9

Does Bipolar Disorder Cause Substance Use Disorder?

No, bipolar disorder does not “cause” substance use disorder. However, bipolar disorder and other mental illnesses are common risk factors for addiction. In fact, a complex bidirectional relationship exists between bipolar disorder and SUDs. However, the ways these conditions influence one another is still not totally clear.⁸

One potential pathway is that many people with mental illness use drugs or alcohol attempting to manage or relieve the severe symptoms associated with their conditions, when, in fact, these substances may ultimately make their conditions worse, despite any temporary relief they may provide.⁸

Mental illnesses like bipolar disorder also share common risk factors with substance use disorders, such as genetic and epigenetic vulnerabilities, issues with similar areas of the brain, and can be influenced by similar environmental factors, such as early exposure to stress or trauma.⁸

Can Substance Use Disorder Cause Bipolar Disorder?

No, just as bipolar disorder doesn’t cause a substance use disorder, substance use disorders cannot “cause” bipolar disorder. The bidirectional relationship between both disorders is complex, and researchers are still working on better understanding the ways they influence each other.⁸

However, addiction can worsen or exacerbate certain symptoms of bipolar disorder. For example, alcohol use disorder and withdrawal are likely to worsen bipolar disorder mood symptoms.¹⁰

Because of this, individuals with co-occurring bipolar and substance use disorders are more likely to be hospitalized, attempt suicide, and accelerate the course of their mental illness.¹⁰

Alternatively, substance users who aren’t currently diagnosed with bipolar disorder may experience symptoms of the disease while intoxicated or when they are experiencing withdrawal symptoms from certain substances. Acute symptoms of mania may be mimicked by intoxication with stimulants, steroids, hallucinogens, or polydrug combinations. They may also be caused by withdrawal from alcohol or other depressants.⁸

Because of this, it may be necessary to maintain a period of abstinence from drugs and alcohol to determine if bipolar disorder exists independent of substance abuse, as treatment plans and medications may need adjusting.⁴

Co-Occurring Disorder Treatment for Bipolar and Addiction

Treatment for a substance use disorder is more complex when an individual has also been diagnosed with bipolar disorder (and vice versa).^4,11 If bipolar disorder co-occurring with a substance use disorder is suspected, medical and mental health professionals can determine the best course of action and develop a safe detox and treatment plan.^4,7

Both are serious illnesses that may have severe and potentially life-threatening consequences when left untreated.^4,7 Self-harm and suicide are very real risks for individuals suffering from bipolar disorder, with evidence suggesting an estimated 20% try to commit suicide.⁸ People with co-occurring bipolar and substance use disorders are significantly more likely to try to commit suicide than people without both conditions.¹³

At Greenhouse Treatment enter, our inpatient drug & alcohol rehab facility in Grand Prairie, Texas, we specialize in the treatment of co-occurring disorders. Our treatment plans are tailored to meet a patient’s individual needs and provide a combination of evidence-based addiction therapies and, if needed, treatment medications.

Behavioral therapy is a critical component in the treatment of both bipolar and substance use disorders.⁴ Our facility in the Dallas-Fort Worth area offers integrated group therapy for addiction recovery that addresses the unique interrelationships between bipolar disorder and substance abuse.

To learn more about our luxe rehab facility amenities and top-tier programs, call us at . Our admissions navigators are available anytime to answer your questions and help you start the rehab admissions process.

Our staff can also review Greenhouse’s various ways to pay for drug and alcohol rehab and how to use insurance to pay for addiction treatment. Or you can find out whether we accept your health insurance plan and confirm your benefits by filling out this quick and secure .

It’s important to remember that despite their complications, addiction and bipolar disorder are both treatable.⁹ If you or someone you love is battling this dual diagnosis, take the first step toward recovery and reach out for help at today.