What Is Bipolar Disorder?
Bipolar disorder is a mood disorder that is characterized by significant shifts in mood, energy, and daily functioning — far beyond what most people experience in everyday life.[1] These mood swings happen in episodes, lasting days, weeks, or months, and have a significant impact on day-to-day functioning and relationships, as well as the ability to work or provide self-care.
The DSM-5 has identified three different types of bipolar disorder:
- Bipolar I Disorder: Characterized by at least one full manic episode, possibly followed by a depressive episode. Some manic episodes are severe enough to require hospitalization.
- Bipolar II Disorder: Characterized by a pattern of depressive episodes and hypomanic episodes. Bipolar II manic episodes are less severe than Bipolar I but still significantly disruptive.
- Cyclothymic Disorder: A less severe but chronic pattern of hypomanic and depressive symptoms that do not meet the full criteria for a hypomanic or depressive episode, lasting for at least two years.
Common symptoms of bipolar disorder vary by episode type.[2] During manic or hypomanic episodes, a person may experience elevated or irritable mood, racing thoughts, decreased need for sleep, impulsive behavior, grandiosity, and significantly increased goal-directed activity. During depressive episodes, they may experience symptoms similar to a major depressive episode: persistent sadness, loss of interest, fatigue, feelings of worthlessness, and significant difficulty functioning in day-to-day activities.
Bipolar Disorder and Substance Abuse: Understanding the Connection
The relationship between bipolar disorder and substance use is complex, well-defined, and extensively documented. According to research published by the National Institute of Mental Health, bipolar disorder has one of the highest rates of co-occurring substance use disorders (alcohol use disorder and cannabis use are the most common combinations) among mental illnesses. Studies indicate up to 60% of people diagnosed with bipolar disorder will develop a substance abuse disorder as well.[3]
There are three primary reasons for the co-occurrence of bipolar disorder and substance use:
- During manic episodes: Impulsivity combined with an elevation in mood can create conditions that create a risk of engaging in problematic substance use. The increased level of inhibition and overconfidence that result from mania allows the person to use substances without realizing how the use will ultimately impact their life.
- During depressive episodes: Many people use substances like alcohol or opioids to self-medicate and cope with feelings of emotional pain and hopelessness. Some people will use stimulants to help combat feelings of fatigue or low energy.
- As a cycle: Over time, substance use further destabilizes mood and, in turn, increases the frequency and severity of both manic and depressive episodes and interferes with the effectiveness of any mood-stabilizing medications that may be prescribed.
This destabilizing effect is one of the most clinically significant consequences of co-occurring bipolar disorder and addiction — and one of the most compelling reasons why treating both conditions together, rather than one at a time, is so important.
Does Bipolar Get Worse With Alcohol?
Yes, alcohol can significantly worsen bipolar disorder. Alcohol is a central nervous system depressant that negatively affects mood and can lead to depressive episodes, disrupted sleep patterns, and medication interactions.[4]
Regularly using alcohol with bipolar disorder is associated with more frequent mood episodes, more severe symptoms, a lack of response to medications, and a greater chance of needing to be hospitalized.[5] Even moderate alcohol use may destabilize the mood of someone with bipolar disorder more than it would someone without it. For this reason, if alcohol abuse is present, treating it should be a requirement of properly addressing bipolar disorder.
When to Get Help for Bipolar Disorder and Addiction
If you are struggling with both bipolar disorder and substance abuse, it is likely that you are aware of the relationship between them. Seeking integrated treatment that focuses on both mental health and substance use is an important step toward a healthier life. You should seek help from an integrated dual diagnosis treatment center if:
- Mood episodes are becoming more frequent, severe, or difficult to manage.
- You have begun using substances to cope with your manic or depressive moods or fatigue.
- Substance use is affecting your ability to take medication or the effectiveness of medications.
- You have been diagnosed with bipolar disorder, but have not received treatment for your substance abuse, or vice versa.
- Your relationships, physical health, or job have suffered due to the combination of both diagnoses.
- You feel you are unable to manage either diagnosis without addressing the other.
No matter where you start, you deserve treatment that meets you where you are. Meridian Recovery is here to help.
Bipolar Disorder and Addiction Treatment at Meridian Recovery
Integrated treatment for bipolar disorder and substance abuse requires a well-coordinated treatment strategy, clinical expertise, and an individualized plan based on how mood episodes and substance use interact. The dual diagnosis program at Meridian Recovery, is designed to provide an integrated approach to treatment.
If you have or know someone who has been diagnosed with bipolar disorder, then addiction is a risk that should be taken very seriously. It’s important to understand that while both bipolar and addiction are serious issues, they both have effective treatments available.
The best treatment for both disorders is integrated dual diagnosis treatment that provides the highest level of stability and security for a real, lasting solution to the problem. If you are ready to take the next step, Meridian Recovery is here to walk alongside you. Our admissions team can answer your questions, verify your insurance, and help you find the level of care that is right for your needs.
