Bipolar disorder, once known as manic depression, is a severe mental health disorder distinguished by abrupt, intense shifts in behavior, mood, and energy levels.

Bipolar disorder and substance abuse are similar in the way they put people at risk of their emotional and physical well-being. People with bipolar disorder have a higher financial instability rate, accidental injuries, relationship issues, and suicide rates than the general population. They are also significantly more inclined to develop a substance addiction along the way. bipolar disorder and addiction

Statistics have shown that:

  • Roughly 56% of bipolar disorder people who engaged in a national study have shown they also suffered from substance addiction during their lifetime.
  • Roughly 46% of people from the study group had shown to be alcoholics.
  • Approximately 41% of people from the group suffered from drug abuse or addiction. 
  • Alcohol was shown to be the most commonly abused substance amongst people in the group with bipolar disorder.

Individuals who have bipolar disorder and addiction require a dual diagnosis treatment program. Co-occurring disorders make the addiction recovery process extremely challenging. People with bipolar disorder will experience severe depression, along with intense episodes of an inflated sense of self-importance. This emotional imbalance can interfere with the patient’s recovery program, making it challenging to comply with rehab plan guidelines.

The Relation Between Bipolar Disorder and Addiction 

There isn’t one solid explanation for the growing rate of people with bipolar disorder and addiction. But one reason for this event is that people try to self-medicate with drugs and alcohol to cope with their bipolar disorder symptoms.

Bipolar disorder symptoms like pain, depression, anxiety, and sleeplessness are so distressing that many people use drugs and alcohol to cope with discomfort. But the counteract of using drugs and alcohol only triggers the depressed and manic mood of bipolar disorder.

Gender and age can also play a part in the relationship between bipolar disorder and addiction. Studies have shown that substance-abuse is most common with young males than other population groups. Young men are more likely than older men or females to take critical risks or act on self-destructive impulses. For older adults with bipolar disorder, the extent of substance abuse is much lower.

Clinical researchers think that brain chemistry could influence both bipolar disorder and substance abuse. Statements have been declaring that individuals with bipolar disorder usually have abnormal dopamine, serotonin, and norepinephrine levels. These chemicals in the brain affect vital functions like sleep, metabolism, appetite, and stress responses. They also affect emotions and mood.

Individuals with bipolar disorder may turn to substance abuse unintentionally to stabilize her mood. Regrettably, though, substance-abuse will produce the opposite effect and make the symptoms of bipolar disorder worsened.

Symptoms and Effects of Bipolar Disorder

Bipolar disorder symptoms will be different for each person affected. There are also various symptoms of depressive and manic episodes. Those who also suffer from substance addiction will usually also have elevated bipolar symptoms.

Four major mood episodes define bipolar disorder: manic, hypomanic, depression, and mixed episodes that all create different symptoms.


Manic is the heightened mood for bipolar disorder which creates symptoms that include:

  • Tremendous enthusiasm and significant unhappiness
  • Flamboyant feelings
  • Fast-talking
  • Insufficient sleep
  • Impaired judgment
  • Irrational behavior
  • Delusional behavior
  • Hallucinations
  • Hyperactivity
  • Inflated sense of self-confidence
  • Thoughts racing
  • Little attention span
  • Dangerous behavior

Some people will experience manic episodes of symptoms so severe that they become unable to function in a social or professional setting. Those who have these episodes may need to be hospitalized. A typical manic episode is not triggered by substance abuse, making it difficult to diagnose bipolar disorder if addiction is present.


Hypomania and manic behavior symptoms are similar but less intense. People with hypomania can usually manage their everyday lives, but they feel higher than normal energy, happiness, or irritability. They may feel capable of taking on more obligations or feeling like then need less sleep. People may find that they’re more friendly or talkative.

People may also engage in risky behaviors, like substance abuse. Hypomanic periods are especially productive for some, and it might seem there’s not an issue because psychotic symptoms do not occur in hypomania.

Major Depressive Episode Symptoms

Another part of bipolar disorder is major depression, which is an emotional state that causes sorrow, crying, and hopelessness. Major depression with bipolar disorder could last days or weeks, depending on mood. These periods are unsafe for people with co-occurring disorders at high risk of self-harm and suicide when using substances during a depressed period.

Major depressive episode symptoms include:

  • Feeling hopeless
  • Loss of interest in hobbies
  • Fatigue
  • Appetite changes
  • Self-loathing
  • Suicidal tendencies 
  • Feeling hopeless 
  • Feeling worthless
  • Weight gain or loss
  • Restlessness
  • Insomnia 
  • Daily fatigue
  • Excessive guilt feelings
  • Inability to concentrate

Major depressive incidents leave people unable to function in social or professional settings. Major depression symptoms must last two weeks minimum to be clinically determined. Similar to manic episodes, major depressive episodes aren’t the result of substance abuse.

Mixed Episodes

Bipolar disorder symptoms aren’t always precisely defined. In a blended episode, actions reveal a combination of manic and major depression. Sufferers could have suicidal thoughts and lose interest in daily activities, coupled with racing thoughts, constrained speech, and sleeplessness.

People experiencing mixed episodes may feel the urge to use substances to balance out the mood swings. But, intoxication is just a temporary fix that won’t produce permanent relief. Professional treatment will be needed to help stabilize moods to deal with the cravings and destructive impulses that characterize addiction to recover fully.

Diagnosing Bipolar Disorder

Diagnosing bipolar disorder and addiction is difficult because of the symptoms experienced by bipolar disorder mirror many substance addiction symptoms. Doctors diagnose bipolar disorder with various tests to differentiate bipolar disorder and addiction.

Diagnostic tests for bipolar disorder include:

Psychological tests

A specialist evaluates the patient’s feelings and thoughts while looking for evidence of any manic or depressive behavior. The specialist might interview friends and family to get a better understanding of their patient’s behavior.

Physical exams

The specialist performs a physical exam to decide if there is anything causing brain imbalances. They’ll also review the patient’s medical history and substance abuse. Finding the exact cause of bipolar disorder can help in treating the condition.

Mood charts

The specialist might require the patient to chart their mood to determine the frequency and magnitude of episodes. Possessing a distinct record of the patient’s episodes and length they last can help in making an accurate diagnosis.

Making comparisons

The specialist will compare the bipolar disorder symptoms against other conditions. Bipolar disorder symptoms are similar to other conditions. For instance, some will have major depressive episodes without having a bipolar disorder. Signs of intoxication can also mirror some bipolar disorder symptoms.

Treatment for Bipolar Disorder and Addiction

Dual diagnosis treatment incorporates multiple therapeutic strategies. Examples include individual psychotherapy with a mental health specialist, individual therapy with addiction specialists, holistic therapy, support groups, and family therapy.

Examples of bipolar disorder and addiction treatment include:

  • Centralized care performed in a rehab facility
  • Treatment teams consisting of psychologists, addiction professionals, and other specialists qualified for dual diagnosis care
  • Individual psychotherapy that centers on managing emotions and reducing substance abuse risks
  • Medication-assisted treatment to manage the peaks and valleys of bipolar disorder
  • Group support from peers who are also battling mental health and substance abuse disorders

It’s not enough to treat substance abuse and bipolar disorder without addressing the problem of each. The only way to avoid relapse is to receive comprehensive care for both conditions. Relapse prevention plans for bipolar disorder patients must incorporate coping skills for managing the mental and emotional triggers of substance abuse.

Specialists might also incorporate therapy and medications to treat these conditions. Dual diagnosis can be treated in both an inpatient or outpatient treatment program.

Cognitive-behavioral therapy (CBT) is another method to treat co-occurring disorders of addiction and bipolar disorder. CBT addresses the beliefs and feelings of those who suffer from dual diagnosis conditions face.

Dual diagnosis patients can better understand their actions by examining the beliefs and feelings that cause depressive and manic behaviors. This helps them plan for episodes and cravings, so they’re able to control their behavior.

Medications for Bipolar Disorder and Addiction

Treatment medication can help patients with bipolar disorder and addiction. Addiction treatment medications ease withdrawal symptoms and extinguish cravings. The addiction medication prescribed will depend on the patient’s substance they had abused, helping patients with bipolar disorder calm their mood shifts and bring stability to their lives. 

Some bipolar disorder medications include:

  • Anticonvulsants
  • Antipsychotics
  • Benzodiazepines
  • Lithium

Each of these treatment medications helps with either depressive or manic episodes. Benzodiazepines can help with manic episodes and withdrawal symptoms simultaneously. Specialists must be careful, though, when prescribing benzodiazepines because of their highly addictive effects. 

Get Help for Bipolar Disorder and Addiction

By comparison, it is simpler to diagnose substance addiction than it is to diagnose bipolar disorder. Those with a history of episodes before they abused substances are more likely to identify the underlying mental health disorder. But, if the disorder developed because of substance addiction, it can be more difficult to tell.

Here at LA Detox, we have one of the best treatment centers in the country with years of expertise in treating dual diagnosis. If you or a loved one believes there is more to addiction than just the substance abuse, seeing a dual diagnosis expert is crucial in getting help. Contact us today at LA Detox and allow our dedicated treatment team to answer all your questions.