Bipolar Disorder and Addiction

what is bipolar disorder?

Bipolar disorder and substance abuse disorders are often co-occurring disorders

What is Bipolar Disorder?

Bipolar disorder, formerly known as manic depression, is a mental health disorder associated with periods of manic highs and depressive lows.

Types of Bipolar

There are five types of bipolar disorder, each characterized by the same foundational symptoms of bipolar disorder – manic highs and depressive lows - but developing, manifesting, and occurring in ways unique to one another.1

Bipolar I disorder is characterized by severe mood swings from highs to lows. There may be periods in which mood is stable and symptoms are less prominent, but milder symptoms are mostly associated with Bipolar II disorder.

The last three types focus more on the progression and pace of mood swings. Cyclothymic disorder features less extensive periods of manic or depression while rapid-cycling disorder is characterized by four or more cycles in twelve months. Mixed features, however, refer to the simultaneous presentation of symptoms.

Symptoms of Bipolar Disorder

Bipolar Disorder and Addiction

Bipolar can manifest in different ways depending on the type and which period – manic or depressive – is currently being experienced. However, several symptoms can be experienced in most bipolar disorder cases during either mood, including these described below.


As a mental disorder, most symptoms manifest at a cognitive level. While this disorder often causes symptoms to develop in different aspects of life, including behavioral and physical symptoms, they often begin as cognitive symptoms. Cognitive symptoms of bipolar disorder include:

  • Sense of grandeur or elevated self-confidence
  • Feelings of worthlessness or self-depreciation
  • Inappropriate or excessive guilt
  • Racing thoughts
  • Distractibility or inability to focus


While behavioral symptoms can develop as individual symptoms, many times, they stem from cognitive symptoms. For example, the cognitive symptom of elevated self-confidence can often lead to the behavioral symptom of impulsivity. Behavioral symptoms of bipolar disorder, during either manic or depressive states, can include:

  • Impulsivity as demonstrated by risk-taking, excessive spending, or other forms of lack of control
  • Change in sleep schedule, with decreased need during manic states and increased during depressive
  • Change in energy levels and productivity
  • Poor decision making
  • Unusual talkativeness or sociability


Physical symptoms and signs are those most often observed in a medical setting. However, they may be witnessed by third parties close to the patient and can consist of:

  • Changes in weight
  • Signs of addiction when co-occurring when a substance use disorder
  • Self-harm

Is Bipolar Disorder Genetic?

While the exact causes of bipolar disorder are still unknown, studies have shown that genetics play a significant role in the development and manifestation of the disorder, which a genetic history of bipolar disorder increasing the likelihood of development.2

Known Causes

The specific gene responsible for bipolar disorder has not yet been identified, but genetics, combined with other factors such as environment and dual diagnosis with substance abuse disorder, has shown to be leading factors.3 While causes are not known, a bipolar test can allow for a diagnosis.

Known Risk Factors

There are also few known risk factors that have been shown to increase the chances for bipolar disorder to develop. These risk factors include:

  • Family history of bipolar disorder
  • Periods of elevated stress or traumatic events
  • Substance use disorders

Addiction and Bipolar disorder - Are they related?

Bipolar Disorder and Addiction

While they are not necessarily related, there is a strong correlation between addiction, substance use disorders, and bipolar disorder.4

Often, the symptoms of bipolar disorder can greatly resemble the symptoms of addiction or active substance abuse. Bipolar disorder can also lead to addiction through prescription drug misuse and dependency or illicit drug abuse as a way to self-manage symptoms or side effects of medications.

However, drug addiction and alcohol addiction can lead to the development of bipolar disorder, especially in those with other significant risk factors. For those with a substance use disorder experiencing bipolar-like symptoms, a bipolar test may be given.

Substance-Induced Bipolar Disorder

Because substance use can cause a change in brain chemistry, prolonged abuse has the potential to induce several mood disorders, including bipolar disorder. While these often are reversed with treatment for the substance use disorder, long-term effects may remain.

Treating Bipolar Disorder and Addiction

Bipolar Disorder and Addiction

When bipolar disorder and addiction are co-occurring, there are different forms of treatment available to alleviate the discomfort that can arise from symptoms while aiding in recovery from substance abuse disorders. Some of the treatment options available for the dual diagnosis of bipolar disorder and addiction in bout inpatient and outpatient drug rehab include:


Medication can be useful in treating both bipolar disorder and addiction. Often, when these are co-occurring in a patient, treating one or both conditions can help alleviate symptoms and promote recovery. In terms of substance-induced bipolar disorder, treating addiction may be enough to completely reverse symptoms.


CBT, more commonly known as cognitive-behavioral therapy, is one of the most beneficial therapies utilized in the treatment of addiction. It focuses on helping the patient better understand the correlation between cognitive process and the resulting behavior.

However, CBT can also be beneficial in managing the symptoms of bipolar disorder, especially impulsivity.


Dialectical behavioral therapy, or DBT, is a form of CBT used in therapy and recovery. DBT specifically is used to treat potentially self-destruct behaviors and manage impulsivity. As a result, it is useful in treat bipolar disorder, addiction, and dual diagnosis between the two. DBT helps manage symptoms such as impulsivity, self-harm, and substance abuse in outpatient drug rehab.

Family Therapy

Since both addiction and bipolar disorder can result from trauma, especially childhood trauma, family therapy can be beneficial in identifying and treating the source of either condition. It also allows the patient to create a healthy support system during outpatient drug rehab.


Ecopsychology is a newer form of interdisciplinary and transdisciplinarity psychotherapy revolving around the correlation between mental health, the environment, and sustainability. The focus of this therapy is to convey and demonstrate the emotional bond between the earth and humans to build a state of mindfulness that can be beneficial during bipolar disorder treatment and addiction treatment. disorder, long-term effects may remain.


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