Last Updated:
September 24th, 2024
Bipolar and Addiction | Links, Symptoms & Treatment
Bipolar disorder is a mental health condition marked by extreme mood swings, including emotional highs (mania) and lows (depression). Recognised in the DSM-5, which mental health professionals use for diagnosing disorders, bipolar disorder can vary significantly in severity. Some people experience milder episodes, while others may have severe and debilitating mood swings that impact daily life. These fluctuations can affect energy, activity levels, sleep patterns and decision-making, making it crucial for those affected to seek appropriate treatment and support.
Bipolar disorder in the UK
According to Bipolar UK, Bipolar disorder is one of the UK’s most prevalent long-term conditions, affecting 1.3 million people. This condition is nearly as widespread as cancer (2.4%) and is more than twice as common as dementia, epilepsy, autism, rheumatoid arthritis and learning disabilities. These statistics highlight the significant impact bipolar disorder has on the population, emphasising the need for awareness and support.
Are there different types of bipolar disorder?
Bipolar disorder manifests in several variations, each with its own distinct set of symptoms and criteria. Understanding these variations is crucial for seeking help for yourself or loved ones exhibiting concerning signs.
Bipolar I disorder
Bipolar I is defined by the occurrence of at least one manic episode, which may be preceded or followed by hypomanic or major depressive episodes.
Symptoms include:
- Manic episodes: Elevated mood, increased energy, reduced need for sleep, grandiosity, talkativeness, racing thoughts, distractibility and risky behaviours.
- Depressive episodes: Intense sadness, fatigue, changes in appetite, sleep disturbances, feelings of worthlessness and thoughts of death or suicide.
The manic episodes in Bipolar I are severe enough to cause significant impairment in daily functioning or may require hospitalisation.
Bipolar II disorder
Bipolar II involves at least one major depressive episode and at least one hypomanic episode but no full-blown manic episodes.
Symptoms include:
- Hypomanic episodes: Similar to manic episodes but less severe, not causing significant impairment or hospitalisation.
- Depressive episodes: Similar to those in Bipolar I, marked by severe depression.
The absence of manic episodes distinguishes Bipolar II from Bipolar I, although the depressive episodes can be more prolonged and debilitating.
Cyclothymic disorder (Cyclothymia)
Cyclothymia is characterised by chronic, fluctuating mood disturbances involving numerous periods of hypomanic symptoms and periods of depressive symptoms that are not severe enough to meet the criteria for a major depressive episode.
Symptoms include:
- Hypomanic symptoms: Less intense than in Bipolar II, causing slight but noticeable changes in mood and behaviour.
- Depressive symptoms: Milder than major depressive episodes but still causing noticeable discomfort and disruption.
The symptoms are persistent for at least two years (one year in children and adolescents) with no symptom-free periods longer than two months.
Is there a link between bipolar disorder and addiction?
Research shows a clear link between bipolar disorder and addiction, with data indicating that 61% of bipolar I patients experience substance use disorders in their lifetime. However, the reasons behind this connection are not straightforward. In the following sections, we will explore the intricacies of bipolar disorder and addiction, examining how each condition might exacerbate or even trigger the other.
Substance-induced bipolar disorder
Substance-induced bipolar disorder occurs when drug or alcohol use triggers manic or depressive episodes in individuals who otherwise do not exhibit bipolar symptoms previously. These mood disturbances are directly linked to substance use and typically diminish or disappear once the substance is no longer in the person’s system.
Research has found that substance-induced mood disorders often resemble their independent counterparts. For example, substance-induced bipolar disorder mirrors the symptoms of bipolar spectrum disorders. Stimulants like cocaine and amphetamines can create effects similar to bipolar disorders, including euphoria, increased energy, anorexia, grandiosity and paranoia. On the flip side, withdrawing from stimulants can lead to anhedonia, apathy, a depressed mood and even suicidal thoughts.
Self-medication leading to addiction
Addiction can often start in individuals with bipolar disorder due to the tendency to self-medicate. According to data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), which surveyed 43,093 community-dwelling adults aged 18 years and older, almost one-quarter of individuals with mood disorders (24.1%) used alcohol or drugs to relieve their symptoms. Among those with bipolar I disorder, the prevalence of self-medication was particularly high at 41.0%.
People with bipolar disorder may turn to self-medication as a way to manage the intense emotional fluctuations associated with the condition. Bipolar disorder can cause extreme mood swings, ranging from manic highs to depressive lows, often accompanied by severe anxiety. The urge to self-medicate stems from a desire to alleviate these overwhelming symptoms quickly. Alcohol and drugs can temporarily reduce feelings of anxiety, stabilise mood swings and provide a sense of relief, albeit short-lived and ultimately harmful.
The longer a person self-medicates with drugs and alcohol, the higher the chance is of forming an addiction to their choice of ‘medication’.
How are addiction and bipolar disorder treated at Linwood House?
Addressing addiction and bipolar disorder together can be quite challenging, as each condition requires specialised treatment. However, many evidence-based therapies that are effective for addiction recovery also offer significant benefits for managing bipolar disorder.
At Linwood House, if you are dealing with both addiction and bipolar disorder, stabilising your bipolar disorder is the first step before beginning rehab treatment. This is because unstable bipolar disorder symptoms can interfere with addiction treatment, making lasting recovery difficult. Once your condition is stable, several of our addiction counselling therapies can also help manage the symptoms of bipolar disorder, including:
Dialectical Behaviour Therapy (DBT)
DBT is a highly effective therapy based on mindfulness and acceptance principles. It teaches skills in mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. These skills can help you manage your emotions, cope with stress and improve relationships, making DBT particularly beneficial for individuals with both bipolar disorder and addiction.
Individual therapy
Individual therapy offers a personalised approach, allowing your therapist to focus on your specific needs and challenges. For those with bipolar disorder and addiction, individual therapy can address issues such as anxiety, depression and mood swings and help you work through underlying psychological issues contributing to your addiction.
Group therapy
Group therapy provides a sense of community and support, enabling you to connect with others experiencing similar challenges. For individuals with bipolar disorder and addiction, group therapy can address issues like social isolation, mood swings and impulsivity and help build a supportive network during and after addiction treatment.
Aftercare
Aftercare is an essential part of addiction treatment. Linwood House offers free weekly group therapy sessions for a year to provide ongoing support and help maintain your recovery. This continuous support and connection can be particularly important for those with bipolar disorder, who may experience periods of depression when motivation for recovery can drop.
What are the next steps?
If you or a loved one is facing the challenges of bipolar disorder and addiction, Linwood House is here to help. Our compassionate team offers a comprehensive treatment program tailored to address both conditions simultaneously. We understand the complexities of dual diagnosis and are dedicated to providing the support needed for lasting recovery. Reach out to Linwood House today and take the first step towards a healthier, balanced life.
(Click here to see works cited)
- “Bipolar – the Facts.” Bipolar UK, www.bipolaruk.org/faqs/bipolar-the-facts. Accessed 27 June 2024.
- Revadigar N, Gupta V. Substance-Induced Mood Disorders. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555887/
- Bolton JM, Robinson J, Sareen J. Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. J Affect Disord. 2009 Jun;115(3):367-75. doi: 10.1016/j.jad.2008.10.003. Epub 2008 Nov 11. PMID: 19004504.
