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The Ins and Outs and Ups and Downs of Bipolar and Addiction

Bi-polar and addiction don’t mix – but try telling that to someone who is addicted and Bipolar. The fact is, drugs and alcohol can initially have a calming effect on the Bipolar brain, which is why so many people with Bipolar become addicted. Using marijuana, alcohol, cocaine, or prescription meds offers temporary and immediate relief not experienced by legally prescribed medications. However; with time, addiction prevails. Soon, the use of drugs and alcohol becomes an addiction and all hell breaks loose.

What You Should Know About Bipolar Disorder

Bipolar Disorder is classified as a severe mental illness that changes a person’s mood between two extremes – mania and depression. Once referred to as “manic-depression,” Bipolar Disorder affects millions of Americans and people around the world. Bipolar causes extreme shifts in a person’s energy levels, moods, and can significantly affect cognition. There is a stigma associated with Bipolar Disorder. Unfortunately, many people fear mental illness. Because people with Bipolar have been known to be unpredictable in their thoughts and moods, many people mistakenly believe people with Bipolar are dangerous. The fact is, most people with Bipolar are more likely to harm themselves than they are to harm anyone else. People with Bipolar Disorder are wildly misunderstood. Most people with Bipolar Disorder are highly intelligent, creative people who make significant contributions to society. There are many famous artists, authors, and actors who have gone on to enjoy successful and fruitful careers because they learned to manage their Bipolar Disorder. It’s time to break the stigma.

Some Statistics Worth Knowing About Bipolar Disorder

Here are some fast facts about Bipolar:

  • Bipolar affects about 5.7 million American adults
  • The average age of Bipolar onset is 25
  • More than two-thirds of people with Bipolar Disorder have a close relative with the illness
  • Bipolar Disorder is equally diagnosed among men and women
  • Internationally, Bipolar Disorder is the sixth leading cause of disability
  • One in five people with Bipolar Disorder will commit suicide
  • People generally suffer from the illness for ten years before being diagnosed

Understanding Bipolar Symptoms

Bipolar Disorder is characterized by episodes of depression and mania. These are explained by rapidly changing chemicals in the brain. Although most people understand depression, there is often some confusion about manic symptoms. Depression happens when there is a dip in the “feel good” chemicals in the brain such as serotonin and dopamine. Mania happens where there is a surge of these chemicals. Here’s what we know about depression and mania: Depression:

  • Extreme sadness
  • Uncontrollable crying
  • Loss of motivation to perform daily tasks
  • Loss of interest in once pleasurable activities
  • Withdrawal from social relationships
  • Body aches
  • Sleep disturbances


  • Extreme energy
  • Rapid speech
  • Decreased need for food or sleep
  • Extreme confidence in one’s own abilities
  • Dangerous risk-taking behavior
  • Delusional or bizarre beliefs

Bipolar Disorder is a baffling condition. Symptoms seem to have a mind and time table of their own. Mania and depression can seemingly come out of nowhere and disappear as quickly as they appear. Researchers are learning more about Bipolar all the time, but unfortunately, the truths behind mental illness are still largely undiscovered. Many mental health experts will tell you they still don’t know a lot about the disorder, although there is a lot of information currently available about Bipolar.

The Types of Bipolar

There are four basic types of bipolar disorder and all of them involve changes in mood, cognition, energy, and activity levels. For someone with Bipolar, moods range from extreme ups to extreme downs – mania and depression. The four types of Bipolar are Bipolar I, Bipolar II, Cyclothymic, and Non-specified. Bipolar I Disorder is defined by the mania that lasts at least seven days. This is the type of Bipolar characterized by extreme mania. With Bipolar I, manic symptoms may become so severe that immediate hospital care is needed. Dangerous depressive episodes also occur with Bipolar I and typically last about two weeks. Mixed episodes – having depressive and manic symptoms at the same time – is also possible with Bipolar I. Bipolar II Disorder is not associated with the heightened level of mania experienced with Bipolar I. This type of Bipolar is defined by a pattern of depressive episodes and hypomanic episodes, which may vary in duration. “Hypomania” is the term used to explain mania of a lesser degree. Someone with Bipolar II does not usually experience full-blown mania. Cyclothymic Bipolar is defined by multiple short-term periods of hypomania coupled with multiple periods of depressive symptoms that last much longer. With Cyclothymic Bipolar, depressive symptoms can last for years but generally do not reach the super low lows associated with Bipolar I and II. Non-specified Bipolar is a generalized term for those who struggle with the ups and downs and highs and lows of Bipolar, but do not fit into the other three categories.

The Facts about Dual-Diagnosis and Bipolar

When addiction and Bipolar are present in the same person, that person is considered to have a dual-diagnosis or co-existing disorders. It’s one thing to have an addiction. It’s another thing to have a mental illness. When the two co-exist, trouble surely follows. Just like other mental health conditions, Bipolar is often accompanied by a substance abuse problem. This is because people with bipolar will “self-medicate” and find temporary relief through the use of drugs or alcohol. The problem is, the Bipolar brain is particularly sensitive to the introduction of chemicals. Someone who has Bipolar and abuses drugs or alcohol is not only going to make their mental health worse, they are also going to have an addiction to deal with. Treating someone for Bipolar and addiction is tricky. Often, symptoms of addiction will mimic symptoms of Bipolar, which makes diagnosis and treatment challenging. For instance, coming down off cocaine can cause someone to be depressed and even suicidal. These are also symptoms of Bipolar. For a treating doctor, there is no way to tell whether the patient is experiencing symptoms caused by Bipolar or addiction. It is recommended that people who are diagnosed with Bipolar Disorder refrain from using drugs and alcohol. Addiction treatment is recommended for those who have developed an addiction and suffer from Bipolar.

Evidence that Marijuana Use May Cause Psychotic Symptoms in People with Bipolar

In terms of public perceptions about marijuana, the country has taken a much more relaxed approach to the drug in recent times. Marijuana has become legal for recreational use in states like Colorado, Washington, and Alaska and has been approved for medicinal use in 28 states and Washington D.C. However; new evidence calls the safety of marijuana into question – especially in relationship to mental illness. Marijuana is the most commonly used illegal substance for those who have a dual-diagnosis. People with Bipolar often use marijuana to manage symptoms and underestimate the powerful effects marijuana can have on the brain. After all, it’s just weed, right? The fact is that smoking marijuana can cause people with Bipolar to have more pronounced mood swings, deeper depression, and heightened irritability. Although marijuana is not linked to mania in Bipolar, there is more and more evidence coming to light that suggests marijuana can worsen depressive and psychotic symptoms for people with the illness.

Bipolar and Cocaine Addiction

For reasons that are not yet understood, the bi-polar brain loves cocaine. People who abuse cocaine or crack and have Bipolar say that using the drug helps with racing thoughts, obsessive thought patterns, and violent mood swings. Also, cocaine is a stimulant and helps to ease the symptoms of depression. One recovering addict with Bipolar puts it this way, “When I am using cocaine, all I think about is using more cocaine! The effects of my Bipolar Disorder take a backseat to cocaine because the drug has complete control of my brain. I guess I abused cocaine because it completely zonked me out. It made me focus on the drug and the high and not my illness.” The problem is, cocaine is a very powerful substance that directly affects the same neurotransmitters in the brain as cocaine. When someone uses cocaine, their brain is overwhelmed with feel-good chemicals like dopamine and serotonin. Once they stop using cocaine, these chemicals are depleted. Cocaine use and its subsequent crash is a lot like Bipolar Disorder – up and down. For someone with Bipolar, these powerful physical symptoms are magnified and make the illness worse.

Recovery from Dual-Diagnosis

Bipolar and addiction are treated with medication, therapy, and an abstinence from drugs and alcohol. Bipolar dual-diagnosis cannot be cured with willpower. Someone who has Bipolar and a substance abuse problem requires specialized treatment. Both the illness and the addiction need to be addressed. Many people who have a Bipolar dual-diagnosis have to complete a detox program or inpatient treatment to detox from the drugs and get sober. This is good news. Many inpatient treatment programs specialize in dual-diagnosis. For those who choose not to go to an inpatient program, outpatient services are also available for people with a dual-diagnosis. Beyond treatment at a rehabilitation facility, there are also 12-Step meetings available. In terms of medication; mood stabilizers, antidepressants, antipsychotics, and sometimes anti-anxiety medications are used to treat Bipolar. However; it is important to recognize that medication alone is not sufficient to treat Bipolar. People with this illness need to take medication and pursue intensive therapy to work through the symptoms of the disorder and learn coping skills. In conjunction with individual therapy conducted with a psychologist, group therapy is especially beneficial for people with Bipolar Disorder. Luckily, groups are free for people with Bipolar through organizations like the National Alliance for the Mentally Ill (NAMI). Although these groups are advertised as support groups, and are often facilitated by a volunteer who is not a mental health professional, NAMI offers these daily groups in cities across the United States. They have proven to increase the quality of life for people with bi-polar.

Get Sober or Stay Bipolar

Although Bipolar is a lifetime illness, many people don’t realize that Bipolar can go into remission. This means someone can actually experience a significant reduction in symptoms of the illness to the degree that it seems the disorder isn’t present at all. When managed properly, Bipolar Disorder can significantly diminish and the person with the diagnosis can experience freedom from the illness. For someone with a dual-diagnosis, remission of Bipolar can only happen if the person is willing to get sober. As long as someone uses cocaine, marijuana, alcohol, or other drugs, he or she is going to continue to suffer. There can be no relief of symptoms unless the cycle of addiction is broken. Chronic drug and alcohol abuse takes a toll on the brain – any brain! For the Bipolar brain, this is even more true. Harmful chemicals that create a “buzz” harm the inner workings of a mind with mental illness and perpetuate the disease.

Bipolar and Suicide

Tragically, 20 percent of all people diagnosed with Bipolar will commit suicide. This is because Bipolar depression is so extreme, the pain of the illness becomes too much to bear. Depression is a natural part of life. We have all been depressed at some point in our lives, but Bipolar Depression is a far cry from having the blues. The loss of a loved one, losing a job, or ending a relationship are all legitimate reasons to feel depressed. But, bipolar depression has no external explanation. It just is. This can make recovering from Bipolar depression feel impossible for someone with the illness. There is no rational explanation for the depression and it feels like it is going to last forever. Bipolar depression can last for months. After a long, exhausting struggle, many people take their own lives as a last resort for trying to cope with the agonizing depression of Bipolar. If you are thinking about harming yourself, reach out for help. There is hope. Call the National Suicide Hotline at 1-800-273-8255. Are you recovering from Bipolar and addiction? Offer your experience, strength, and hope to others below.