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Living with bipolar disorder can feel like an emotional rollercoaster, with extreme highs and crushing lows that make everyday life unpredictable. For many people, dealing with these intense mood swings is overwhelming enough, but when addiction gets added into the mix, things can become even more complicated. The relationship between bipolar disorder and addiction can make it harder to find stability, and it’s something that affects many people.
Can Bipolar Disorder Cause Addiction?
Bipolar disorder does not directly cause addiction; however, the two conditions are often interlinked. Impulsivity is a common symptom of bipolar disorder, especially during manic episodes, which can make people more likely to engage in risky behavior.
Dealing with intense mood swings can feel overwhelming, leaving those with bipolar disorder more at risk of developing unhealthy ways to cope through things like drugs and alcohol. While the disorder itself doesn’t directly cause addiction, it can create situations where addiction is more likely to develop.
What Causes Co-Occurring Bipolar Disorder and Addiction?
Studies show that between 30% and 50% of people with bipolar disorder will develop a substance use disorder (SUD). While there isn’t a single cause, there are several factors that contribute to this co-occurrence, including self-medication, brain abnormalities, and genetics.
Self-Medication
Self-medication is a common but harmful way some people with bipolar disorder try to manage the intense emotional swings they experience. During manic or hypomanic episodes, the surge of energy and impulsive behavior can lead to risky decisions. Drugs or alcohol may be used to amplify the euphoric feelings of mania, making someone feel more invincible in the moment.
On the other hand, during depressive episodes, the overwhelming sadness, hopelessness, or anxiety can push someone to self-medicate as a way to numb those painful emotions. Some of the most commonly abused substances include:
- Alcohol
- Prescription drugs
- Illicit drugs
- Cigarettes
- Marijuana
In fact, studies show that as many as 50-70% of people with bipolar disorder smoke cigarettes to cope with anxiety or stress. While these substances may seem like a quick fix, they can quickly lead to dependence.
Brain Abnormalities
Research has shown that people with bipolar disorder often have differences in certain areas of the brain, especially in regions that help regulate emotions and control impulses. These areas include parts of the prefrontal cortex – the insular cortex, temporopolar cortex, and amygdala. These parts of the brain help in decision-making and managing emotional responses. When the prefrontal cortex isn’t working properly, it can lead to a difficulty in controlling impulses.
The same areas of the brain affected by bipolar disorder are also affected in people who struggle with substance use disorders. This overlap might be one reason why bipolar disorder and addiction often occur together.
Additionally, research into gray matter volume has shown distinct differences that may put adolescents with bipolar disorder at a higher risk for future substance use problems. For instance, in females, decreased gray matter volume in brain regions associated with internalizing behavior and emotional processing may increase the risk. In males, regions involved in attention and executive functioning seem to be more affected. These structural differences could contribute to the increased likelihood of addiction later on in life.
Genetics
If mental illness runs in your family, your genes may increase your chances of struggling with substance use. Research from Washington University in St. Louis found a link between the risk of mental illness and substance abuse.
The study measured this connection using polygenic risk scores (PRS), which indicate how certain genetic factors might influence the risk of both bipolar disorder and substance dependence. Here’s what they study revealed:
- A higher bipolar disorder (BIP) PRS was linked to more symptoms of alcohol dependence among regular drinkers.
- People with higher BIP PRS were more likely to use cannabis and experience moderate dependence compared to non-users.
- Those with cocaine dependence had higher BIP PRS compared to non-users or those with less severe use.
- Elevated BIP PRS was associated with mild opioid dependence, with people experiencing one or two dependence symptoms.
These findings suggest that genetics play a large role in determining how vulnerable someone might be to both bipolar disorder and substance use. If someone is genetically predisposed to bipolar disorder, they may also be more prone to developing substance use issues, even if their substance use starts out recreationally or casually.
Signs of Addiction in People with Bipolar Disorder
Recognizing addiction in someone with bipolar disorder can be tricky because the symptoms of both conditions can overlap or even mask each other. However, there are certain signs to watch for that could indicate someone is struggling with both bipolar and addiction. These signs include:
- Behavior shifts beyond normal mood swings
- Increased impulsivity and risky decision making, especially during manic episodes
- Constant substance use during manic phases
- Isolation and substance use during depressive episodes
- Difficulty managing responsibilities like work, school, or relationships
- Increased tolerance needing more of the substance for the same effect
- Withdrawal symptoms when not using the substance
- Loss of control over substance use
- Changes in social behavior
Treating Both Bipolar and Addiction
When someone is dealing with both bipolar disorder and addiction, treating each condition separately often isn’t enough. Research shows that an integrated treatment approach in which both conditions are treated together leads to better outcomes. This is because the two issues feed into each, and addressing them simultaneously helps break the cycle.
Treatment usually begins with medical detox if necessary to safely manage withdrawal symptoms. From there, inpatient or outpatient programs can provide the structure and support needed for recovery.
Medications can be part of the treatment plan, depending on someone’s specific situation, but medications alone may not be enough. Behavioral therapies can help people manage both their mental health and their addiction.
Some effective therapy options include:
- Cognitive Behavioral Therapy (CBT) helps people identify and change harmful thought patterns.
- Dialectical Behavior Therapy (DBT) teaches skills for managing intense emotions and improving relationships.
- Acceptance and Commitment Therapy (ACT) encourages accepting emotions rather than avoiding them.
- Interpersonal and Social Rhythm Therapy (IGT) focuses on stabilizing daily routines to help regulate mood.
- Contingency Management (CM) or Motivational Interviewing (MI) encourages positive behavior changes through goal setting and rewards.
By combining medication and therapy, people with co-occurring bipolar disorder and addiction have a better chance at long-term recovery. If you or someone you love is struggling with both, reaching out for help is the first step toward healing. There are several resources available that can help guide you through the process and support you along the way.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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