Prevalence Of Comorbid Substance Abuse And Bipolar Disorder
Similar to major depression, there is a growing body of literature linking the comorbidity of substance abuse disorders and bipolar disorders. Interestingly, symptoms of mood instability have been reported as among the most commonly reported psychiatric symptoms in a patient population with substance abuse problems.1, 2
Alternatively, studies examining individuals who have been diagnosed with bipolar disorder have found that substance abuse is the single most commonly occurring comorbidity.
More specifically, it has been estimated that about 60% of individuals who have been diagnosed with bipolar disorder are expected to also struggle with substance abuse at some point during their lifetime.7
Much like depression, individuals with bipolar disorder experience a number of distressing symptoms.
It is not surprising that they would look to drugs or alcohol as a quick and easy way of managing their feelings of distress.
Alcohol has been found to be the most commonly abused substance by individuals with bipolar disorder.
The second most common substance abused by individuals with bipolar disorder is cannabis, followed by amphetamines and cocaine.8
Treatments Specifically For Drug Addiction
Drug addiction is one of the most commonly reported reasons for emergency room visits, as well as one of the leading preventable causes of death, making a top major health concern. Long-term substance abuse can lead to irreversible damage to the major organs of the body, including the liver, kidneys, and even the heart.
Receiving treatment for substance abuse can be a difficult matter. In many cases a number of family members have become very intimately involved in the individuals problem, owing to enabling behaviors.
The best way to ensure successful outcomes from treatment is first to avoid using substances altogether. Secondly, its important to recognize symptoms of substance abuse early and seek treatment at the first sign of a substance abuse problem.
Can You Develop Bipolar Disorder Due To Substance Abuse
Both disorders are characterized by chemical dysfunction in the brains reward and motivation systems, so its possible that someone who develops a substance addiction can display symptoms of bipolar disorder, especially feelings of mania when intoxicated by their drug of choice. Depressive-like episodes are also common during periods of withdrawal.
However, there isnt currently evidence that a substance abuse problem can cause continued bipolar symptoms after a user has quit using their drug of choice past the point of withdrawal symptoms.
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Drug Addiction And The Brain
Sadly, no matter what substance is consumed, drug abuse often leads to drug addiction. This can have a major impact on the brain. When a person develops a drug addiction, their brain is restructured to reinforce the consumption of whatever substance they are addicted to. In general, this means the brain makes a person more likely to engage in addictive behavior, forcing them to seek out immediate, usually unhealthy pleasures.
Who Is Most Likely To Have Comorbid Bipolar Disorder And Substance Use Disorder
More men than women have substance use disorder, most often alcohol abuse.2 The same applies to men with bipolar disorder, who are more likely to have substance use disorder.2 Of the patients with bipolar disorder, those with mania are 14 times more likely to have a drug abuse disorder and 6 times more likely to have alcoholism.1 People with substance use disorder have higher rates of mania and hypomania than the general population.1
In a meta-analysis of 22 large multicenter studies and 56 individual studies of comorbid bipolar disorder and substance use disorder, Hunt and colleagues found that both bipolar disorder I and bipolar disorder II had the same prevalence of substance use disorder.2 They characterized the prevalence of bipolar disorder comorbidities, and alcohol use by far was the largest subgroup, at 42%, followed by cannabis , illicit drugs , and cocaine and amphetamine .2
For patients with a lifetime substance use disorder, the mean age of onset of bipolar disorder was 20.7 years vs 24.0 years for those without substance use disorder.2 Patients who had bipolar disorder and comorbid substance use disorder had an earlier age of onset for both disorders and tended to have more hospitalizations than nonusing patients.2 Researchers theorize that early onset of substance use disorder may be both a cause and a consequence of being predisposed to bipolar disorder.2
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Anxiety Depression And Mental Disorders
If a person already suffers from anxiety, or other mental illnesses like post-traumatic stress disorder or social phobia, they may have a higher risk of developing bipolar disorder, according to the NIH. In addition, simply going through stressful experiences, or moments of grief, can increase a persons risk for bipolar disorder.
This may perhaps explain why 11 to 39 percent of bipolar patients also meet criteria for PTSD. Whether PTSD is a direct cause of bipolar disorder or vice versa, however, isnt completely understood. Its possible that traumatic experiences in childhood, such as physical or sexual abuse, can lead to bipolar disorder but its also possible that someone with bipolar disorder might be more likely to be exposed to traumatic experiences during a manic episode and thus develop PTSD later as a result of bipolar disorder.
In addition, studies have shown that children with attention-deficit disorder or attention-deficit hyperactivity disorder are more likely to develop bipolar later on. But its important to recognize that ADHD and bipolar disorder are not the same people often confuse the symptoms of one for the other.
What About Treatment During Pregnancy
There is a special treatment option available for pregnant women with a substance use disorder. This treatment is based on keeping the baby as safe as possible. Otherwise, treatment for men and women is mostly the same.
When addressing treatment for bipolar disorder and addiction during pregnancy, doctors tend to prescribe lithium and other antidepressants due to their track record when it comes to protecting the baby.
In general, though, doctors and treatment professionals will try to limit the number of medications a developing baby is exposed to during pregnancy. As a result, for those women who are pregnant and in treatment, their treatment will focus more on the mental and behavioral side of things such as CBT and other types of alternative treatment like:
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Ten Things You Should Know About Bipolar Disorder And Addiction
Bipolar disorder, formerly known as manic depression, is a fairly well-known mental health condition. The DSM-V identifies different types of bipolar disorder, including bipolar I disorder, bipolar II disorder, cyclothymic disorder, or bipolar disorder not otherwise specified .1
Bipolar disorder and addiction commonly occur at the same time. In fact, up to 56% of all bipolar patients have experienced substance use issues at some point in their lives.2 Integrated treatment for these two co-occurring disorders is a great way to heal both issues at the same time.
Here are 10 things you should know about the co-existence of bipolar disorder and substance use disorders :
What Is The Connection Between Bipolar Disorder And Alcohol Use Disorder
When bipolar disorder and alcohol use disorder occur together, the combination can be more severe than having each diagnosis independently.
Research indicates a person will experience a decrease in functioning, an exacerbation of manic or depressive symptoms, and a higher risk of suicide when these conditions co-occur. In addition, experiencing bipolar disorder and AUD together can cause longer-lasting symptoms and a poorer response to treatment.
Verywell / Ellen Lindner
Mood states are relevant, as some people may use alcohol to cope with emotional discomfort or feelings such as anxiety and depression.
In bipolar disorder, mania reduces inhibitions. Alcohol has the same effect. Mania coupled with alcohol use can further decrease inhibitions, leading to risky behaviors and painful consequences.
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Drug Abuse As A Hindrance To Bipolar Treatment
Treatment of bipolar disorder typically involves both therapy and medication. In the case of bipolar disorder, medication is essential. While trauma and personal factors can worsen and trigger bipolar symptoms, the disorder is biologically driven and persists even when people make significant psychological breakthroughs in therapy.
The medications most frequently prescribed for bipolar disorder are a class of mood stabilizers called anticonvulsants. Medications like lamotrigine and oxcarbazepine for bipolar disorder can help prevent or lessen symptoms of depression and mania. One of the biggest risks for people with bipolar disorder is thinking their symptoms have been cured, discontinuing medications and experiencing a serious manic or depressive episode.
Substance abuse significantly increases the risk that a person with bipolar disorder will stop taking their medications and trigger a recurrence of symptoms that may have been controlled for a long time. Using substances also interrupts the therapeutic process, causing people to forget or abandon skills or insights from therapy. The consequences of dropping out of bipolar disorder treatment can be severe, leading to hospitalization or even attempted suicide.
What Is Drug Abuse
When asked what drug abuse is, most people will likely respond with an answer that resembles something closer to drug addiction than drug abuse. Drug abuse occurs anytime a person consumes any drug in excess, not as prescribed or instructed, or any drug that is illegal.
Because of this, drug abuse applies to a variety of situations. For example, if a person consumes an excess of ibuprofen for a headache, their drug use can be considered abuse. Furthermore, if a person consumes cannabis in a state where cannabis is still illegal, their drug use is also drug abuse even if it might be legal on the other side of a state line.
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Finding The Right Treatment Program
Make sure that the program is appropriately licensed and accredited, the treatment methods are backed by research, and there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.
There are a variety of approaches that treatment programs may take, but there are some basics of effective treatment that you should look for:
- Treatment addresses both the substance abuse problem and your mental health problem.
- You share in the decision-making process and are actively involved in setting goals and developing strategies for change.
- Treatment includes basic education about your disorder and related problems.
- You are taught healthy coping skills and strategies to minimize substance abuse, strengthen your relationships, and cope with lifes stressors, challenges, and upset.
Dual diagnosis programs
Finding the right program can help you to:
Rate Of Substance Abuse For Total Population
Past Year Substance Dependence or Abuse among Adults Aged 18 or Older, by Major Depressive Episode in the Past Year: 2012
On the flip side, studies have also demonstrated that individuals suffering from drug addiction problems are at an augmented risk for also suffering from symptoms of depression. In fact, findings from a large epidemiological study have indicated that adults with either alcohol or other drug-related disorders are 1.9 to 4.7 times, respectively, more likely to have been diagnosed with depression or another affective disorder, than that of the general population.5
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Bipolar Disorders And Substance Abuse Treatment
Until recently, bipolar disorder and chemical dependence were diagnosed separately and treated at various facilities. People diagnosed as bipolar were treated at mental health treatment centers or psychiatric clinics while abusing drugs or alcohol were referred to rehabilitation centers.
Today, addiction professionals understand the importance of treating bipolar disorder and substance abuse simultaneously through integrated treatment.
Integrated treatment involves several various forms of treatment. For instance, your treatment plan might include counseling sessions with an addiction specialist, or one-on-one sessions with a mental health professional, Dual Diagnosis support groups, family counseling, and holistic therapy.
A Bipolar Disorder and Addiction Integrated Program Include These Features:
- Centralized care provided in a rehabilitation facility
- treatment from the team of psychologists, addiction therapists, and other professionals skilled in dual diagnosis
- Psychotherapy aimed at managing your emotions and reducing the risk of substance abuse
- medication prescribed by a described by tor to help you handle the ups and downs of bipolar disorder
- group support for those who are dealing with addiction and bipolar disorder
The Effects Of Drugs On Brain Function And Mood
Drug abuse can lead to addiction, which is when someone becomes dependent on a substance like alcohol or illegal drugs. Addiction is a chronic disease that requires treatment.
When someone abuses drugs or alcohol, he or she experiences withdrawal symptoms when they stop using them.
These symptoms include: sweating, shaking, nausea, vomiting, diarrhea, abdominal pain, headache, muscle aches, insomnia, anxiety, tremors, and hallucinations.
After a person stops abusing drugs, his or her body goes through a process called detoxification. During this time, the body eliminates all the toxins from the system.
As the body cleanses itself, it produces certain chemicals called neurotransmitters. These neurotransmitters regulate how we feel, think, and act.
They also influence our emotions. For example, dopamine regulates movement, pleasure, and reward serotonin regulates sleep, appetite, and mood and norepinephrine controls arousal and attention.
The effects of drug use on these neurotransmitters can result in changes in mood and behavior which may exacerbate mood disorders like bipolar disorder.
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How Is Bipolar Disorder Diagnosed
A mental disorder like bipolar can only be diagnosed by a medical professional. Its one of the most challenging mental health issues to diagnose, particularly when theres also a substance abuse issue at play. Bipolar disorder and substance use disorders share common symptoms, and the following tests help diagnosing professionals make the distinction:
- A doctor uses a range of psychological tests to evaluate the mood, behavior, thoughts and feelings of the individual. They identify examples of depressive or manic episodes and might speak to friends and family to get a more varied perspective.
- Doctors often ask people who display symptoms of bipolar disorder to fill out a mood chart that displays the frequency and intensity of episodes, making an accurate diagnosis easier.
- The medical professional assesses the individuals medical history and history of substance abuse.
- The doctor checks the symptoms the individual displays against the DSM-5 criteria for other mental health disorders addiction and major depression share similarities to bipolar disorder.
The Comorbidity Of Alcohol Use And Bipolar Disorder
The co-occurrence of bipolar disorder and alcohol abuse is more common than originally thought. In an epidemiological study of psychiatric disorders by the National Institute of Mental Healths Epidemiologic Catchment Area , researchers sought to determine just how common this comorbidity is.
Ultimately, the researchers found that more than 60 percent of people with bipolar I disorder and nearly 50 percent of people with bipolar II disorder also struggle with addiction.
At this point, research only has theories as to why alcohol abuse and bipolar disorder are often diagnosed together. For example, behavioral health experts believe genetics and family history play a role in a persons likelihood of suffering from both disorders. It may also be possible that one disorder triggers or worsens the other.
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How Do Doctors Treat Bipolar Disorder
After a successful detox treament, it is time to address both the bipolar and substance use disorder. Depending on your recommended treatment plan, you might begin medication to help address mood swings and other issues with mental illness. Medications for bipolar disorder can calm mood swings and bring equilibrium to a persons life.
Some medications for people with bipolar disorder include:
- Benzodiazepines
For those who either feel uncomfortable or are deemed to be at risk by taking medication, cognitive behavioral therapy is another popular treatment method for addressing addiction and bipolar disorder. Cognitive behavioral therapy addresses the thoughts and feelings that people with these conditions face. By examining the thoughts and feelings that lead to manic and depressive behaviors, addicted people with bipolar disorder can better understand their actions.
Symptoms Of Alcohol Use Disorder
A person must exhibit at least two of the following symptoms within a 12-month period to be diagnosed with alcohol use disorder:
- Cravings or intense urges to drink
- Drinking more significant amounts of alcohol or drinking over more prolonged periods
- Unsuccessful attempts to reduce or stop drinking
- Continued use despite negative consequences at home, school, or work
- Continued drinking despite repercussions in interpersonal relationships
- Drinking in situations that may be dangerous
- Recurrent use of alcohol when the person has mental or physical health-related issues that are made worse by drinking
- Tolerance, as defined by needing more alcohol to achieve intoxication or diminished effect over time when consuming the same amount of alcohol
- Withdrawal symptoms
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Tip : Find New Meaning In Life
To stay alcohol- or drug-free for the long term, youll need to build a new, meaningful life where substance abuse no longer has a place.
Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When youre doing things you find fulfilling, youll feel better about yourself and substance use will hold less appeal.
Avoid the things that trigger your urge to use. If certain people, places, or activities trigger a craving for drugs or alcohol, try to avoid them. This may mean making major changes to your social life, such as finding new things to do with your old buddiesor even giving up those friends and making new connections.