The Truth About Bipolar And Addiction Treatment

What Is Bipolar And Addiction?

Multiple comorbidities co-occur with bipolar disorder, but substance abuse is widespread.  Its co-occurrence often leads to a more damaging and tricky to treat the course of illness;  it is called “dual diagnosis.”  Genetic and family studies also suggested a considerable overlap and interplay between the two disorders, implying that early-onset bipolar disorder and substance use disorder share some genetic vulnerabilities.  Those with early-onset bipolar disorder are also more likely to have substance use disorders than those with adult onsets.  [1]  The good news is, bipolar and addiction treatment can be obtained simultaneously.

Bipolar disorder is a serious, chronic mental illness distinguished by extreme changes in mood, energy, and activity levels.  Early diagnosis and appropriate treatment of bipolar disorder are crucial because the condition carries a high risk of suicide and can critically impair academic and work performance, social and family relationships, and quality of life.

Research suggests that from 30% to more than 50% of people with bipolar disorder (bipolar I or bipolar II) will develop a substance use disorder (SUD) sometime during their lives.  This co-occurrence obscures the course, diagnosis, and treatment of addiction.  However, bipolar and addiction treatment is available, and relief and recovery are possible—especially with early intervention. [2]

Facts About Bipolar Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSMIV-TR), classified bipolar disorder as a mood disorder and other related mood disorders (e.g., major depressive disorder, dysthymia).  However, the Fifth Edition (DSM-5) placed bipolar disorder in a new category—”Bipolar and Related Disorders.”

Bipolar and addiction treatment is obtainable and effective with the proper diagnosis.
Bipolar and addiction treatment is obtainable and effective with the proper diagnosis.

Bipolar disorder involves encountering two conflicting emotional states:  mania and depression, from which the condition got its former name of manic-depressive illness.  During manic episodes, people feel excited, self-confident, energetic, and euphoric and often have shortened sleep.  During depressive episodes, they feel sad, melancholy, and heavy.

However, bipolar disorder is more complex than a simple division between mania and depression.  Many people with bipolar disorder go through periods when their mood is balanced or euthymic (i.e., not euphoric, manic, or depressed), even without medication.  In addition, some people feel a “mixed state” that fuses the features of mania and depression concurrently.  Mania does not always mean feeling good, however.  Some people feel irritable instead, particularly when substance use is involved.

Also, manic episodes can vary in severity.  Therefore, DSM-5 divides manic episodes into two types:

Mania:  Persisting at least a week and causing significant impairment in social and occupational functioning or requiring hospitalization  (Mania:  Mental illness marked by periods of great excitement or euphoria, delusions, and overactivity.)

Hypomania:  Lasting at least 4 days, often with less severity  (i.e., the transition may be obvious but may not impair functioning)

Signs Of Hypomania

  • Abnormally upbeat, jumpy, or wired
  • Increased activity, energy, or agitation
  • An exaggerated sense of well-being and self-confidence (euphoria)
  • Decreased need for sleep
  • Unusual talkativeness
  • Racing thoughts
  • Distractibility

Some people with bipolar disorder experience  [3]  psychotic features, such as delusions and hallucinations.

One study found that individuals with bipolar disorder described a significantly greater incidence of childhood trauma (such as sexual abuse or physical neglect) and internalized shame than a control group without bipolar disorder.  Another study found a history of childhood trauma in approximately 50% of individuals with bipolar disorder.  Multiple forms of abuse were present in roughly 33% of individuals with bipolar disorder.  Other studies have also found a correlation between childhood trauma and a more complex or severe course of bipolar disorder.  [4]

Types Of Bipolar Disorder Identified In DSM-5

The types of bipolar disorder DSM-5 organizes bipolar disorder into several different diagnostic categories chiefly based on the frequency and severity of the manic and depressive episodes.

  • To be diagnosed with bipolar I disorder, an individual must have had at least one episode of mania.  People with bipolar I disorder experience depression, but having a major depressive episode is unnecessary for the diagnosis.
  • The diagnostic criteria for bipolar II disorder involve having at least one episode of hypomania that lasts at least 4 days and a major depressive episode that lasts at least 2 weeks.  Between 5 and 15% of people with bipolar II disorder eventually have a manic episode that reclassifies their condition as bipolar I disorder.  Bipolar II disorder is sometimes misunderstood as being less severe than bipolar I disorder.  It is not.  Like bipolar I, bipolar II is a chronic illness, and the depressive phases of bipolar II can be severe and disabling.
Do you know that bipolar and addiction treatment can be obtained at the same time? This is called "Dual Diagnosis Treatment".
Do you know that bipolar and addiction treatment can be obtained at the same time? This is called “Dual Diagnosis Treatment”.
  • Significant numbers of individuals have bipolar symptoms at subthreshold or subsyndromal levels  (i.e., below levels required for bipolar I or II).  Some researchers have proposed that subthreshold bipolar symptom presentations be included in a broader category called bipolar spectrum disorders, including other types of bipolar disorders identified in DSM-5, such as cyclothymic disorder and substance/medication-induced bipolar and related disorder.  [3]

Other mental disorders can also be mistakenly diagnosed as bipolar disorder because of symptoms that overlap.  For instance, one study found that 40% of people with borderline personality disorder had been misdiagnosed as having bipolar disorder.  Bipolar disorder and attention deficit hyperactivity disorder (ADHD) also have many symptoms in common, and differentiating between the two is a task for an experienced, licensed mental health professional. [5]

Bipolar And Addiction Treatment And Their Correlation

Symptoms that seem to be caused by bipolar disorder may instead be acute substance misuse or withdrawal symptoms.  Chronic use of central nervous system stimulants, such as cocaine and amphetamines, can produce manic-like symptoms, including euphoria, increased energy, grandiosity, and paranoia.  In contrast, withdrawal can have depression-like symptoms, including apathy, anhedonia (inability to feel pleasure), and thoughts of suicide.  Chronic use of central nervous system depressants, such as alcohol, benzodiazepines, and opioids, can result in poor concentration, anhedonia, and sleep problems, whereas withdrawal can make people agitated and anxious.

A diagnosis of bipolar disorder must be made by a mental health professional licensed to diagnose mental conditions and familiar with differential diagnosis  (the process of differentiating between illnesses or disorders with similar characteristics).

People with bipolar disorder generally misuse alcohol.  People with bipolar disorder and co-occurring alcohol use disorder are less inclined to respond and adhere to treatment and more likely to be hospitalized and attempt suicide than people with bipolar disorder only.  In some cases, the combination of bipolar disorder and addiction may deepen bipolar disorder’s manic and depressive symptoms.  [6]

Only a behavioral health professional licensed to diagnose and treat mental disorders should provide treatment for bipolar disorder.  Treatment can be complex and is often personalized according to a client’s symptoms, needs, preferences, and responses to treatment.

Bipolar And Addiction Treatment And The Problem With Self-Medication

Every day, millions of people take over-the-counter drugs or supplements in their effort to treat general health problems.  It’s handy, cost and time-efficient and keeps them from a doctor’s visit and an expensive bill.

The internet enables individuals to conduct their examination and make a self-diagnosis, which is often incorrect.  In addition, with so many products obtainable at the local pharmacy and even the gas station, people are more predisposed to self-medicate than see a physician.

Self-medication is quite widespread.  Someone with a headache can buy aspirin or Tylenol and feel fine.  Others, whose anxiety may flare up in certain social circumstances, might drink a quick beer to loosen up before a big event.

These are mild instances of self-medication.  However, there are extreme and dangerous situations where someone relies heavily on alcohol, prescription medications, or illegal drugs as a cure.  Not only can this type of self-medication lead to addiction, but it could cost you your life.

Bipolar And Addiction Treatment Dual Diagnosis Approach At We Level Up NJ

We Level Up NJ Dual Diagnosis Treatment Center includes evidence-based therapeutic practices and offers support to family members and loved ones, friends, and the community at large.

We Level Up New Jersey offers comprehensive bipolar and addiction treatment with evidence-based therapies and medically assisted detox.
We Level Up New Jersey offers comprehensive bipolar and addiction treatment with evidence-based therapies and medically assisted detox.
  • Detox & Inpatient:  Inpatient treatment takes place in residential settings and typically lasts 30 to 90 days.  Clients may interest in group therapy, individual therapy, family therapy, medication management, and social environments.
  • Detox & Outpatient:  Outpatient treatment may take place at a clinic or similar setting.  You may meet with your medical professional once per week or several times per week.  This type of treatment takes place in a group setting, although the client may have a chance to meet individually with the counselor.  You may listen to others discuss their struggles with substance use, share their story, or meet with their family in treatment.
  • 12-Step Programs:  Examples include Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), which also provide chances to listen to others who have struggled with substance use.  There are also occasions to socialize with others, seek support from others who may better understand what you are going through, and even connect with a sponsor to help you with your recovery.
  • Support Groups:  Lastly, people can partake in a support group for substance use, bipolar disorder, or both. Support groups may or may not be led by a professional. Still, they often contribute to sharing struggles with others while also listening to and connecting with others who have related struggles.

Like mood disorders, including bipolar disorder, the signs and symptoms that can show if someone may be suffering from a personality disorder will be different depending on the type of personality disorder the individual is struggling with. [4]  It is important to seek professional help to diagnose your condition precisely and get proper treatment.  Above all, never turn to substances of abuse because they will only complicate your life.

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Sources:

[1] BIPOLAR DISORDER AND SUBSTANCE ABUSE: PATHOLOGICAL AND THERAPEUTIC IMPLICATIONS OF THEIR COMORBIDITY AND CROSS SENSITIZATION – National Center for Biotechnology Information

[2,4,5,6] An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders – Substance Abuse and Mental Health Service Administration

[3] Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 Book by American Psychiatric Association

[4] Mood and Personality Disorder – We Level Up