Bipolar Disorder and Addiction

Living with bipolar disorder can feel like riding an emotional rollercoaster; soaring highs, crushing lows, and the uncertainty of what tomorrow might bring. For many, the struggle doesn’t stop there: research shows that people with bipolar disorder are far more likely to develop substance use disorders than the general population. Drugs or alcohol may seem like a way to quiet racing thoughts or smooth out the unpredictable swings of bipolar disorder, but they often intensify the cycle and make recovery harder. Explore the link between bipolar disorder and addiction as well as options for effective healing with Avenues Recovery, a leading provider of addiction treatment.

What Is Bipolar Disorder?

Bipolar disorder is a mental health condition marked by extreme mood swings that include episodes of mania and depression. Mania involves high energy, reduced need for sleep, and impulsive behavior, while depression causes low energy, sadness, and hopelessness. 

A “manic” episode may include:

• Intense feelings of euphoria, excitement, or happiness
• Appearing abnormally jumpy or wired
• Having excessive energy and feeling very productive
• Insomnia or restlessness (a decreased need for sleep)
• Speaking fast or being unusually talkative
• Racing or jumbled thoughts
• Distractibility
• Inflated self-esteem and a feeling of invincibility
• Doing impulsive, uncharacteristic, or risky things - like unsafe sex or spending uncontrollably
• Increased agitation and irritability
• Hypomania

A “depressive” episode may include:

• Feeling down, sad, worried, worthless, anxious, guilty, empty, or hopeless
• Loss of interest in activities
• Avoiding friends and family
• Feeling tired, having low energy
• Forgetfulness
• Indecisiveness
• Difficulty concentrating
• Changes in sleep, either sleeping too much or too little
• Changes in appetite, either eating too much or too little
• Thoughts of death and/or suicide

A severe manic or depressive episode may also feature psychotic symptoms, such as delusions or hallucinations.

A person who has bipolar disorder also experiences changes in their energy, thinking, behavior, and sleep. During bipolar mood episodes, it can be difficult for individuals to carry out day-to-day tasks, go to work or school, and maintain relationships.

Bipolar Disorder and Co-Occurring Substance Abuse

When bipolar and substance abuse occur together, this is known as comorbidity - the existence of two or more diseases or medical conditions in a patient at the same time. In such circumstances, a dual diagnosis is made. Three different situations can contribute to the comorbidity between bipolar disorder and substance use disorders (SUDs), or bipolar and alcohol abuse. These are:

• Common risk factors, such as childhood trauma and stress, can make people more susceptible to both bipolar and substance use disorders. There are also genetic factors that may predispose a person to both conditions.
• Mental health conditions - in this case, bipolar disorder - may contribute to substance use and addiction.
• On the flip side, substance use and addiction can contribute to the development of mental illness. Individuals who develop bipolar disorder from drug use have what is known as a substance-induced mood disorder, where the substance use disorder precedes the bipolar disorder.

Regarding these last two factors, research shows that people with bipolar disorder are at an increased risk of developing an SUD (substance use disorder), and people with SUDs are more likely to have bipolar disorder than the general population.

The Relationship Between Bipolar and Substance Abuse

There are several reasons why bipolar and drug addiction are linked. Some of these reasons include:

• Self-medication: People with bipolar disorder may use drugs or alcohol to relieve the negative symptoms of bipolar disorder or the side effects of the medications they use to treat it. For example, they may use stimulants to boost their energy during depressive episodes or depressants to calm down during manic episodes.
• Cope with stress and trauma: Individuals with bipolar disorder are at an increased risk of experiencing trauma and stress, which can trigger mood episodes. Drugs and alcohol can be used as a way to cope with these difficult emotions.
• Impulsivity: People with bipolar disorder often have difficulty controlling their impulses. This can make them more likely to start using drugs or alcohol – even though they know how harmful it is - and less likely to stop once they are addicted.

Teenage Bipolar and Substance Abuse 

Teenagers with bipolar disorder are at a high risk of substance abuse, often using alcohol or drugs to cope with intense mood swings, stress, or social pressure. Substance use can worsen symptoms, trigger more frequent mood episodes, and interfere with treatment, making the disorder harder to manage. Because the teenage brain is still developing, this combination can have long-term effects on decision-making, impulse control, and emotional regulation. Parents and carers need to be vigilant with teenagers struggling with bipolar disorder, as drugs and alcohol may seem like an easy option to them. 

Why Co-Occurring Bipolar Disorder and Substance Abuse is Harmful to You

Drug abuse can have some negative consequences for people with bipolar disorder. These repercussions include:

• Worsened symptoms: Although drugs and alcohol may temporarily reduce negative bipolar symptoms, in the long run, they can alter the brain’s chemistry and exacerbate the symptoms of bipolar disorder, both during manic and depressive episodes. This can make it difficult for people to manage their condition and function in their daily lives.
• Worse effects from drugs: Changes in brain activity from bipolar (or any other mental illness) can enhance the drug’s rewarding effects and reduce awareness of its negative effects. This obliviousness to the harmful effects of drugs can make a person more vulnerable to drug misuse.
• Reduced treatment effectiveness: Drug abuse can also reduce the effectiveness of treatment for bipolar disorder. This is because drugs and alcohol can interfere with the way that medications work. Lithium is a drug commonly used to treat bipolar disorder. If other drugs increase lithium levels in the blood, this can lead to lithium toxicity, which can be dangerous and even fatal. If drugs decrease lithium levels in the blood, this can make lithium less effective, which can lead to a return of bipolar symptoms.
• Increased risk of relapse: People with bipolar disorder who abuse drugs and alcohol are more likely to relapse. Patients with comorbid disorders demonstrate poorer treatment adherence and higher rates of treatment dropout than those without mental illness.
• Increased risk of suicide: Drug abuse and alcohol abuse are both risk factors for suicide. This is especially true for people with bipolar disorder, who are already at an increased risk of suicide.

Bipolar and Substance Abuse Treatment

People wonder how to deal with a drug addict who also struggles with bipolar disorder. One of the first steps of treatment will involve working with a specialist to distinguish which symptoms are the result of bipolar disorder and which are the result of drug abuse or withdrawal. At times, these two disorders can manifest similar characteristics. The chronic use of central nervous system stimulants, such as cocaine and Adderall, can produce manic-like symptoms, whereas withdrawal can produce depression-like symptoms.

There are several treatment options available for people with bipolar disorder who are also struggling with drug abuse.

These treatment options include:

• Integrated treatment: Co-occurring disorder treatment programs address both bipolar disorder and drug abuse at the same time, rather than the individual having separate treatment for each diagnosis. This type of treatment is often the most effective for people with co-occurring disorders.
• Medication management: Medication management is an important part of treatment for both bipolar disorder and drug abuse. Being on the right medication for bipolar disorder can help stabilize a person’s mood and make them feel more level-headed and able to think more clearly. This allows them to be more in control of their condition and reduces their need to turn to drugs and alcohol.
• Therapy: Therapy can help people understand their bipolar condition better and learn coping skills for managing it. It can help individuals discover which aspects of bipolar disorder they struggle with the most, as well as what things trigger them and make them feel as though they need to take drugs.

Manage Bipolar Disorder and Addiction With Avenues Recovery

Dealing with both bipolar disorder and addiction at the same time can be incredibly challenging and overwhelming, but know that you’re not alone. If you or someone you know has bipolar disorder and is struggling with drug abuse, don’t hesitate to contact Avenues Recovery. Our professional and highly trained staff will work with you every step of the way, in a caring and sensitive manner, to help you regain control of your life. Our staff are experts in the fields of mental health and addiction, and they will not stop at anything until you have reached a place where you can manage your bipolar disorder and live a fulfilling life of sobriety. Contact us today to take your first giant step towards recovery.

FAQs on Bipolar Disorder and Addiction

Can drug use cause bipolar?

Drug use does not directly cause bipolar disorder, but it can trigger symptoms in people who are genetically predisposed. Substances such as cocaine, cannabis, or alcohol can worsen mood swings, increase relapse risk, and make diagnosis harder. Long-term abuse may mimic bipolar symptoms, but it is not the root cause.

What is the relationship between bipolar and substance abuse?

The relationship between bipolar disorder and substance abuse is bidirectional. People with bipolar disorder are more likely to abuse drugs or alcohol to self-medicate mood swings. Substance abuse, in turn, worsens mood instability, increases relapse rates, and complicates treatment, making recovery more difficult and symptoms more severe.

Are people with bipolar disorder more prone to addiction?

Yes, people with bipolar disorder are more prone to addiction. Studies show up to 60% of individuals with bipolar disorder experience substance use disorders, compared to about 10% in the general population. Mood swings, impulsivity, and attempts to self-medicate contribute to this higher risk, making dual diagnosis common.

What is the biggest trigger for bipolar disorder?

The biggest trigger for bipolar disorder is stress. High-stress events such as major life changes, trauma, or sleep disruption often trigger manic or depressive episodes. Stress activates brain systems that worsen mood instability, making stress management and stable sleep patterns critical for preventing relapse and maintaining balance.