Bipolar & Addiction

San Diego Dual Diagnosis Treatment Center

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The Link Between Bipolar & Addiction

Many individuals struggling with addiction also struggle with a co-existing mental health disorder like bipolar disorder. Bipolar disorder, previously called “manic depression,” causes mood swings between extreme emotional lows and highs.

About 2.8% of U.S. adults struggle with bipolar disorder, according to the National Comorbidity Survey Replication (NCS-R). One study found that almost half of people with bipolar disorder also struggle with substance abuse in their lifetime. Treatment for both conditions can be essential for finding long-lasting recovery.

What are Bipolar Disorders?

Fluctuations in mood can be common among the population as a whole, but these mood changes generally last a few hours. Bipolar disorders are associated with experiencing extreme emotional states (mood episodes) that usually occur during specific periods of days and weeks. Bipolar disorder is a type of brain condition that causes energy, mood, and functionality to change.

Experts categorize mood episodes as manic, hypomanic, or depressive with bipolar disorder. A neutral mood may occur in between episodes of depression and mania.

This condition can disrupt relationships with family, friends, and loved ones. Difficulties working and going to school may occur when in a depressive or manic episode. Receiving treatment for bipolar disorder can help with living a productive and full life.

Types of Bipolar Disorders

Bipolar disorders regardless of the type all share a clear change in mood, energy, and activity levels. Mood swings with bipolar disorder can include periods of elevated mood and reduced moods. Depending on the type of bipolar disorder, depressive, manic, or hypomanic episodes may occur.

Three categories of bipolar disorder include²:

Bipolar I – to receive a bipolar I diagnosis, experiences with manic episodes must occur. While in a manic episode, intense energy is increasing, and feelings of being uncomfortably irritable may occur.
Bipolar II – a minimum of at least one hypomanic and one major depressive episode must occur. Normally functionality typically resumes between episodes. Treatment for this type of bipolar is often sought out during an initial depressive episode because hypomanic episodes frequently feel pleasurable.
Cyclothymic Disorder – milder form of bipolar disorder involving numerous “mood swings,” with depressive and hypomania symptoms. Symptoms experienced and emotional ups and downs can be less severe than Bipolar I and II disorders.
Types of Bipolar Disorders in San Diego CA

Depressive Symptoms

Bipolar disorders can include experiences with depressive episodes that are similar to the symptoms of major depressive disorder. These kinds of symptoms can last several days to weeks. Depressive episodes can make functioning in daily life challenging.

Depressive episodes can include:

Lacking energy
Feeling hopeless, sad, or irritable much of the time
Feeling self-doubt
Having trouble remembering things or concentrating
Feeling despair or guilt
Feeling worthless or empty
Losing interest in daily activities
Difficulties with eating and sleeping
Having suicidal thoughts
Feeling pessimistic

Mania Symptoms

Manic and hypomanic episodes share similar symptoms of heightened mood but differ in severity. Manic symptoms have the potential to cause a cognitive detachment from reality, while hypomanic symptoms are less severe.

Manic episodes typically include:

Feeling self-important
Feeling elated, happy, or overjoyed
Feeling full of energy
Talking very quickly
Being easily distracted
Lacking sleep
Being easily agitated or irritated
Having seemingly important plans and ideas
Participating in harmful or risky behaviors
Lacking appetite 

What is Addiction?

Addiction is a chronic brain system dysfunction involving motivation, reward, and memory. Drug and alcohol addiction is about how the body craves a behavior or substance. Addiction can cause obsessive or compulsive thoughts over the reward of feeling the effects produced by drugs and alcohol. Focusing on the reward can be accompanied without the care of consequences.

Addiction can manifest with:

Showing a lack of self-control
Inability to stay away from the substance
Lacking an emotional response
Increasing desire for the substance
Not caring how behaviors are causing issues
As time goes on, addictions can interfere with day-to-day life seriously. Addiction also comes with the susceptibility to relapse and remissions cycles.


Addiction in San Diego CA

Signs of Addiction

Most addiction signs relate to an inability or impaired ability to stay in control. Behavioral, social, personality, and health-related changes can occur due to struggling with addiction to substances. Struggling with addiction can cause an inability to stop behaviors despite consequences.

Emotional and behavior changes linked with addiction include:

Blaming other people or factors for problems related to addiction
Poor or unrealistic assessment of the pros and cons that go with behaviors or using substances
Trouble identifying feelings
Increasing sensitivity and more serious reactions to stress
Not being able to tell the difference between physical sensations and emotions

Dual Diagnosis: Bipolar & Addiction

Bipolar and addiction have a high comorbidity level, meaning that the two disorders are commonly diagnosed together. Alcohol and drug use can start as a way to decrease discomfort and bipolar symptoms. But, alcohol and drug misuse can cause manic and depressive episodes, creating a vicious downward cycle.

Gender and age also affect addiction development. Young adults have a greater risk of participating in reckless behaviors or abusing substances compared to other individuals. Men have a greater chance of engaging in illicit drug and start using substances at a younger age than women.

Brain chemistry also is a contributing factor. Irregular norepinephrine, dopamine, and serotonin levels can increase the risk of developing a co-occurring disorder.

Co-occurring alcohol or drug addiction also magnifies bipolar disorder’s negative outcomes. Because of this, inquiring about combining therapies that will target both addiction and bipolar disorder may be beneficial.

Treatment for Bipolar & Addiction

Bipolar and addiction can be diagnosed simultaneously and often requires special treatment. Dual diagnosis treatment can treat both disorders simultaneously and provide the best chance of long-lasting recovery. Therapy and medication management can be offered to help treat addiction and bipolar disorder based on individual needs.

Healthy Life Recovery in San Diego, CA, offers dual diagnosis treatment for bipolar disorders and addiction. If you or a loved one are struggling with bipolar and addiction, reach out to us today. Our team can answer any questions you may have and give you a better understanding of our outpatient program.

Dr. Sanajai Thankachen

Medically Reviewed By:

Dr. Sanjai Thankachen

Dr. Sanjai Thankachen graduated from Adichunchanagiri Institute of Medicine in 2000. He completed his residency in psychiatry in 2008 at Creedmoor Psychiatric Center in New York. Dr. Thankachen is currently working with Pacific Neuropsychiatric Specialists in an outpatient practice, as well as working at multiple in-patient psychiatric and medical units bringing his patients the most advanced healthcare treatment in psychiatry. Dr. Thankachen sees patients with an array of disorders, including depression, bipolar illness, schizophrenia, anxiety, and dementia-related problems.

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Dr. Sanajai Thankachen

Edited for Clinical Accuracy By:

Sean Leonard, Psychiatric Nurse Practitioner

Sean Leonard is a board-certified psychiatric nurse practitioner. He received his master’s degree in adult geriatric primary care nurse practitioner from Walden University and a second postmaster specialty in psychiatry mental health nurse practitioner from Rocky Mountain University. Sean has experience working in various diverse settings, including an outpatient clinic, inpatient detox and rehab, psychiatric emergency, and dual diagnosis programs. His specialty areas include substance abuse, depression, anxiety, mood disorders, PTSD, ADHD, and OCD.

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