The Connection Between Bipolar Disorder and Addiction
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Bipolar Disorder and Addiction The Connection

Bipolar disorder can change the way you feel about yourself, your family, and your friends. It can also change your relationship with substances like alcohol and marijuana. Your nightly drink of scotch or bowl of weed could be the crutch you need to get through the day without damaging your relationships.

If you have both bipolar disorder and addiction, you’re certainly not alone. Tapping into a community of other people who share your concerns could be just what you need to help you get better.

What Is Bipolar Disorder?

Close to 3 percent of American adults have bipolar disorder, says the National Alliance on Mental Illness. The condition touches men and women equally, and in most cases, symptoms appear around age 25. To understand what the disorder is and how it works, we’ll need to dig into a few definitions.

Bipolar disorder is a disease of moods. While all of us go from happy to moderate to blue during an average week, people with bipolar disorder have bigger changes during shorter time periods.

Mania is at one end of the spectrum. Someone having a manic episode may feel:

  • Energetic
  • Irritable
  • Productive
  • Creative
  • Sped up
  • Reckless
  • Hyper
  • Powerful

Depression is at the other end. Someone having a depressive episode may feel:

  • Sluggish
  • Sedated
  • Upset
  • Worried
  • Forgetful
  • Exhausted
  • Suicidal

two sides of same bipolar woman

Everyone with bipolar disorder has shifts in mood. But where you move on this spectrum from mania to depression characterizes what type of bipolar you have. There are four different versions, says the National Institute of Mental Health:

  • Bipolar I: Your manic episodes last at least seven days, or the symptoms are so serious that you must get treatment in a hospital. Your depressive episodes last about two weeks. You might have times when you feel manic and depressive at once.
  • Bipolar II: Your depressive episodes are long and deep, but you don’t experience the extremes of mania. You might have moments in which you’re slightly manic, but you never achieve the full power of it. Researchers call this hypomania.
  • Cyclothymia: You have hypomanic episodes and depressive episodes, but both are mild.
  • Unspecified bipolar: You shift from mania to depression, but your symptoms don’t meet the criteria of any of the illnesses we’ve already mentioned.

Bipolar disorder is dangerous. You won’t be able to control when you move from one state to another, and while you might want to keep your symptoms hidden, you may find it hard to do so. Your condition will worsen without help, and that could lead you to make dangerous choices.

According to experts, suicide is the leading cause of death among people with bipolar disorder, as up to 17 percent take their own lives due to untreated illness.

Bipolar Disorder’s Link to Addiction

People with bipolar disorder often struggle with addiction. Researchers say that more than 60 percent of people with bipolar I have some kind of substance abuse problem, and about half of people with bipolar II do too.

Almost any substance could be a target for use and abuse if you have bipolar disorder, but most people with the condition focus on alcohol. Researchers say that more than 40 percent of people with both addictions and bipolar disorder abuse alcohol, and about 20 percent abuse marijuana.

Why does substance abuse seem like a good solution for bipolar disorder? That’s a question each person might answer a little differently. But researchers have some theories, including:

  • Shared vulnerabilities. Bipolar disorder causes impulsivity, poor judgment, and hedonism, researchers point out. Substance abuse relies on these same traits. You’ll need a dedication to pleasure and a willingness to ignore consequences to abuse drugs. Bipolar disorder could predispose you to abuse drugs when you would never make that choice without the mental illness.
  • An attempt at control. People with bipolar disorder look for help from four doctors over at least eight years, researchers They understand that something is wrong, but they can’t get the help they need. They turn to drugs or alcohol as a way to control a high mood or ease depression.
  • Hidden problems. Some researchers theorize that people with substance abuse issues sometimes have bipolar disorder, but they just don’t know it. The substances tend to rip off the mask that’s hiding the disorder, and that allows the problems to worsen.

When you have bipolar disorder, it’s hard to control your substance use. When you’re manic, you feel invincible. You lose the ability to see a drug’s dangers. When you’re depressed, you’re unable to find the strength to resist your cravings.

It’s very hard to recover from both conditions without help. But a treatment program can be remarkably effective.

man receiving treatment

How Is Bipolar Disorder Treated?

Imagine coming into an emergency room with a broken finger and a broken heart. If you think the team will home in on your finger and avoid your emotions, you’re right. Addiction medicine is different. Holistic care ensures you get treatment for everything that’s bothering you, including addiction.

Your addiction and your mental health are entwined and tangled. Your team won’t try to separate them. You’ll get care for both issues at the same time.

Bipolar disorder can be treated with medications, and as Mayo Clinic points out, you’ll need to take those drugs for the rest of your life. There may be times when you feel high and happy, and you hope to skip your doses because you don’t need them. That could lead to a relapse of your symptoms as well as a worsening of your addiction.

Your team can also use therapy to help you improve. The Substance Abuse and Mental Health Services Administration says these types of therapy are useful in treating bipolar disorder:

  • Cognitive behavioral therapy: You’ll identify and amend negative thoughts, behaviors, and habits that lead to poor choices.
  • Family-focused therapy: Your family will learn more about your mental illness, and they’ll help you manage symptoms when they start.
  • Interpersonal and social rhythm therapy: You’ll learn more about bipolar disorder, you’ll find ways to keep your life stable, and you’ll work to repair relationships.

The goal of these therapies is to give you power. You’ll understand why your emotions change, and you’ll develop skills to put to use when problems appear. When you know what’s happening and you have tools to use, you’ll be less likely to lean on solutions that don’t work, including drug abuse.

Treatment Works

You can get better, but know that you’ll continue your work for the rest of your life. You’ll need to take your medications, and you may need to check in with your therapist periodically to ensure that you’re still in a safe space.

Don’t consider your therapy a burden. With each day, you’ll be getting stronger and healthier. And you’ll be learning lessons about resolve, relationships, and communication that you can apply in all areas of your life.


Bipolar Disorder. (August 2017). National Alliance on Mental Illness.

Bipolar Disorder. (April 2016). National Institute of Mental Health.

Bipolar Disorder (Manic-Depressive Illness). Mental Illness Policy Org.

Substance Abuse and Bipolar Disorder. (December 2005). Medscape.

Bipolar Disorder. (January 2018). Mayo Clinic.

An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders. (2016). Substance Abuse and Mental Health Services Administration.

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