Bipolar disorder is strongly linked to vulnerability to substance use disorders. While nearly 1 in 8 or about 24.5 million U.S. adults struggle with a substance use disorder, 7.2 million of those struggle with a mental disorder such as bipolar disorder. Some studies suggest that the frequency of substance use disorder for bipolar persons is over 30%, thanks to a range of vulnerabilities, personalities that encourage reckless behavior, and self-medication.
If you or a loved one is struggling with substance abuse, there is help. Understanding how bipolar disorder influences addiction and vice versa will help you to make the right decisions about substance use. If you or your loved one is still actively abusing a substance, it’s also important that you work to get help, hopefully from a rehabilitation center offering comorbid or dual-diagnosis addiction treatment.
What is Dual Diagnosis?
Dual diagnosis or comorbidity is the medical term for anyone having more than one mental disorder –co-occurring at once. While dual diagnosis applies to persons with co-occurring disorders such as depression and anxiety, bipolar disorder and PTSD, etc., it also frequently refers to individuals suffering from a mental disorder such as bipolar disorder alongside a substance use disorder. Persons with existing mental disorders are more vulnerable to and more prone to substance abuse and therefore to addiction, meaning that persons with bipolar disorder have a significantly higher frequency of abuse and addiction than an otherwise healthy individual.
This is especially visible when you look at statistics. Persons with comorbid disorders make up over 30% of all persons with substance use disorders. With 1 in 5 adults experiencing some form of mental disorder (including substance use disorder), persons with mental disorders are more than four times as likely to suffer from a substance use disorder. This holds true for the 2.8% of the U.S. population struggling with bipolar disorder.
Why Does Bipolar Disorder Increase Vulnerability to Addiction?
Vulnerability to addiction is made up of multiple facets including genetics, behavior, personality, and environment. While the most decisive factor of addiction (exposure) is down to choice, persons with bipolar disorder struggle with numerous personality and behavior traits increasing their risk of exposure, increasing their risk of abuse, and decreasing their judgement. Each of these greatly exacerbates the risk of addiction, meaning that a large percentage of persons with bipolar disorder eventually struggle with drug or alcohol abuse.
Risk-Taking – Bipolar disorder increases the likelihood of risk-taking, reckless behavior, and impulse decisions. Individuals with bipolar disorder have poor impulse control, especially during manic episodes. This is especially relevant when data showing that bipolar individuals with mania are 14 times more likely to have a substance use disorder than bipolar people without expressions of mania. This is a crucial factor for individuals who experience weeks or even months of uncontrollable impulsive and manic behavior, which can lead to a drug-abuse problem that persists even after the manic period is over.
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Self-Medication – Individuals with mental disorders are significantly statistically likely to attempt to self-medicate, using drugs to reduce mania, try to regain the high of mania, or to compensate for a perceived feeling of being unwell. This can relate to prescription medication abuse as well as seeking out uppers and downers to self-medicate. Persons with bipolar disorder are especially vulnerable thanks to the mood-swings, intensity of emotions, and long periods of up and down associated with the disorder. Someone experiencing a very manic high may recognize that something is wrong and attempt to use drugs to be more normal. Someone in a depressive episode may attempt to use stimulants to recapture the high of mania.
Negative Emotions – Persons with bipolar disorder typically experience extreme emotional highs and lows, which can contribute to substance use and abuse. Individuals are highly likely to use drugs and alcohol to either celebrate highs or to attempt to self-medicate negative emotions, and persons with bipolar disorder are especially vulnerable. This is very true during recovery as well, where negative emotions are often a trigger for relapse, putting bipolar persons at greater risk of relapse than an otherwise healthy individual. At the same time, persons with mental disorders such as bipolar disorder are more likely to be lonely, socially isolated, and to put themselves in positions where they hurt their loved ones. This can create an increased propensity to feel negative emotions, and more strongly, which increases the likelihood of substance abuse.
Bipolar disorder contributes to an increased chance of addiction in numerous ways, meaning that you are more vulnerable. However, that does not mean you can’t get treatment.
Recovering from Addiction with Bipolar Disorder
An estimated 51% of all persons with bipolar disorder suffer from a substance use disorder at some point during their lives. While many never go on to seek help, many rehabilitation facilities offer programs specifically designed to help comorbid and dual-diagnosis patients, including those with dual diagnosis. In some cases, these programs will be specifically tailored to individuals with bipolar disorder but are much more likely to be personalized and tailored to the individual patient during intake.
Dual-Diagnosis addiction treatment programs treat bipolar disorder and substance use disorder as interlinking disorders which cannot be treated separately. This is a stark contrast to traditional programs, which only treat substance use disorder. It’s also an important shift in approach, because persons with bipolar disorder cannot typically recover from substance use disorder without having their bipolar disorder treated, but they can’t have their bipolar disorder properly treated without recovering from substance use disorder.
The answer is an integrated treatment, typically designed around the individual, with psychotherapy, counseling, behavioral therapy, and counseling. In most cases, this means seeking out intensive inpatient care in a rehabilitation facility, seeking out treatment from a rehab facility offering psychologists trained in dual diagnosis, and seeking out bipolar management treatment including psychotherapy to manage emotions.
Behavioral Therapy – Behavioral therapy is overwhelmingly the most popular option for treating both bipolar disorder and substance use disorder. For dual-diagnosis patients, it’s often used to approach both cravings and behavior behind substance abuse and emotional regulation and manic/ depressive episodes. Behavioral therapy is typically one-on-one with a therapist who may use cognitive behavioral therapy, dialectical behavioral therapy, or another similar therapy to help patients recognize, change, and replace behaviors.
If you or your loved-one is seeking help for substance addiction, call us at (714) 443-8218 and look into our recovery programs. Our Drug and Alcohol Treatment Center in Huntington Beach helps clients by providing them with addiction intervention services, detox, and residential addiction treatment.
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