Bipolar Disorder and Addiction

Bipolar disorder used to be known as manic depression. However, the extremes of clinical depression on the one hand and mania on the other, which justify use of the term bipolar, are still the defining symptoms of the disorder.

If we were to think of a symbol to reflect the experience of bipolar disorder, a see-saw or child’s swing might come to mind; although the swing between one extreme and the other is by no means necessarily even or predictable.  There are wide variations in the patterns of mood swings that sufferers experience as there are also in the number and frequency of bipolar episodes.

The extremes of Bipolar Disorder may disrupt normal life

In the depressed phase, a person may get so low in mood that they become overwhelmed with feelings of hopelessness and worthlessness, which may in turn bring on thoughts of suicide leading sometimes to attempts on life. In a manic episode a person may become “high” with unusual amounts of energy, making grand plans and/or working excitedly on ideas and creative projects. Money may be spent in a seemingly reckless manner. They often don’t feel much like eating or sleeping and become prone to speaking quite rapidly. They may also become quite easily irritated. People in the throes of a manic episode can suffer the symptoms of psychosis such as delusions and hallucinations.

Episodes in which one or other mood predominates can last for weeks and in some cases longer. Some people will find they are only able to enjoy a few periods where mood swings are not so pronounced. It is easy to see why bipolar disorder can come to interfere with the normal and safe conduct of life.

Bipolar Disorder and Addiction may co-exist

Addiction develops as a result of attempting to control mood. It is therefore perhaps unsurprising that people experiencing a distressing degree of volatility in their mood, as with bipolar disorder, may reach for substances of one kind or another in the hopes of self-regulation. A high proportion of people diagnosed with bipolar disorder, which can affect men and women from all backgrounds, are found to have a substance-use problem.  Conversely, addiction may bring on such pronounced swings in mood that a bipolar disorder may develop. However, it is suspected that the condition most often predates substance addiction, while going largely unrecognised. Addiction’s cycle of impending withdrawal and renewed use may exacerbate bipolar patterns.

Simultaneous Treatment and Recovery

It is essential to treat addiction and bipolar disorder simultaneously. Clinical assessment will clarify priorities further once withdrawal from addictive substances has been achieved. Recovery programmes for both addiction and bipolar disorder where they co-exist need to be integrated and complement each other. Medication may well be required to treat symptoms of depression, mania or psychosis but psychological therapies, improved understanding of the conditions and related lifestyle changes, particularly where exercise, sleep and diet are concerned, are essential to any treatment and recovery plan.

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Clinically Reviewed By

Jeff Van Reenen

Jeff van Reenen, MSc, is an Addictions Therapist with 18 years of experience and a personal journey through addiction recovery. Specialising in substance use disorder, behavioural addictions, and relational trauma, Jeff is a member of Addiction Professionals and a certified NARM therapist. His work is particularly focused on supporting the LGBTQIA+ community and those with C-PTSD, leveraging his training in post-induction therapy and motivational interviewing.

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