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Bipolar Disorder & Addiction | Dual Diagnosis Prevalence, Symptoms, Risk Factors, & Treatment

Published on April 28, 2021
Bipolar Disorder & Addiction | Dual Diagnosis Symptoms & Treatment

Bipolar disorder is a serious mood disorder that affects thinking, mood, and energy. Some studies show that almost half of bipolar patients also suffer from a form of substance use disorder (SUD).

Left untreated, a co-occurring case of bipolar disorder and alcohol or drug addiction can cause lasting health effects. Serious mental health problems, including suicidal behavior, are more commonly seen in patients suffering from both conditions at once.

Common forms of substance use disorders in bipolar patients include alcohol use disorders and opioid use disorders.

Prevalence Of Bipolar Disorder & Addiction

A 2007 study found that 40% of patients with bipolar I disorder also had a substance use disorder (SUD). The same study reported slightly lower rates of SUDs for patients with bipolar II disorder.

Differences in comorbidity (co-occurring health conditions) between bipolar I and bipolar II may have different causes. Bipolar I disorder is often a more severe mental illness than bipolar II, and hospitalizations can be frequent.

As a result, bipolar I patients may be more likely to turn to more extreme coping methods compared to bipolar II patients.

Symptoms Of Bipolar Disorder & Drug Addiction

Comorbid bipolar disorder and drug addiction can be hard to spot. Symptoms can vary depending on the type of substance taken. They may also be similar to other mental health conditions.

Taking substances may be a way to manage mood swings, maintain energy levels, or simply escape from the mental toll of a manic or hypomanic episode. In the long-term, substances may only make these issues worse. 

Symptoms of both bipolar disorder and addiction can include:

  • aggressive or violent behavior
  • dysphoria
  • more frequent and intense mood episodes
  • changes in decision-making

Suicide attempts and other forms of suicidal behavior are more common in patients struggling with co-occurring disorders.

Risk Factors For Co-Occurring Bipolar Disorder & Addiction

Having a bipolar disorder is one factor that can put you at increased risk of drug abuse and addiction. Other factors can increase your chances of developing both mental health conditions.

Lack Of Access To Resources

Not everyone with bipolar disorder has the means to handle their mental health properly. In these situations, one may turn to illicit drugs or alcohol to self-medicate themselves, or to better manage their symptoms.

Taking drugs or alcohol to cope can lead to a substance use disorder and addiction. 

Stressful Environments

Victims of traumatic, difficult, or stress-inducing incidents may have a higher risk of substance abuse. This may be especially true for trauma and stress during childhood, where there is usually an emphasis placed on proper development.

The same stress-inducing environments have also been linked to more frequent bipolar episodes later on in life.

The Genetic Link

Differences in genetics can affect how your brain chemistry works. This includes how the brain works normally, and how it responds to substances or stressful situations. 

Some people may have a higher risk for mental health disorders, substance abuse, and addiction due to their brain chemistry. Stressors and trauma can add to these risks.

Treatment Options For Co-Occurring Disorders

Finding treatments for both bipolar disorder and substance abuse can be intimidating at first. Struggling with substance abuse may make you more hesitant to seek out treatments that involve other medications.

Treatments that can help with one disorder may not treat both at the same time. Lithium, a common treatment for bipolar disorder, may not be as effective for both bipolar disorder and chronic drug use. Healthcare providers or clinicians you talk to may recommend other options.


Forms of behavioral therapy are proven methods for treating bipolar disorder. Interpersonal and social rhythm therapy (IPSRT) was made specifically to treat bipolar disorder.

The goal of IPSRT is to help bipolar patients understand and stabilize their mental health. This may include setting up and following daily routines, as well as understanding how mood episodes may affect their relationships. Patients may be closely monitored and given interventions if necessary.

There is evidence that treating symptoms of psychosis can lead to a reduced risk of substance abuse. IPSRT may be an effective treatment for patients struggling with both mental health disorders at the same time.

Medication Options

Different medications have been tested for the specific combination of bipolar disorder and drug addiction. Antipsychotics such as aripiprazole (Abilify) and quetiapine (Seroquel) may reduce drug cravings, while effectively treating psychotic disorders like bipolar disorder.

Other medications that have been researched for this purpose include anticonvulsants and antidepressants. Some studies have linked these substances to a lower amount of money spent on illegal drugs, and a longer amount of time spent off of them.

The effectiveness of medications may depend on whether a bipolar patient is entering a manic episode or depressive episode, as well as other factors. Further research may be needed to know how effective these substances are at treating co-occurring disorders.

Find Treatment Options For Dual Diagnosis Today

Finding a dedicated treatment center can help you manage your mental health. You can access both inpatient and outpatient treatment programs where medical professionals can properly diagnose and treat your symptoms.

To find the best treatment available for yourself or your loved one, talk to your healthcare provider or contact us today.

Bipolar And Addiction FAQ

Does Bipolar Disorder Frequently Co-Occur With Cocaine Addiction

Although bipolar disorder is more likely to co-occur with alcohol use and cannabis use disorders, cocaine addiction is the next in line for a dual diagnosis.

Learn more about Bipolar Disorder & Cocaine Use

Is There A Link Between Bipolar Disorder & Meth Use?

Meth use can make bipolar symptoms worse and bipolar disorder can often hide behind the effects of meth use, making it hard to diagnose and treat both conditions.

Learn more about Bipolar Disorder & Meth Abuse

Does Xanax Make Bipolar Disorder Worse?

Xanax can help manage bipolar disorder in the short-term, but Xanax abuse can make symptoms of bipolar disorder worse. Xanax’s sedative effects can make a depressive episode more intense, while Xanax withdrawal can cause symptoms that overlap with bipolar disorder.

Learn more about Bipolar Disorder & Xanax Abuse

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.
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