Bipolar disorder is a brain disorder that causes a person’s mind to shift. This affects your mood and energy levels. It becomes challenging to carry out daily responsibilities and causes problems with relationships of every nature. Also known as manic-depressive illness, it is known to be a genetic disease. Moods can be highly elevated where you’ll feel incredibly alive and full of energy. These are known as manic episodes. It will eventually turn into a very sad, depressed state which is known as depressive episodes.

Addiction to drugs or alcohol is very common for those with bipolar disorder. There are a variety of reasons someone with bipolar 2 would abuse substances. Part of the disorder causes emotional ups and downs which affects how you behave. Your judgements might be off and you look to numb the dramatic emotions that plague your life. It’s complicated to treat the co-occurring disorder between bipolar disorder and substance addiction. Therefore, addiction treatment is specialized for someone with a co-occurring disorder. If you struggle with addiction and have bipolar 2 disorder, there are ways you can get help and begin recovery.

The Relation Between Bipolar Disorder and Addiction

Substance abuse and bipolar disorder of any kind has a negative effect on your physical and emotional well-being. If you have bipolar disorder, you will often experience problems with relationships, financial issues, accidental injuries and risk of suicide. You are also more likely to become addicted to drugs or alcohol.

The American Journal of Managed Care did a study on bipolar disorder and addiction. Statistics included:

  • Over half of people that participated in the study and suffered from bipolar experienced a problem with drugs or alcohol addiction at some point.
  • Within the group, 46% had abused/and or, had become addicted to alcohol. There were 41% that abused drugs and were addicted.
  • The most commonly abused substance for those with bipolar is alcohol.

Bipolar types

There are four main bipolar types of illness. Each of them share similar characteristics which include obvious changes in your mood as well as energy and activity levels. Your mood rises and then plummets and you don’t have control over when or where it will happen. There is a least severe manic period which is called hypomanic episodes.

  • Bipolar I Disorder is defined by a manic episode that lasts up to one week. The symptoms of the manic episode can be so intense that you’ll need to be hospitalized. Depressive episodes will also occur and will often last up to two weeks. Additionally, it’s possible to experience the symptoms of manic and depression simultaneously.
  • Bipolar II Disorder is defined by depressive and hypomanic episodes. So the hypomanic episode is not as intense as Bipolar I. Full-blown manic episodes won’t occur.
  • Cyclothymic Disorder (cyclothymia) is when many periods of hypomanic symptoms and depressive symptoms occur for up to two years. For children and adolescents, it will usually be one year of symptoms. Cyclothymic Disorder doesn’t meet the requirements to be considered a hypomanic or depressive episode.
  • Other Specified and Unspecified Bipolar and Related Disorders will include bipolar disorder symptoms but don’t match the categories discussed. They may come and go and last for a small amount of time.

More on Bipolar II

Everyone experiences sadness or depression along with elation from time to time. We may intensely focus on a task or feel full of energy. Someone with bipolar II disorder will not be able to control their moods. They are extreme and continue to happen over and over in an uncontrollable pattern.

Bipolar II can be interpreted as a depressive disorder at times. The hypomanic episode might not be detectable in some cases or the patient sees it as their normal character. The problem with this is that if not treated, the hypomanic episodes can turn into the extreme manic episodes or deeper depression.

There are two mood episodes that go along with bipolar II. They include:

Depressive Episodes

The depressive episodes in Bipolar 2 will last for up to two weeks. Typical feelings associated with the depressive episode includes sadness, disinterest in life, and hopelessness. You will feel exhausted during this time as well as agitated, unable to focus, indecisive and potentially suicidal.

Hypomanic Episodes

When comparing bipolar 2 vs 1, one of the big difference is that the hypomanic episode is less extreme. Bipolar I is defined as full-blown manic episodes. With bipolar II, the manic intensity is much less. Hypomanic episode in bipolar 2 will include increased productivity and happiness. You’ll feel like your functioning at a high frequency. You’ll tend to forget that anything is wrong during the time of hypomania. People around you are likely to notice the changes that have occurred with you.

An In-depth Look at Symptoms

There will be two opposing sets of symptoms for bipolar II. The manic symptoms and the depressive symptoms.

Manic Symptoms:

  • Abnormal highs or elation for life.
  • You’ll have a lot of energy.
  • Your activity levels will increase.
  • You’ll feel jumpy and wired.
  • It is usually difficult to sleep.
  • You’re more active than usual.
  • You’ll talk quickly and deviate from subjects, moving onto new topics.
  • You’ll feel irritable, agitated and overly sensitive emotionally.
  • You’ll have a hard time holding onto thoughts because they’re moving so quickly through your mind.
  • You’ll believe you can multi-task with ease.
  • You’re prone to doing risky things like spending money, having reckless sex, or abusing substances.

Depressive Symptoms:

  • You’ll feel a deep sense of sadness, emptiness and hopelessness.
  • You won’t have any energy.
  • Activity levels will decrease.
  • You may have problems with sleeping whether it’s too little or too much.
  • You are unable to enjoy life.
  • You feel worried.
  • You’ll find it difficult to concentrate.
  • You will forget things.
  • You may either over or under eat.
  • You’ll feel exhausted all the time.
  • You may consider death and suicide at this time.

Why People with Bipolar II Abuse Substances

There is no straight forward answer as to why substance abuse and addiction is so prevalent among patients with bipolar disorder. One of the reasons is that many people self-medicated with drugs and alcohol in order to numb the pain associated with their symptoms. When you experience anxiety, pain, depression, or unable to sleep, it can become so overwhelming, you turn to drugs.

This can decrease the feelings of discomfort for a time. The problem lies in that it exasperates once the high wears off. Studies have found that alcohol and drug use can actually trigger bipolar depression or manic episodes. It becomes an evil cycle that is challenging to get out of. Complex addiction treatment may be necessary to assist in recovery of dual diagnosis illness.

Who’s at Risk of Dual Diagnosis for Bipolar Disorder and Addiction?

Age as well as gender make up the dual diagnosis of bipolar 2 and addiction. The Journal of Bipolar Disorder found that young males make up the majority. Secondly, it’s young females. The theory is that the younger population takes more risks and will act on self-destructive impulses more often. Elderly patients with bipolar disorder will abuse substances much less.

Researchers have found that there is an influence on brain chemistry from bipolar disorder as well as substance abuse. If you have bipolar disorder, your levels of serotonin, dopamine, and norepinephrine are abnormal. These are the chemicals that govern things like your response to stress, your appetite, metabolism, and how well you sleep. They also influence your moods and feelings.

If you abuse drugs or alcohol, this also interferes with how the brain processes the chemicals in your brain. It can cause erratic energy levels depending on what substance you use. You become even more emotionally unstable and are more susceptible to falling into depression. Generally, people will turn to drugs and alcohol unconsciously to feel more normal. By the time addiction has taken hold, you’re all too aware that substance abuse has the opposite effect. Bipolar disorder worsens through substance abuse.

The Risks of Abusing Substance If You’re Bipolar II

Substance abuse will affect bipolar disorder negatively. Here are some of the common issues that arise through abuse of substance:

  • The moods that come with bipolar 2 will be amplified. This includes impulses, hostility, irritability, highs and lows, and poor judgment.
  • The episodes of emotional instability will last longer.
  • There is a greater risk of suicide.
  • Quality of life will diminish and there will be a feeling of complete hopelessness.

How Manic Episodes Contribute to Addiction

Bipolar II brings about psychotic episodes where you’re not living in reality. Delusions of grandeur and hallucinations may occur. The difference between bipolar I disorder and bipolar II disorder is intensity levels. It is more common in bipolar I patients to fall out of reality fully and is the reason for hospitalization. There is also unrealistic thinking with bipolar II patients. Beliefs that are not conducive to reality.

Due to these beliefs, high-risk behaviors may occur. The belief of invincibility can cause you to think you can fly or that you can have risky sex without consequence. This may also promote heavy drug or alcohol abuse. Symptoms of manic episodes may cause you to numb yourself, get to sleep, or relax.

How Depressive Episodes Contribute to Addiction

JAMA has found that bipolar depression episodes are the more debilitating aspect of the disorder. It is the depression that makes it feel impossible to live. This is where you will miss out on life and stop going to work. You might lay in bed all day and think extreme negative, dark thoughts. During the time of hypomanic episodes, you may have already become accustomed to excessive drinking or drug use.

During the depressive episode, you may then use substances to harm yourself. You may try to overdose as symptoms during this time include suicidal ideation. If you’re feeling hopeless, self-destruction is a natural pattern. All of these symptoms within depression increase your chances of abusing drugs or alcohol.

The Similar Symptoms Between Addiction and Bipolar

It’s hard for you to know whether it’s the substance abuse or bipolar disorder that’s causing symptoms. They become so closely intertwined, you can’t determine what is dominating your moods. If you’re going through a manic episode, it may appear to others that you’re using cocaine. Your mood is elevated and you have a lot of energy.

If you’re in the midst of a depressive episode, it might seem like you’re going through withdrawal. The symptoms are so similar. When you are suffering with addiction and have a co-occurring bipolar disorder, you’ll need to get help from someone professional trained in making the dual diagnosis. It’s challenging to distinguish what symptoms sit with what disorder.

Treating Co-Occurring Disorders

To effectively treat a co-occurring disorder, a professional would have to tackle two problems at once. Often medication is put in place for short term in order to treat conditions. Someone with bipolar II disorder who has an addiction can go through medically-assisted detox. This will also focus on reducing symptoms of your bipolar disorder.

Medications Used for Bipolar Disorder and Addiction

Many times, doctors will put someone with bipolar disorder on medications to ease symptoms. If you’ve been self-medicating, you likely haven’t used these medications. Addiction medications will help reduce cravings and withdrawal symptoms. These medications will vary depending on what you’re addicted to.

Medications for bipolar disorder 2 can relax the body and shift your mood, bringing balance back into your life. While medication is by no means the answer, when you’re dealing with the co-occurrence of bipolar and addiction, it may be necessary to get you on the road to recovery. Medications related to bipolar disorder include anticonvulsants, antipsychotics, lithium, and benzodiazepines. Doctors are less likely to prescribe benzos in this case because they’re addictive.

Cognitive Behavioral Therapy has been proven through studies to effectively help with both addiction and bipolar symptoms. This therapy focuses on how you feel and what you’re thinking. Through examination of these thoughts, you begin to understand your actions. This will help you to maintain strength through cravings as well as manic and depressive episodes.

Dual Diagnosis Help

It’s important to note that diagnosing addiction is easier than seeing bipolar disorder for what it is. If you have a history of manic episodes and bipolar depression episodes, your addiction may be covering it up. Some may have developed as a result of addiction which makes it even more challenging. Not to say that drugs and alcohol cause bipolar disorder, but it can cause it to surface in midst of addiction.

For someone with bipolar disease, you’re four times more likely to have a substance abuse problem. Nobody wants to feel the kind of sadness you feel as someone with a bipolar disorder. In your feelings of despair, you may feel that drug or alcohol abuse is your only solution. There are alternatives though and when you get the help you need, you gain hope with the possibility of leading a normal life.