What’s the Link Between Alcoholism & Substance Abuse and Bipolar Disorder

Meet John, a twenty-two-year-old man who was diagnosed with bipolar disorder. Recently, he has been drinking several alcoholic beverages every evening because he says it helps him sleep. Unfortunately, John does not realize that he’s developing a drinking problem.

John believes he’s drinking to relax after a hard day at work, but what he’s actually doing is coping with the stress of his debilitating mental disorder. Like many bipolar patients, John’s drinking habit is actually an attempt at self-medication to help balance the whirlwind of emotions experienced during a rapid cycle, which is also referred to as a “mood swing.”

But what exactly is bipolar disorder, and why does it have such close ties to drug and alcohol addiction? Let’s investigate.

The Basics of Bipolar Disorder


Bipolar disorder is defined as a serious mental illness that can cause rapid fluctuations in mood, ranging from extremely low, depressed states to manic, or high states.

It’s for this reason that bipolar disorder is also referred to as manic depression. Bipolar mood swings can be sudden and, at times, incredibly intense. A bipolar mood can shift from a blissful state to an extremely dark and isolated condition very quickly.

Besides mood swings, other common symptoms of bipolar disorder include the following:

  • Physical pain: Bipolar depression can cause more than mental distress. It can also manifest in chronic aches and pains, specifically in the form of migraine headaches and fibromyalgia.
  • Anxiety: Bipolar disorder can intensify feelings of anxiety, sometimes to the point where the anxiety becomes so overwhelming that it becomes detrimental to daily life. Work and personal life can both suffer as a result. This often leads to further anxiety, leaving the sufferer overwhelmed.
  • Sleep disorders: Some patients may experience strong bouts of insomnia, or sleeplessness, while others will suffer from extreme exhaustion. Changes in sleep patterns are especially dangerous. Many bodily functions depend on normal sleep cycles in order to properly function.

Mixed Episodes

Sometimes these symptoms overlap and send conflicting signals to a patient with bipolar disorder. When this happens, it’s referred to as a “mixed episode.” A mixed episode can significantly intensify discomfort and cause a patient to reach for substances or participate in risky behaviors that they wouldn’t typically engage in.

An example of a mixed episode is a person experiencing anxiety while also suffering from sleeplessness. This person may appear to have extra energy and agitation, combined with paranoid thoughts.

During intense episodes, it can be a major challenge for a person with bipolar disorder to coexist with others and carry on a normal, functional life. It’s for this reason people suffering from bipolar disorder are often prone to social, financial, learning or other developmental problems.

Specifics About Drug Addiction

Alcohol and drugs are common escapes that help bipolar patients cope with the struggles of their everyday lives. Through the process of self-medication, bipolar patients attempt to ease their pain and live normal lives. Addicts often hide information from employers, family members and friends for fear of rejection or negative repercussions.

“People with these disorders often feel hopeless about ever getting better,” explained Professor of Psychiatry at Harvard Medical School Dr. Roger D. Weiss. “They often feel that no matter what they do, it doesn’t help; so they stop trying.”

People who live with drug abuse and bipolar disorder oftentimes abuse substances to try to feel normal, not to get high. Yet there is nothing normal about drug abuse. This can become apparent after a short time of abuse, or a prolonged duration.

Bipolar with Drug Addiction: A Dangerous Combination


The combination of a chemical imbalance and a chemical dependency is called dual diagnosis. Think of it like fighting two intense battles at the same time. The two problems can become deeply intertwined, feeding into one another and making it an even greater challenge to overcome.

How Do Different Drugs Affect Bipolar Patients?

Not all drugs will affect bipolar patients in the same way. The symptoms of bipolar disorder are a direct result of a person’s natural brain chemistry. A person’s age and gender could also play a role in determining physical reactions. Certain chemicals and micro proteins can cause changes in neurotransmitters and brain chemicals like serotonin and dopamine, causing the hallmark mood swings associated with the illness.

It’s for this reason that young bipolar patients are strongly encouraged to be assessed for substance abuse, and to be wary of taking the medication process into their own hands.


Downers, opiates, cannabis and alcohol may temporarily relieve negative symptoms, but can then worsen depressive states once the drugs subside and lead to sickness. This often leaves a user reaching for more chemicals in hopes of regaining the numb sensation that the drugs produced.


Stimulants like cocaine, on the other hand, can produce intense euphoric states, but are also liable to cause major crashes that have the potential to further exacerbate the depressed state that follows.


Some hallucinogenic drugs, like LSD, can even produce full-blown psychotic episodes, which can lead to further bouts of reckless behavior.

Drug Mixing

Further complications may also arise when bipolar patients mix drugs in an attempt to counter the effects of an ingested substance. For example, a person may take a strong stimulant like cocaine in an attempt to gain enough energy to carry on with their normal day, only to find that they have the same fatigue and depression as before. Then, they may take an opiate to try calm their body down from the stimulant.

This type of mixing is extremely dangerous, and could result in hospitalization or even death.

How Common Is Bipolar Disorder and Alcohol Abuse?

Bipolar disorder, previously called manic depression, is a mood disorder categorized by severe changes in mood from euphoric to depressed. Depending on the type of bipolar disorder, individuals may present more depressive symptoms or more manic symptoms, all of which look different among individuals.

Mood disorders, like bipolar, are a common dual diagnosis with alcohol addiction. In fact, the National Institute on Alcohol Abuse and Alcoholism (NIH) reports that 32% of individuals with a mood disorder experience substance abuse or addiction. The NIH also reports that as many as 60% of individuals with bipolar disorder abuse or are addicted to substances of some kind. Even more specifically, around 30% of individuals with bipolar disorder experience alcohol dependence. In other words, roughly one-third of people with bipolar disorder also struggle with alcoholism. That is astonishing.

Why Are Alcoholism and Bipolar Disorder so Closely Connected?

Currently, there is no one scientific explanation behind the co-morbidity of bipolar disorder and alcoholism. Some studies have found connections in genetics which would predispose individuals to both disorders. Other studies have asserted a nature versus nurture approach, citing family relationships and connections to the disorders as the main predictor for co-morbidity. What can be fully understood is the effect of alcoholism on bipolar disorder.

Can Drug and Alcohol Abuse Cause Bipolar Disorder?


Medical experts have concluded that the two problems are separate psychological conditions. Just because someone is diagnosed as being bipolar does not necessarily mean that he or she is dependent on a particular substance, and vice-versa.

It does mean, however, that a person with bipolar disorder is at a higher risk of developing a chemical addiction and should therefore be assessed and educated about the dangers of drugs and alcohol. This is especially true for diagnosed adolescents, who are just beginning to face new temptations. The earlier patients can be informed about their conditions, the better chance they will have of accepting it and choosing to live healthy and productive lives.

Who Is at Risk?

As indicated by the National Alliance on Mental Illness, there are specific groups of people with mental illnesses who are at an increased risk of developing an addiction to psychoactive substances. These groups include males, military veterans and people of lower socioeconomic statuses. People who fall into high-risk categories should be extra cautious about their lifestyle choices.

Remember that drugs and alcohol exacerbate bipolar symptoms and can trigger random or unknown effects. They may in some cases elicit bipolar tendencies that had not previously manifested. But these chemicals alone do not actually cause the disease; bipolar disorder is a condition that is formed from a combination of genetic and environmental conditions.

How Common Is Substance Abuse Among People with Bipolar Disorder?


The likelihood of someone who has been diagnosed with bipolar disorder developing a substance abuse problem is significant. According to a study conducted by The American Journal of Managed Care, about 56 percent of bipolar respondents experienced drug or alcohol addiction at one point during their lifetime.

Further, at least 37 percent of alcohol abusers and 53 percent of drug abusers have at least one serious underlying mental illness. This number could be much higher amongst the general American population. But because many people are misdiagnosed, they’re only being treated for one of their disorders.

Experts believe that of the adults living with co-occurring disorders, or “dual diagnoses” just 34 percent receive proper mental health counseling. Two percent of these adults enroll in drug treatment centers, but only 12 percent seek help for both conditions.

This often creates a vicious cycle where a person may be treated successfully for one condition, but upon being released will wonder why they still feel mentally afflicted. Enrolling in a specific dual diagnosis treatment center is therefore recommended for people in this category.

Dual Diagnosis Treatment: A Holistic Approach


Dual diagnosis is a modern approach to substance abuse and bipolar depression treatment. In the past, the medical industry was reluctant to offer mental health treatment to people who were admittedly addicted to drugs or alcohol. As a result of this, many people were turned away instead of given needed treatment.

There was no understanding, in other words, that the two concepts were so closely tied together. Medical experts believed in linear treatment patterns, where patients suffering from bipolar and drug addiction were told that they need to fix one problem before they could solve the other.

Now that scientists know more about bipolar disorder, there is a greater understanding about how the two conditions feed off of one another. Facilities can now become licensed to treat both disorders at once; these are known as dual diagnosis treatment centers.

Dual diagnosis can include several different types of treatment, depending on the severity of a person’s underlying condition:

  • Immediate medical treatment: Some addictions, specifically those related to alcohol, can require advanced medical treatment in order to prevent issues like seizures or heart attacks during initial withdrawal periods. These patients, who may also include drug addicts, must be closely monitored by a team of physicians before they can participate in additional methods of recovery.
  • Psychiatric counseling: Counseling is a major part of the recovery process because it is designed to teach addicts skills that can help them understand and deal with their illnesses. This form of counseling is especially helpful for people with bipolar disorder.
  • Group support: Dual diagnosis patients must learn to properly reintegrate back into society. Therefore, they are highly encouraged to spend time with and take part in group activities with other recovering addicts. When the patient is deemed healthy enough (for example, they pass through initial withdrawal stages and no longer pose a danger to themselves), they’re often allowed to expand their role in the recovery community.

Unfortunately, not all recovery facilities are created equal. During the dual recovery stage, patients may likely be in fragile mental conditions. They may respond slower to medical treatment, and they may have to spend more time under the close watch of a team of supervisors.

Therefore, it’s vital that the addict is placed in a comfortable facility that offers the level of care needed to help the addict feels safe and secure. The atmosphere should be relaxing and conducive to reflection on past decisions and future plans for a new life of recovery.

The 12 Keys Approach to Dual Diagnosis

12 Keys Rehab, a dual diagnosis treatment facility located in Jensen Beach, Florida, welcomes patients in any condition. Whether it’s someone in the grip of a serious addiction or someone who feels they have simply lost control of their lives, 12 Keys offers immediate and empathetic help.

12 Keys is capable of helping patients fully detoxify from drugs and alcohol while at the same time helping them learn and apply strategies for coping with the severity of bipolar disorder.

Our staff is composed of an advanced team of licensed physicians and counselors, as well as a staff of recovering alcoholics and addicts who can provide firsthand knowledge and support for those in the recovery process.

Offering a full suite of amenities and activities like horseback riding, swimming, fishing and kayaking, 12 Keys strategically and effectively guides dual diagnosis patients toward healthy reintegration into society.

Thanks to the diligent and compassionate care of the 12 Keys staff and onsite resources, patients don’t just come out recovered; they emerge with a renewed sense of confidence and zest for life.

Don’t hesitate to call if you have questions about bipolar vs drug addiction, or think that you or someone you know may be suffering from addiction and bipolar disorder. Take the first step toward recovery and contact 12 Keys today.

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