Today we continue our examination of dual diagnoses, or the co occurrence of mental illness and addiction. This time, we’re shining the light on bipolar disorder. A staggering 50% of patients with bipolar disorder have struggled with substance addiction at some point in their life.

Bipolar Disorder Defined
Bipolar disorder (also known as manic-depressive disorder) is characterized by dramatic swings in mood. These mood episodes will affect how the person interacts with others, how they sleep, their energy levels, risk-taking behaviors, and even delusions.

During the “up” mood phase, your brain is going a mile a minute, so that you can hardly keep up with it. You might think that you can take any risk, including substance abuse, risky sex, or illegal activities. You’ll probably feel agitated, jumpy, or wired.

Conversely, during the “down” mood, you’re depressed, despairing and despondent. You may find yourself thinking about suicide, and feeling tired, yet unable to sleep. In this mood, patients lose their appetite, lose interest in all their old passions and hobbies, and have a hard time focusing and remembering.

Sometimes, these phases can even be mixed, and people can manifest symptoms from both sides of the spectrum at the same time. Episodes can swing from one to the other several times a week, or several times a year, depending on the person.

The Relationship Between Bipolar Disorder and Addiction
As with depression, patients with bipolar disorder seek out illicit substances in order to moderate their symptoms–both the high and low stages of the disorder. Often bipolar disorder can be traced back to excess or insufficient levels of serotonin, dopamine, and norepinephrine, all of which greatly affect your emotional state. These hormones also moderate your sleep, your stress response, and your appetite.

Unfortunately, drugs and alcohol can worsen the condition, throwing your brain chemistry completely off-kilter. In fact, in some cases, bipolar disorder is a direct result of substance abuse, because of the damage done to the body’s natural regulation systems.

Bipolar Disorder and Addiction Have Some Common Roots
Risk-taking behavior is common in both bipolar disorder and addiction. During the “up” phase of bipolar disorder, people often feel invulnerable. No danger can touch them, and the world is their oyster. Without concern for risk and self-preservation, substance abuse doesn’t hold the same weight. Both bipolar disorder and addiction can cause a person to take bigger and bigger risks, and make bigger and bigger sacrifices in their life for the sake of sensation-seeking.

Bipolar disorder and addiction also have trauma in common. Both can be caused by a history with traumatic environments and conditions. Additionally, both can cause harmful, traumatic conditions and incidents, creating yet another self-perpetuating cycle from which it would be hard for patients to break free.

Treatment of Bipolar Disorder and Addiction
Both of these conditions must be treated together. If a patient is treated for their addiction, but finds him or herself back in an extreme high or low caused by bipolar disorder, all of the lessons, coping mechanisms, and physical rehabilitation gained from therapy can be thrown out the window.