Bipolar disorder and substance abuse often go hand in hand. Research shows that up to 50% of people with a mental health condition also struggle with addiction, and those with bipolar disorder are seven times more likely to develop drug or alcohol dependence.
This prevalence is significantly higher than in the general population, highlighting the increased risks faced by individuals with bipolar disorder. This link stems from shared genetic, environmental, and neurological risk factors (often referred to as common risk factors) that help to explain the strong correlation between bipolar disorder and substance abuse.
Because of this overlap, effective treatment must address both conditions together through an integrated and individualized approach. People with bipolar disorder often have unique treatment needs due to the complex interaction between their mood symptoms and substance use.
Individuals with bipolar disorder who also experience addiction require specialized care that takes their unique challenges and vulnerabilities into account. At 449 Recovery, our dual diagnosis program combines comprehensive addiction care with specialized bipolar disorder treatment to help clients manage their symptoms, achieve sobriety, and build healthier lives.
Bipolar disorder is a mental health condition that impacts a person’s mood, energy levels, concentration, and daily functioning. Formerly known as manic depression, it is marked by extreme mood swings between manic, hypomanic, and depressive episodes that disrupt everyday life.
The symptoms of bipolar disorder include distinct episodes of mania, hypomania, and depression, each with specific signs that affect emotional, physical, and behavioral functioning. These bipolar symptoms can vary in intensity and duration, often complicating diagnosis and treatment. Bipolar disorder often co-occurs with other conditions, and can influence (or be influenced by) additional mental health challenges, making comprehensive mental health treatment in Orange County essential for long-term stability.
A depressive episode is a distinct period of low mood, often marked by persistent sadness, indifference, or hopelessness. These episodes can mirror the severity of major depression and may include:
- Persistent feelings of depression or anxiety
- Restlessness or irritability
- Sleep problems (such as insomnia, frequent waking, or oversleeping)
- Slowed or limited speech
- Forgetfulness
- Difficulty making decisions or concentrating
- Loss of interest in social activities
- Inability to manage daily tasks (such as bathing or eating)
- Feelings of worthlessness or hopelessness
- Suicidal thoughts or ideation
A major depressive episode, as defined by the Diagnostic and Statistical Manual, lasts at least two weeks and includes many of these symptoms. These episodes are a key feature in diagnosing mood disorders like bipolar disorder.
In contrast, manic episodes bring a surge of energy and heightened activity. Individuals may feel overly confident, impulsive, and struggle to sleep. This state is known as a manic episode, characterized by elevated mood, increased risk-taking, and behavioral changes that can have significant diagnostic implications, especially in bipolar disorder. Manic episode symptoms include:
- Excessive energy and hyperactivity
- Rapid, scattered speech
- Reckless decision-making
- Reduced need for sleep
- Grandiose or inflated self-esteem
- Risky behaviors (such as substance use)
- Intense irritability
- Racing thoughts
- Increased appetite for food, sex, or other activities
- Delusions of grandeur
Sometimes depressive and manic symptoms overlap, creating a “mixed episode.” In this state, a person may feel excessively energized while also hopeless, irritable, or depressed. This can make this type of episode especially disruptive and challenging to manage.
There are multiple types of bipolar disorder, which can differ in severity and symptom patterns:
- Bipolar I Disorder: This type involves severe manic episodes lasting a week or more, often alternating with major depression. Diagnosis and treatment can be challenging when substance use mimics or exacerbates mood episodes, making it harder to distinguish between symptoms and the effects of self-medication.
- Bipolar II Disorder: Bipolar II is characterized by longer periods of severe depression with shorter, less intense hypomanic episodes. Individuals with this type of bipolar disorder frequently self-medicate with substances to manage mood symptoms.
- Cyclothymic Disorder: This condition consists of milder depressive and hypomanic episodes, lasting for at least two years.
- Rapid Cycling: This subtype consists of four or more bipolar episodes in a year, with mood shifts occurring in days or even hours.
The Link Between Bipolar Disorder and Substance Abuse
For individuals already diagnosed with bipolar disorder, drug abuse can worsen symptoms, lengthen manic or depressive episodes, and make mood swings more severe. Many turn to substances in an effort to stabilize emotions, but this often leads to dependence and further complications.
According to the National Library of Medicine, some cases of substance-induced bipolar disorder may resolve with treatment. However, if someone is predisposed to bipolar disorder, substance abuse can trigger its onset earlier or intensify their symptoms. Withdrawal can also mimic or worsen bipolar episodes, making diagnosis and treatment more challenging.
Bipolar Disorder and Substance Abuse
Not everyone with bipolar disorder develops a substance use disorder, but research shows a strong correlation between the two. Alcohol use disorder is especially common and often worsens symptoms of bipolar disorders. When both conditions exist together, the person is said to have a dual diagnosis.
Dual diagnosis treatment for addiction is essential because it provides integrated, evidence-based care that addresses both bipolar disorder and substance use disorder at the same time. This improves the chances of effective recovery.
According to the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association, individuals with bipolar disorder are at a higher risk of developing substance use disorders, including drug or alcohol addiction. Bipolar disorder and substance abuse are complex conditions that often co-occur, and understanding the risk factors for both is essential for effective treatment and prevention.
Several risk factors can contribute to the development of bipolar disorder and substance abuse, including genetic predisposition, brain chemistry, and environmental factors. Individuals with a family history of bipolar disorder or substance abuse are more likely to develop these conditions. People with anxiety disorders, such as post-traumatic stress disorder (PTSD), are at a higher risk of developing bipolar disorder and substance use disorders.
The Mental Health Services Administration reports that individuals with bipolar II disorder are more likely to experience co-occurring substance use disorders, particularly alcohol use disorder. This highlights the importance of addressing substance misuse in individuals with bipolar disorder. Research suggests that individuals with bipolar disorder are more likely to experience depressive symptoms, which can also increase the risk of substance abuse.
A dual diagnosis can be dangerous if left untreated. Proper integrated care addresses the relationship between the two conditions and how they may interact with each other. Without this comprehensive care, individuals may:
| Without Proper Treatment | Potential Consequences |
| Mental health disorder left unaddressed | Worsening symptoms |
| Addiction treated in isolation | Higher risk of relapse |
| Lack of integrated care | Difficulty achieving long-term sobriety |
| Ongoing mental health struggles | Increased risk of self-harm |
Because mental illness often underlies or contributes to substance use, both must be addressed together. Integrated treatment that combines addiction recovery with mental health care can help to stabilize symptoms, reduce relapse risk, and improve long-term recovery outcomes.
Contact 449 Recovery Today!
Find The Help You Need By Reaching Out To Us Today!
Treatment for Bipolar Disorder and Substance Abuse
There is no one-size-fits-all approach to dual diagnosis care. Treatment should be tailored to each person, combining therapies and medications in a way that addresses their unique challenges and goals.
Effective treatment addresses both bipolar disorder and substance abuse simultaneously. The most successful approach is individualized, combining therapy, medication, and supportive care tailored to the person’s needs.
Medication-assisted treatment (MAT) combines counseling with medications to stabilize mood, manage symptoms, and reduce cravings. Treatment medications play a crucial role in integrated treatment plans for co-occurring bipolar disorder and substance use disorder, as they can help reduce substance use and support mood stabilization. Some bipolar medications can carry risks for misuse, so medical supervision is essential.
Therapy plays a central role in working to manage bipolar disorder and substance use. Common evidence-based therapies for treating both conditions include:
- Cognitive-Behavioral Therapy (CBT): Helps identify triggers, challenge negative thought patterns, and develop coping skills.
- Dialectical Behavior Therapy (DBT): A version of CBT designed to improve emotional regulation, reduce impulsivity, and strengthen relationships.
- Psychoeducation: Provides education on bipolar disorder and substance use, empowering individuals to manage symptoms and recognize their triggers.
- Interpersonal Therapy: Focuses on improving communication, setting boundaries, and resolving relationship issues.
- Integrated Group Therapy: Addresses both bipolar disorder and substance abuse together in a supportive group setting.
Recover Today at 449 Recovery
At 449 Recovery in Southern California, we specialize in treating bipolar disorder and co-occurring substance use disorders. Our team creates personalized treatment plans that account for contributing factors, guiding clients toward long-term recovery.
We help individuals identify their personal triggers, provide education on bipolar disorder and addiction, and offer therapies that support both symptom management and sobriety.
Our bipolar disorder treatment center is here to provide the compassionate, comprehensive care you need to reclaim your life. Contact us today to begin your recovery journey.
Dr. Warren Taff MD, graduated from the University of Birmingham, England School of Medicine, with a BA from Rutgers University. He then went on to UCLA School of Public Health in Los Angeles Health and Human Services and received an MPH. He also attended an internship in internal medicine, with the Veterans Administration. Dr. Taff’s residency includes General Psychiatry at USC, with elective residencies at the Royal Prince Alfred Hospital in Sydney, Australia, and Royal College of Psychiatry. Board certifications include American Board of Psychiatry and Neurology. Dr. Taff has extensive experience in both psychiatry and addiction medicine, extending from 1979 to present. He has held professional titles that include Chief of Staff and Medical Directorship in both hospitals and private sectors.
