Bipolar Disorder and Addiction

Bipolar Disorder and Addiction

Table of Contents

What is Bipolar Disorder?

Bipolar disorder, once referred to as manic-depressive illness or manic depression, causes unusual shifts in mood and can make it difficult to handle day-to-day tasks.1 Liz experienced some bipolar episodes in 2002, 2004, 2005, and 2006. These episodes left her stressed and unable to sleep. She also experienced strange realities, believing she was immortal and the next Queen (Elizabeth III).2 Liz is used to living with bipolar disorder. She finds ways to manage her illness through exercise, support groups, and counseling sessions. Liz’s story is similar to other experiences of individuals that live with bipolar disorder.

The Four Types Of Bipolar Disorder

There are four types of bipolar disorder. The four types include bipolar I, bipolar II, cyclothymia, and bipolar disorder (unspecified).

Bipolar I disorder involves severe episodes of changing moods from mania to depression.

Bipolar II disorder is milder and includes hypomania episodes, or being revved-up, and alternates with periods of severe depression.

Cyclothymic disorder is brief periods of hypomanic symptoms that alternate with short periods of depressive symptoms. These episodes are not as long-lasting like in fully hypomanic or depressive episodes.

Bipolar disorder (mixed or unspecified) is simultaneous symptoms of opposite mood polarities during manic, hypomanic, or depressive episodes. Some people describe the episodes as feeling high energy, sleeplessness, and racing thoughts. During this, the individual may experience:

  • Hopelessness
  • Despair
  • Irritability
  • Suicidal thoughts

Bipolar Disorder and Addiction

Bipolar disorder frequently occurs with substance use disorders (SUD).3 The presence of SUD makes it more challenging to treat these illnesses. In general, people with bipolar disorder are four times more likely to have a substance use disorder.4 It’s common for those living with bipolar symptoms to look for ways to manage symptoms. In some cases, people are willing to find any way to escape from bipolar symptoms. Stimulants, both legal and illegal, frequently work on some symptoms. However, drugs are a quick-fix solution, and the body will begin to crave it.

Rates of Substance Abuse

SUD and bipolar disorder appear with alcohol use 42% of the time. Cannabis is also connected to substance use disorders and bipolar disorders about 20% of the time. Tobacco use among people with bipolar disorder is as high as 60-80%. Data shows a relationship exists between both bipolar symptoms and substance abuse by sharing pathways and behavioral sensitization.5

Substance-Use Mood Disorders

There are times when the use of substances like alcohol, drugs, or medication can lead to a substance-induced mood disorder. To diagnose this, providers must know if there was a mental health problem before the substance use. Often, taking a drug or drinking alcohol can lead to drug-induced mood disorder, which occurs immediately after taking the drug or during the withdrawal phase. Typically symptoms subside within a few days as the detox process progresses.

Four Types of Bipolar Episodes

Bipolar episodes have patterns of mania, severe and moderate, and depressive episodes. The timing, severity, and length of the episode depend on the type of disorder.
Mania and hypomania are two types of bipolar episodes. These episodes have similar symptoms, but mania is more severe than hypomania and can cause more daily life problems. Mania can cause more noticeable issues at work, school, or in other social activities. Mania may also trigger breaks from reality (psychosis), which can require hospitalization. Mania is associated with Bipolar 1 Disorder and lasts at least seven days. Mania is severe and can include episodes of depression, sometimes occurring at the same time. Hypomania is associated with Bipolar 2 Disorder but is less intense with lighter manic episodes and depressive episodes patterns.6

Cyclothymic disorder is a bipolar episode also referred to as cyclothymia. Cyclothymia includes periods of hypomanic symptoms and periods of depressive symptoms that last for at least two years in adults or one year in children. Cyclothymia is defined this way because it is not considered a bipolar I or bipolar II disorder.

Symptoms and Effects of Bipolar Disorder

Experiences of bipolar disorder differ depending on the type. People experience intense emotion, changes in sleep and activity levels, and behaviors that aren’t common to their personalities.7 These periods of change are called mood episodes and can last several days or weeks. Symptoms for manic episodes may include:

  • Elation
  • Irritability
  • Feeling jumpy
  • Decreased need for sleep
  • Loss of appetite
  • Talkativeness
  • Risky behaviors

Symptoms in depressive episodes may include:

  • Feeling worried
  • Hopeless
  • Sad
  • Feeling slowed down
  • Having trouble falling asleep
  • Weight gain
  • Slow talking
  • Trouble concentrating
  • Feeling hopeless or worthless

Major Depressive Disorder Episode

Major depressive episodes are when symptoms have been continuous for at least two weeks. Other symptoms of a major depressive episode include:8

  • Depressed mood
  • Loss of interest in most enjoyable activities
  • Change in appetite
  • Agitation
  • Restlessness
  • Fatigue
  • Feelings of worthlessness or guilt

Treating and Diagnosing Bipolar Disorder


Diagnosing bipolar disorder includes talking to a healthcare provider and getting a complete physical exam. After the primary care appointment, there will be a specialist appointment with a psychiatrist, psychologist, or social worker.

Studies continue to look into the causes of bipolar and genetic risk factors, and most agree there isn’t a single cause. Research has suggested that specific genes are more likely to be connected to bipolar disorder. Research shows that people with a parent or sibling are more likely to have bipolar disorder themselves.


Treatment helps you live with bipolar symptoms and get back to your everyday life. Bipolar disorder is a lifelong illness, and manic or depressive episodes may come back over time. Effective treatments use a combination of talk therapy and medications. Medications include mood stabilizers and antidepressants.

Other therapies include psychotherapy, talk therapy, and cognitive-behavioral therapy.

Substance abuse remains a related issue with bipolar symptoms, with some 60% of people (in one study) having a history of addiction. Although the connection is not fully understood, addiction is involved in many cases and worsens bipolar symptoms.

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