Treating Bipolar Disorder and Drug or Alcohol Addiction

A co-occurring disorder is a term used to describe when an individual has at least one mental health disorder in addition to at least one substance use disorder. Recent data indicates that around 17 million adults in the United States have co-occurring disorders.¹

People who have a mental health disorder have a higher likelihood of developing a substance use disorder as mental health disorders can be a trigger for the development of substance use disorders,² and specifically, individuals with bipolar disorder are at a greater risk of developing a substance use disorder. ³

Our guide will help you understand what bipolar disorder is, its association with addiction, risk factors for co-occurring disorders, and effective treatment options for individuals struggling with a dual diagnosis, such as co-occurring bipolar and substance use disorder.

What is Bipolar Disorder?

Bipolar disorder is a mood disorder that is characterized by unusual changes in mood, thought patterns and energy with symptoms of both depression and mania. ³ While most people experience highs and lows in mood and energy levels, bipolar disorder “swings” can be extreme and change rapidly or very slowly over time and are markedly different than “normal” changes in mood or behavior as these changes drastically affect an individual’s daily living.³

An estimated 2.8% of adults in the United States have had a bipolar disorder diagnosis in the past year.⁵ Overall, around 4.4% of all people in the U.S. have had a bipolar disorder diagnosis at some point.⁵

Symptoms of Bipolar Disorder

Bipolar disorder is marked by periods of depression and mania or hypomania. Symptoms of bipolar disorder can vary in severity, occurrence, and frequency.^6,7 Generally speaking, symptoms are divided into three categories^,6,7

Episodes of Mania. These episodes are typically the “highs” of bipolar disorder and can include:

• Experiencing excessive energy and activity.
• Risk-taking behavior.
• Feelings of grandiosity and that nothing can go wrong.
• Restlessness.
• Irritability.
• Decreased need for sleep.
• Racing thoughts and excessive talkativeness.

Episodes of Hypomania. These episodes are similar to episodes of mania but less intense. It may not be evident to those with bipolar disorder that they are experiencing an episode of hypomania, but others around them may recognize an unusual pattern of behaviors.

Episodes of Depression. These episodes are typically the “lows” of bipolar disorder and can resemble “traditional” depression symptoms, including:

• Irritability.
• Restlessness.
• Profound sadness.
• Feelings of emptiness.
• Low energy or lethargy.
• Loss of interest in day-to-day activities, hobbies, or socialization.
• Suicidal ideation.

Bipolar disorder is broken down into subtypes depending on the frequency and presentation of symptoms.^6,7 A qualified healthcare professional can provide a diagnosis of bipolar disorder after taking a detailed physical and mental health history.⁷

Co-Occurring Bipolar Disorder and Substance Use Disorder

Substance use and misuse can exacerbate symptoms of bipolar disorder.³ For instance, cocaine use can produce symptoms that are similar to manic episodes, and alcohol use and other central nervous system depressants can lead to symptoms that are commonly seen in depressive episodes. Conversely, bipolar disorder may drive individuals to misuse substances in order to alleviate or cope with any unwanted symptoms associated with their bipolar disorder.³

Someone with bipolar disorder is more likely to also struggle with addiction to drugs or alcohol.⁸ Evidence suggests that between 30%–50% of people with a bipolar disorder diagnosis will develop a substance use disorder in their lifetime.³

Risk Factors for Co-occurring Bipolar Disorder and Addiction

The impact of substance misuse on mental illness, and vice versa, are often intertwined, making it challenging to know which came first.⁹

There is no specific reason or combination of reasons why someone will develop a mental health disorder, substance use disorder, or co-occurring disorders.⁹ On the whole, both mental health and substance use disorders have some overlapping risk factors that include:^9,10

• Parental substance use or mental illness.
• Abuse, trauma, or neglect—especially during childhood.
• Socioeconomic factors, such as poverty.
• Biological factors, including brain structure and neurochemical functioning.

Risk factors for bipolar disorder include life experiences, genetics, and environmental influences. However, this does not mean that any one of these factors directly causes bipolar disorder to emerge.¹¹ Risk factors for bipolar disorder include:^6,11

• Childhood abuse, trauma, or neglect.
• Family history of bipolar disorder as well as schizoaffective disorders (there is a large genetic component to bipolar disorder).
• Substance use, especially at an earlier age.

How to Treat Co-occurring Bipolar Disorder and Addiction

It is not uncommon for individuals struggling with mental health disorders, to have a co-occurring substance use disorder.¹² Research indicates that treating both bipolar disorder and a co-occurring substance use disorder simultaneously is the best opportunity for successfully managing them.^12,13

AdCare offers an integrated treatment program that addresses both bipolar disorder and substance use disorder at the same time. Our inpatient and outpatient programs focus on whole-person care, using evidence-based therapies to effectively treat and manage co-occurring disorders.

If you are struggling with co-occurring bipolar and substance use disorders, or wondering how to help a loved one with addiction, we can support you on the journey. Call our admissions navigators at to learn more about our inpatient addiction treatment centers in Massachusetts and Rhode Island. They will be happy to answer your questions about the treatment admissions process, using health insurance to pay for treatment, and other ways to pay for treatment.

When you’re ready, we’re here to help. Reach out to us today to get on the road to recovery.