Bipolar disorder, formerly known as manic depression, is a fairly well-known mental health condition. The DSM-V identifies different types of bipolar disorder, including bipolar I disorder, bipolar II disorder, cyclothymic disorder, or bipolar disorder not otherwise specified (BP-NOS).1

Bipolar disorder and addiction commonly occur at the same time. In fact, up to 56% of all bipolar patients have experienced substance use issues at some point in their lives.2 Integrated treatment for these two co-occurring disorders is a great way to heal both issues at the same time.

Lisa H, who shares her story at HeroesInRecovery.com, didn’t understand the connection between her co-occurring issues of alcoholism and bipolar disorder until she began pursuing sobriety: “My sobriety birthday is July 5th of 1999. I’m also in recovery with bipolar disorder. I’ve been maintaining a sober life, because I do address my mental illness and work with a doctor on that.  I am in AA to address my issues with addiction. What I didn’t realize was I’ve never shared about both of them, and never thought about how much they go hand-in-hand.”

Here are 10 things you should know about the co-existence of bipolar disorder and substance use disorders (addiction):

  1. Misdiagnosis of bipolar disorder co-occurring with substance abuse is common. Because cessation of drug and/or alcohol use can trigger symptoms of depression and the effects of many drugs can mimic mania, many physicians miss the signs of bipolar disorder among new patients in detox. Without a current diagnosis, the problem may be missed entirely during addiction treatment unless there is a focus on identifying co-occurring disorders.
  2. Screening and assessment may be the first step to understand the origin of symptoms. Proper screening and evaluation can lead to an accurate diagnosis of any co-occurring disorder, including bipolar disorder.
  3. The coexistence of bipolar disorder and addiction in the same patient is not uncommon. Many patients who are living with an active substance abuse problem are also living with a co-occurring mental health disorder – and vice versa. Because mood disorders like bipolar disorder are exceedingly common in the United States, it is common for patients to exhibit both bipolar disorder and alcoholism or drug dependence.
  4. There is no one known cause for bipolar disorder, addiction or the co-occurrence of both disorders. A combination of genetics, environment, biology and other factors are believed to all play a part in the development of both disorders.
  5. Drug use may trigger the onset of bipolar disorder symptoms. Often people question whether or not bipolar disorder predates addiction, but in many cases, it may be that use of drugs and alcohol makes the extreme shifts of mood more extreme and therefore more apparent.3
  6. Many patients use drugs or alcohol to self-medicate the symptoms of bipolar disorder. Because extreme feelings of depression can be uncomfortable, many people who struggle with bipolar disorder drink or get high in order to manage symptoms. Conversely, many bipolar individuals enjoy the manic period of their disorder and attempt to extend it by taking stimulant drugs.
  7. When both bipolar disorder and addiction are present, treatment for both disorders is essentialBipolar disorder and addiction triggers and symptoms are often deeply intertwined, thus treating one disorder without addressing the other is hugely ineffective. Rather, a rehabilitation program that provides intense treatment for both disorders at the same time is advised.
  8. Treatment for bipolar disorder can reduce cravings for drugs or alcohol. Cravings for the drug of choice can be significantly reduced with intensive treatment for bipolar disorder. Other treatment services designed to help prevent relapse are recommended as well.
  9. Medications can be useful for the treatment of co-occurring disorders. There are a number of medications that can be help patients manage detox or limit cravings (depending upon the drug of choice), and there are a number of medications that are useful to help manage the symptoms of bipolar disorder. A combination of these may be appropriate in many cases.
  10. Psychotherapeutic interventions can help patients to regroup and move forward. Ongoing therapeutic treatment is recommended for patients struggling with co-occurring disorder. Long-term sobriety is dependent upon ongoing treatment for both issues and sustained growth in therapeutic treatment.

Want more information about bipolar disorder and how it can affect drug and alcohol addiction treatment at Michael’s House? Contact us today for more information.


1 Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington: American Psychiatric Association, 2013. 123.

2 Hirschfeld, R., Vornik, L. “Bipolar Disorder Costs and Co-Morbidity.” American Journal of Managed Care. 15 June 2005. Accessed 09 Aug 2017.

3 Quello, Susan B., Kathleen T. Brady, and Susan C. Sonne. “Mood Disorders and Substance Use Disorder: A Complex Comorbidity.” Science & Practice Perspectives 3.1 (2005): 13–21. Accessed 09 Aug 2017.

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