Bipolar Disorder and Substance Abuse Treatment in New Jersey

Substance use disorders commonly coexist with bipolar disorder, impacting clinical outcomes significantly. The reasons for the heightened risk of addictive disorders in individuals with bipolar disorder remain unclear, but emerging data suggest shared underlying neurobiological and genetic factors. Treating bipolar disorder and addiction necessitates a comprehensive, multidisciplinary approach. Addressing the complexities of a mental health disorder and substance use disorder is referred to as dual diagnosis treatment.

What is Bipolar Disorder?

Bipolar disorder is a mental illness that causes a person to have extreme shifts in moods. It affects roughly 1.5% to 2.5% of the population.

These extreme shifts are caused by chemical imbalances in the brain. This could be due to genetics or even a traumatic event in someone’s life. Often, they are referred to as “episodes” and can last for days or even weeks.

Depending on the individual, episodes can occur several times a week or only a few times a year. The extreme nature of these imbalances in moods greatly affects a person’s level of energy and ability to focus. Substance abuse can make these imbalances even more severe.

What are the Different Types of Bipolar Disorder?

Bipolar disorder is a mental health condition that causes extreme mood swings. Understanding bipolar disorder starts with recognizing the different types. There are several types of bipolar disorder, each with its unique characteristics:

1. Bipolar I Disorder: This type involves one or more manic episodes, sometimes followed by hypomanic or major depressive episodes. Manic episodes last at least a week and are severe enough to require immediate medical care.
2. Bipolar II Disorder: In this type, one or more major depressive episodes occur along with at least one hypomanic episode. Hypomanic episodes are similar to manic episodes but less severe.
3. Cyclothymic Disorder (Cyclothymia): Cyclothymia involves periods of hypomanic symptoms and periods of depressive symptoms lasting for at least two years (one year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
4. Other Types: These include, among others, bipolar and related disorders due to another medical condition, such as Cushing’s disease, multiple sclerosis, or stroke. Another type is “drug abuse-induced bipolar and related disorder,” which is directly caused by substance abuse or due to the side effects of a medication or other treatments.

Each type of bipolar disorder has different symptoms and requires different treatment strategies. Therefore, a correct diagnosis is crucial for effective management of the condition.

What are the Different Episodes A Person with Bipolar Disorder Experiences?

• Depression or depressive episodes – These symptoms are similar to the clinical definition of depression. A person will feel sad, low energy, and have low self-esteem. They will also withdraw away from interests as they have little ability to concentrate. They may also eat very little, or another extreme is over-eating.
• Mania or manic episodes — Someone experiencing a manic episode will have extremely high energy, racing thoughts, and overall restlessness. Their excitement and enthusiasm levels will also be elevated. This is dangerous as it can cause them to be reckless and risky due to their careless attitude.
• Hypomania or Hypomanic episodes – These symptoms are similar to mania; however, the individual is not acting as extreme as in a manic episode. These episodes also typically last only a few days.
• Other Mixed Episodes – Some individuals will suffer from a blend of these episodes. It is usually due to the use of alcohol and drugs that could be triggering more chemical imbalances.

Bipolar disorder can even be brought on by substance abuse. Drug use changes chemical balances in the brain, most notably, the reward center that makes using drugs feel good. Because of continued or excessive use of a substance, it can have the ability to rewire parts of the brain that affect your overall mood and actions. Sadly, even a person who has no previous issues with a mental illness can develop bipolar disorder due to drug use.

How Does Bipolar Disorder Develop?

The development of bipolar disorder is usually attributed to a combination of genetic, environmental, and physiological factors:

• Genetic Factors: Bipolar disorder tends to run in families, suggesting a genetic component. Genetic factors account for approximately 80% of the cause of the condition.
• Brain Structure and Functioning: Some experts believe bipolar disorder is partly caused by an underlying problem with specific brain circuits and the functioning of brain chemicals. Three brain chemicals — norepinephrine, serotonin, and dopamine — are involved in both brain and bodily functions.
• Environmental Factors: Certain life events and experiences can trigger bipolar disorder in people who have a genetic predisposition. Some experts believe that experiencing a lot of emotional distress as a child, such as trauma or abuse, can cause bipolar disorder to develop.
• Age and Onset: Most of the time, bipolar disorder symptoms start during late adolescence or early adulthood. Occasionally, children may experience bipolar disorder symptoms. The disorder can occur at any age, although it often develops between the ages of 15 and 19 and rarely develops after 40.

While the exact cause of bipolar disorder is unknown, it is generally accepted that it is the result of a complex interplay of genetic, physiological, and environmental factors.

Can Drug or Alcohol Abuse Cause Co-Occurring Bipolar Disorder to Develop?

Substance abuse does not cause bipolar disorder to develop, but it can trigger or worsen bipolar symptoms in individuals who already have the condition. Drug abuse and addiction can cause changes in the brain that lead to bipolar disorder symptoms. Even people who were mentally healthy before their addiction can start to exhibit these symptoms.

Substance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Substance abuse also significantly increases the risk of a person with bipolar disorder stopping their medication, which can trigger a recurrence.

However, while drug abuse can make the symptoms of bipolar disorder more severe or frequent, it does not directly cause the disorder. Some medications, drugs, and alcohol may cause you to experience some bipolar moods and symptoms. Numerous studies have reported a connection between alcohol and drug abuse and bipolar disorder.

How Do I Know if I Have Bipolar Disorder?

As we’ve stated before, bipolar disorder is characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Recognizing the signs can be the first step toward getting diagnosed and treated. Here are some of the common symptoms associated with this condition:

Manic or Hypomanic Bipolar Symptoms:

• Feeling very up, high, elated, or extremely irritable or touchy
• Increased activity, energy, or agitation
• Exaggerated sense of well-being and self-confidence (euphoria)
• Decreased need for sleep without experiencing fatigue
• Racing thoughts, talkativeness, and rapid speech
• Poor decision-making, such as making grandiose plans or engaging in risky behavior

Depressive Bipolar Symptoms:

• Feeling very down or sad
• Feeling hopeless or having a lack of energy
• Low self-esteem
• Difficulty concentrating or remembering
• Sleeping too much or too little
• Thoughts of death or suicide

If you’ve experienced some or all of these symptoms, it’s important to see a healthcare provider. They will perform a physical exam, ask about your symptoms, and recommend blood testing to determine if another condition, such as hypothyroidism or a drug interaction, might be causing your symptoms.

Remember, only a healthcare provider can diagnose you with bipolar disorder. If you think you may have this condition, it’s essential to seek help promptly.

Bipolar Disorder and Substance Abuse: A Common Dual Diagnosis

Unfortunately, it is very common for people suffering from bipolar disorder to become victims of substance use disorders. It has been found that around 42% seek out alcohol, and 20% will abuse marijuana.

Typically, people with bipolar disorder are genetically predisposed to alcohol use disorder at somewhere between 47%-57%. This means that the disorders are in some way genetically related.

Also, due to the traits that a person with bipolar disorder develops, it elevates the chances they will engage in substance abuse.

These traits include:

• Inability to cope with stress or stressful situations
• Engaging in excessive reward-seeking activities that occur with mania
• Impulsive behaviors
• Searching for release from depressive episodes

A basic explanation of why a person who has bipolar disorder would look for relief in drugs or alcohol is because they are simply looking to alleviate the symptoms of mental illness. However, people engaging in this behavior may be causing more chemical imbalances by trying to self-medicate.

It is often difficult to diagnose someone with bipolar disorder and substance abuse. Many individuals are not forthcoming about their drug and alcohol addiction, and family and friends may only see the depressive episodes. Therefore, the individual only gets treated for depression.

Addiction and Bipolar Disorder Treatment: Getting the Proper Diagnosis

Dual diagnosis is the very first challenge in caring for people suffering from this co-occurring mental health condition. Next is finding an effective treatment for all bipolar symptoms. A medical specialist must be evaluated to make a thorough assessment.

Receiving a proper bipolar disorder diagnosis is crucial for multiple reasons:

• Appropriate Treatment: Bipolar disorder and substance abuse are complex conditions that require specific treatments. A correct dual diagnosis can help healthcare providers develop an effective treatment plan, which may include medication, therapy, lifestyle changes, or a combination of these to treat bipolar symptoms.
• Understanding the Condition: A proper dual diagnosis can provide clarity to the individual and their loved ones about what manic or depressive symptoms the person is dealing with. It helps in understanding the symptoms, triggers, and measures needed to manage bipolar disorder.
• Reducing Misdiagnosis: Bipolar disorders can often be misdiagnosed because they share similar symptoms with depression and anxiety disorders. However, the treatments for these conditions are different. Therefore, a correct diagnosis can prevent ineffective or potentially harmful treatments.
• Preventing Comorbidity: Substance abuse often co-occurs with bipolar disorder. Without a proper diagnosis, one condition can exacerbate the other, leading to a more severe overall mood disorder.
• Reducing the Risk of Suicide: Both bipolar disorder and substance abuse increase the risk of suicide. Early diagnosis and bipolar disorder treatment can significantly reduce this risk.
• Improving Quality of Life: With the right treatment and support, individuals with bipolar disorder and substance abuse can lead fulfilling, productive lives. Without a proper diagnosis, they may continue to struggle with unmanaged bipolar symptoms.

A proper diagnosis is essential to manage bipolar disorder and find recovery from drug and alcohol abuse. It is essential for the well-being and long-term health of the individual who receives the integrated treatment that bipolar disorder requires.