Managing Bipolar While Battling an Addiction

Bipolar Disorder and Substance Abuse

Bipolar and Substance AbuseBeing on the bipolar spectrum is hard to come to terms with and hard to deal with on a long-term basis. Add in substance and/or alcohol abuse to this diagnosis and life can become increasingly difficult.

The risk of comorbidity between bipolar disorder and the abuse of either substances or alcohol is high – multiple recent studies have placed the correlation as high as 60%. This factor brings with it new dangers and symptoms, and can place a person with bipolar at a greater risk of harm.

There are multiple reasons that someone with bipolar disorder might seek out creating an alternative state of mind through alcohol or drugs; it may be a way of self medicating or a way of coping with the symptoms that bipolar brings with it.

Some people use stimulants like cocaine, methamphetamine or speed to try to end a depressive episode by triggering a hypomanic episode. Using stimulants could also be the result of early stages of hypomania itself, as inhibitions are lowered and the sufferer begins to chase an even greater high. In contrast, some people use substances that bring mood down – like heroin, benzodiazepines and alcohol ­– in an attempt to dampen down a manic episode.

Statistics show that substance abuse is more likely to affect men with a bipolar disorder diagnosis, however some studies have shown that it tends to be women who self medicate with alcohol to a greater degree.


This could be in part due to gender differences in bipolar disorder. Men are more likely to be diagnosed with bipolar I and have more manic episodes, thus making them more likely to seek out stimulants to increase the high. Conversely, women are more likely to be diagnosed with bipolar II, which brings with it more depressive episodes and potentially alcohol dependency in an attempt to numb the feelings that depression brings with it.

There have been multiple studies conducted with regards to substance/alcohol abuse and bipolar disorder, and a lot of the associated findings have been very useful in advancing treatment options and providing a greater understanding of how the two factors link in together.

For example, multiple studies have shown a strong correlation between the age of bipolar disorder onset and the risk of substance/alcohol abuse. Patients who showed their first episode (in particular a manic one) between before the age of 19 were far more likely to suffer with some form of addiction at some point during their disorder.

My Story

Cocaine has been found to be one of the most common drugs used by bipolar sufferers. It is also one of the most addictive. In my mid 20s, after being diagnosed with rapid cycling bipolar I but before I was stabilized, I would abuse cocaine during an episode in order to party harder and chase that elusive higher state.

Sometimes I’d even use cocaine to trigger a manic episode. My depressive episodes, although rare, hit hard and fast and it seemed to me that triggering the first stages of mania, those productive weeks where I felt unstoppable, was the only option.

I was extremely lucky that I never became addicted to such a dangerous drug, but I still do not let my guard down in regards to this – I understand I am at a greater risk, especially during the early stages of mania.

Next page: getting help.

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