Footprints to Recovery

Bipolar Disorder and Addiction

Medically Reviewed by David Szarka, MA, LCADC

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Treating bipolar disorder and addiction requires an integrated treatment program. That means treating them simultaneously, as co-occurring disorders. This program should include a team of qualified professionals and a strong support system at home. Although there isn’t a cure for bipolar disorder, there are treatments that can help you maintain a fulfilling and meaningful life.

What is Bipolar Disorder?

Bipolar disorder is a psychiatric disorder consisting of depressed and manic episodes. Around 1% of the population has this condition.

People with bipolar disorder oscillate between various moods. These moods can affect your:

  • Activity levels
  • Concentration
  • Energy level
  • Relationships
  • Work
  • Daily responsibilities

In a depressed episode, people usually experience symptoms including:

  • Extreme fatigue and tiredness
  • Feelings of worthlessness
  • Depressed mood
  • Significant changes in weight
  • Sleep problems or disturbances
  • Losing interest in usual hobbies or activities
  • Restlessness
  • Suicidal thoughts or actions

A manic episode consists of symptoms like:

  • Excessive mind-racing
  • Surges in energy or activity level
  • Abnormally upbeat or wired energy
  • Distractibility
  • Impulsive decision-making (for instance: deciding to start a business or buy a house)
  • Little or no sleep
  • High levels of self-confidence
  • Spending excessive amounts of money (i.e., going on a shopping spree or gambling)

There are three types of bipolar disorder:

  1. Bipolar I disorder consists of a manic episode that persists for at least one week. You may also experience depressed episodes with mixed features: depressive and manic symptoms together.
  2. Bipolar II disorder is defined by a combination of depressive episodes and hypomanic episodes. Hypomanic episodes are less severe than typical manic episodes.
  3. Cyclothymic disorder consists of lower-level hypomanic symptoms and depressive symptoms that persist for over two years.

Bipolar disorder may also include psychotic symptoms. Sometimes it can be hard to tell bipolar disorder apart from other conditions, like schizophrenia or substance use disorders.

What Causes Bipolar Disorder?

Researchers and medical professionals still don’t know exactly what causes bipolar disorder. They do know there are risk factors that may include:

  • Having a family history of bipolar disorder
  • Drug or alcohol abuse
  • Continuous periods of high stress

Is Bipolar Disorder Curable?

In a short answer, no.

There are no cures for mental illness, but you can learn to live with bipolar disorder without your symptoms overpowering your life. Many people with bipolar disorder learn to maintain stable moods for extended periods. During recovery intervals, they may not experience any symptoms at all.

It’s important to remember that each case of bipolar disorder looks different, so any treatment you seek should be specific to you.

Bipolar Disorder and Substance Abuse

Unfortunately, bipolar disorder and substance abuse often go hand-in-hand. People with substance use disorders have higher rates of mania and hypomania. Additionally, those with mania are 14 times more likely to struggle with drug abuse and 6 times more likely to struggle with alcoholism.

Drug use can make it more complicated to determine whether someone has bipolar disorder. That’s because both disorders share symptoms. It’s also because drug use can trigger some bipolar symptoms, like mood swings or psychosis.

Self-Medicating Bipolar Disorder

Unfortunately, many people with bipolar disorder self-medicate with drugs or alcohol. That means they use substances to “treat” unwanted symptoms, without the help of medical professionals. In the short-term, this strategy may provide some temporary relief, but it is dangerous for several reasons:

  • It reinforces the need to continue taking drugs or alcohol, which can lead to a substance use disorder.
  • Drugs can cause unpredictable side effects.
  • You may deal with drug withdrawal symptoms.
  • You’re handling your mental disorder—and possibly a substance use disorder—without the help of experienced healthcare professionals.

What are the Treatment Options for Bipolar Disorder?

Medication and therapy are the most popular treatment methods for bipolar disorder. Your doctor or treatment team will collaborate with you to determine the best care.


Many medications can help treat bipolar disorder. Keep in mind it may take some time to find the right medication and dose. It’s essential to take your medication as prescribed. When starting a new medication, you should also learn about potential drug interactions and track your side effects.

Mood stabilizers like Lithium and Depakote can reduce manic symptoms and mood swings. They can also help with rapid cycling symptoms and hallucinations or delusions.

Antipsychotic medications include medications like:

  • Zyprexa
  • Seroquel
  • Abilify
  • Risperdal

They can help if you lose touch with reality during an episode. Antipsychotic medications may be combined with lithium or Depakote. 

Benzodiazepines like Xanax or Klonopin can offer support while waiting for mood stabilizers to reach their full effect. Benzodiazepines can reduce symptoms of anxiety and agitation, but they can also be addictive. Benzodiazepines are a short-term solution for bipolar disorder. People with histories of substance should be cautious about taking these medications and do so only under the care of a doctor.

Thyroid medication can be helpful because many people with bipolar disorder have abnormal thyroid levels.
Antidepressants are taken bysome people to manage depressive symptoms, but antidepressants may trigger manic episodes. To reduce this chance, doctors also typically prescribe mood stabilizers or antipsychotics.


Therapy helps lots of people manage their bipolar disorder symptoms. It can also help you boost your confidence and self-esteem.

Cognitive behavioral therapy (CBTteaches you about the connection between your thoughts, your feelings, and your behaviors. By learning how to change negative thoughts, you can start feeling better. CBT can also help you determine what triggers your manic or depressed symptoms. You will learn effective ways to manage those triggers.

Family therapy can teach your loved ones about bipolar disorder. It gives everyone a chance to process their feelings, communicate their needs, and set healthy boundaries with one another.

Interpersonal and social rhythm therapy (IPSRTfocuses on building stabilizing daily activities. Daily routines can help reduce mood swings. They can also restore confidence and help you feel empowered.

There are many alternative therapy options to consider for bipolar disorder. For example, you may benefit from:

  • Light therapy
  • Meditation
  • Yoga
  • Acupuncture

Treating Bipolar Disorder and Addiction

When a person has a dual diagnosis (both a mental illness and a substance use disorder), it’s important to have a comprehensive care approach. This means addressing both conditions simultaneously. Bipolar disorder and substance abuse exacerbate one another. If you only treat one condition, you may relapse with the other.

In treating both bipolar and addiction, many people benefit from a combination of therapies. These may include:

At Footprints to Recovery, we specialize in providing comprehensive care. If you’re ready to face your substance abuse and you have bipolar disorder as well, we’re here for you. Contact us today to learn more about how we can help.

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