Guest Post: Bipolar Disorder and Substance Abuse by Sharon Torres

substance-abuse-torn-pieces-paper-450w-724878184Bipolar disorder is a condition where the person experiences dramatic changes in mood, activity, behavior, and energy. This constant shift will shape the person’s ability to live, much less perform daily tasks.

This should not be mistaken for mood swings because the effects are more severe in the sense that their ability to function is impaired.

Bipolar disorder is quite common despite the prevailing myth that it’s quite rare. This thought process is understandable considering that you may live all your life without really meeting somebody with this condition.

For instance, the National Institute on Mental Health estimates that there are almost 6 million adults, translating to about 2.6%, in the United States have this mental health issue.

Meanwhile, around 13.2 million adults or 4.4% have suffered from bipolar disorder at some point in their lives.

It should be noted, however, that not everyone with this condition could no longer function.

In fact, only about 8 in 10 people with bipolar disorder have symptoms that are so severe that their lives are seriously impaired. The rest has mild to moderate impairment or also called functional impairment, where the symptoms may have an impact on their occupational functions and social relationships.

The Uncertainty of the Severe Mood Swings

Any bipolar person will tell you that they fear the unpredictability the most.

There are three types of bipolar disorders:

Bipolar I – The person will experience a manic episode, which may be followed by depression.

Bipolar II – This is when the depression will last two weeks at the very least, then followed by a hypomanic period that can last for four days at the minimum.

Cyclothymic Disorder – These individuals are constantly suffering. They can either be depressed or manic throughout the whole year. In fact, they can count themselves lucky if they don’t experience any symptom for about two months in a year.

For people who don’t know, the depression and manic states don’t swing violently like a pendulum. In fact, the bipolar will be more often than not be depressed rather than feel euphoric.

The important thing is to get treatment. This is the only way they can reduce the symptoms. However, it’s good to know the triggers that can cause mood swings:

  1. Insomnia or sleep disturbance
  2. Stress from work or family
  3. Sudden changes in work schedules
  4. Thyroid problems
  5. Prescription medicines like corticosteroids and antidepressants
  6. Caffeine
  7. Alcohol
  8. Changes in the season

As a result, they often feel anxious and have trouble concentrating, even on very simple tasks. They act irritated and will lash out at people around them, including their loved ones. They will also lose interest even on hobbies they are passionate about. When good news is shared, it’s likely they won’t react with joy.

They will also fail to empathize when something tragic happens to a loved one or friend. Or worse, they will experience hallucinations or detachment from reality.

On the other end of the spectrum, they will have a distorted image of self-worth when they have a manic episode. They will be very talkative and even skip sleep because they are too full of energy. They will have a million ideas racing through their heads but fail to act on a single one. They would engage in risky behaviors that may have long-term repercussions to their health or finances. They would also tend to be hypersexual.

How to Cope with the Episodes:

Now that you know the triggers, you can at least anticipate if an episode is coming.

  1. Limit the amount of stress – This may be easier said than done, especially for some people who can’t stand when they lose control of the situation. Take time off from your work to travel and just enjoy life.

 

  1. Lay down the ground rules – It’s important that you are supported by family and friends who will offer their full support and avoid becoming stressors in your life.

 

  1. Talk to your superiors about a regular schedule – If there’s a rotational night shift in your office, it’s best that you are excluded from this routine. In the same vein, make sure to keep a schedule of your daily life—even the time you eat and sleep—and keep it.

 

  1. Sleep at the right time – If you have trouble sleeping, make sure to change your habits. Take the TV out of the room, invest in heavy curtains, play some relaxing music, and sex.

 

  1. Exercise – Get some sweat in. You will be surprised at how your mood will improve after a good workout.

 

  1. Refrain from drinking caffeinated and alcoholic drinks – Alcohol is a depressant while caffeine is a stimulant. Those substances are the last things you want in your system.

Bipolar Disorder and Substance Abuse

Speaking of substances, people with bipolar disorders are likely to also have a substance abuse problem.

According to the American Journal of Managed Care, as shared by DualDiagnosis.org, revealed that more than 5 in 10 of bipolar individuals have struggled with alcohol and drug addiction at least once in their lifetime.

Almost 5 in 10 of them have an alcohol abuse disorder while 4 in 10 have a drug addiction.

The relationship between bipolar disorder and substance abuse, however, is rather complicated.

Scientists have yet to map the brain to find a direct link between addiction and mental health disorder. But they are one in saying that one aggravates the other.

Bipolar disorder can be blamed on hormonal imbalance although the exact cause is unknown. There are some who suggest that this condition is inherited while others think that it’s caused by environmental factors.

The answer probably lies in between.

Looking for Answers

You can’t dismiss outright the genetic factors because a child is 30% more at risk if one of the parents has a bipolar disorder. On environmental factors, people who’ve experienced violent trauma were also diagnosed with this condition later in their lives.

In bipolar disorders, the neurotransmitters in the brain are not functioning as they should, which led to severe mood swings.  In should be noted, however, these include dopamine or serotonin.

Illicit drugs work by overstimulating the brain with dopamine or serotonin, which produces that feeling of “high.”

Researchers believe that this same action in the brain in a bipolar person is what makes him seek out alcohol or drugs.

Another reason why bipolar individuals are at risk of being addicted is their tendency to self-medicate.

The problem is that they are not even aware they have the disease in the first place. For instance, around 2 in 10 of bipolar patients are mistakenly diagnosed, which means they are not getting the right treatment.

For example, they are prescribed with anti-depressants by their primary care doctor who thought they are suffering from depression.

And as stated above, anti-depressants can trigger the severe mood swings. Instead of getting better, they are actually getting worse.

One reason why the mania is often ignored is that nobody really thinks of it as a problem compared to depression. After all, how is it a bad thing if the person is full of energy and mirth? How can you complain when during this episode you are most productive?

A 2005 study titled “Mood Disorders and Substance Use Disorder: A Complex Comorbidity” showed the glimpse of how people with bipolar disorder select the type of substance to abuse. For instance, those who are trying to cope with depression do take stimulants like cocaine.

People who have uncontrolled aggression and rage tend to abuse drugs like opiates, which can calm them down.

Alcohol is probably the common denominator, regardless of the symptoms mainly because it’s very accessible.

Treating Co-Occurring Diseases

Rehab centers like Sunshine Behavioral Health in Texas have been treating co-occurring diseases or dual diagnosis. These cases are actually more common than you think.

Dual diagnosis is a condition where the rehab patient is dealing not just with substance abuse but also with a mental disorder. The mental issue can come in many forms such as bipolar disorder, ADHD, depression, severe anxiety, and post-traumatic syndrome disorder.

Substance abuse will aggravate the mental condition in such a way that the symptoms become more severe. Bipolar patients who are genetically predisposed are especially vulnerable to this because the same chemical imbalance in their brains will be exacerbated by alcohol or drug use.

However, tracing which of the two conditions is the triggering factor is an exercise in futility. Rehab centers have a protocol of addressing the addiction first before moving on to the mental health issue.

The patient will undergo detox—which is nothing more than the procedure to manage the withdrawal symptoms—to flush out the toxins from the system. After which, the person may undergo behavioral and psychosocial therapy in the hopes of getting to the root of the addiction.

It’s important that the family should first inquire whether the rehab facility offers dual diagnosis treatment. In instances when this is not offered, the patient may be endorsed to another facility that specializes in bipolar disorder treatment.

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About Michelle Clark Bipolar Bandit

I am a strong advocate for the mentally ill and have been since I was first approached by a lawyer in a psychiatric facility as a teenager. He wanted me to help him fight how the mentally ill are mistreated. I was diagnosed with bipolar disorder at the age of 17 after a full blown manic episode. Before that, I suffered from debilitating depression for 4 years. My goals are to help others by sharing my story and providing tips to deal with mania and depression. I often write blogs related to advocating for people like myself. I want to encourage, inspire, and educate those with #bipolar disorder and other mental illnesses and also include inspirational #quotes. I founded the group Advocates for People with Mental Illnesses and the page Mental Health Advocates United and have several social media sites that are related to bipolar disorder and/or advocacy. If you are an advocate or would like to be, I hope you join our FB group: Advocates for People with Mental Illnesses
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