Understanding the Overlap Between Bipolar Disorder and Substance Use

substance use and bipolar disorder

Understanding the Overlap Between Bipolar Disorder and Substance Use

Many teens turn to substances to self-medicate undiagnosed mental health issues, like bipolar disorder, depression, and anxiety. As medication is one of the most common and effective forms of treatment for bipolar disorder, it can influence teens’ attitudes towards prescription pill use and other drugs. By taking medication, teens learn substances are an effective way to change the way they feel and cope with negative emotions.Often, people focus more on substance use behavior rather than addressing potential underlying issues. Understanding the overlap between bipolar disorder and substance use helps professionals address dual diagnoses simultaneously. 

Underlying Issues Associated with Bipolar Disorder

Signs of Mania:

  • Hyperactivity
  • Inflated sense of self-confidence
  • Decreased need for sleep
  • Extreme talkativeness
  • Racing thoughts
  • Short attention span
  • Risky behavior
  • Preoccupation with a specific goal

Signs of Depression:

  • Feeling depressed or hopeless most of the day
  • Having a sense of worthlessness
  • Weight loss or gain
  • Restlessness
  • Insomnia or feeling the need to oversleep
  • Loss of interest or pleasure in once enjoyable activities
  • Feeling fatigued nearly every day
  • Excessive feelings of guilt
  • Lack of concentration

Association with Substance Use

Mood Swings

Studies suggest that 60% of individuals with Bipolar Disorder have a history of substance abuse at some point in their lifetime. While it’s not fully understood why bipolar disorder may make people more likely to use substances, they are known to intensify symptoms of bipolar disorder. 

Like bipolar, substances can cause mood swings between intense emotional highs and lows, depending on the drug. Someone going through a manic episode can look and act like someone on cocaine. Those having a major depressive episode can also have the same symptoms as someone in withdrawal. 

Another factor contributing to mood swings in teens are hormonal changes they go through during adolescence. This explains why most professionals delay official diagnoses of bipolar until late adolescence, although they make a note of the intensity of mood swings and try to address possible contributing factors.

Unpredictable Energy

Stimulants, like cocaine or ADHD medication, contribute to elevated mood and energy in teens. As these substances are shorter-acting, teens may rapidly cycle from hyperactivity, preoccupation with a certain goal, and increased self-confidence to completely deflated in a short period of time. Mood swings in teens with bipolar tend to last days or weeks, rather than minutes or hours, but can look very similar. 

Impulsive Tendencies

Although most teens with bipolar “prefer” manic states where they are full of energy and great ideas, they are more likely to turn to risky behaviors and ignore potential negative consequences. The restlessness and often sleeplessness they experience can affect decision-making capacities. Teens are more likely to romanticize mania and substance use when they focus on these thrills and their carefree attitudes. While mania is a factor in justifying substance use as a rational decision, the crash they experience during depressive phases or withdrawal from a substance triggers cravings for substances to boost their mood or energy once again. 

For this reason, teens with bipolar disorder often struggle to break the cycle of substance use and may require a different approach to find out what works for them. While medication management is a great option for many teens with bipolar, it is not the only way to help.

ViewPoint Center Can Help

ViewPoint Center is a short-term residential Crisis and Assessment Center that helps teenagers ages 12 to 17. Our students struggle with emotional and behavioral issues, such as depression, anxiety, and bipolar that puts them at a higher risk for substance use and other process addictions. At ViewPoint Center, we provide superior assessment, diagnosis,  treatment, and stabilization–all in a personalized environment for your child in crisis. We have years of experience working with students with dual diagnoses, acknowledging the overlap, and differentiating between underlying issues and behavioral problems.


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