Addiction and Bipolar Disorder Treatment

Like many other mental health disorders, bipolar disorder does not have just one cause. Instead, it is likely that a mix of brain, genetic, and social factors leads to the development of bipolar disorder.

Brain Chemistry and Structure

Like depression, bipolar disorder is linked to an imbalance in certain chemicals in the brain, namely serotonin, dopamine, and norepinephrine. These hormones or neurotransmitters help regulate mood, sleep, hunger, pleasure, body temperature, and more.

The brain structure of a person with bipolar disorder may also be affected. It is not clear whether the difference in the brain structure is caused by the disorder or if the changes cause the disorder. What is clear is that brain imaging shows that those with bipolar disorder have significantly less gray matter in their brains. They also have a smaller hippocampus, which regulates emotions and memory retrieval.

Genetics

Bipolar disorder is also thought to have a genetic component, as it often runs in families. There is no “bipolar gene,” but those who have a parent, sibling, or child with bipolar disorder are more likely to develop it themselves. Having a genetic predisposition to bipolar disorder makes a person more likely to be susceptible to social factors that might trigger the disorder.

Social

Social factors like childhood trauma may lead to the development of bipolar disorder. Childhood trauma might include abuse, neglect, or the loss of a parent.

Stressful life events as an adult might also influence a person’s development of bipolar disorder. These events are things like the loss of a loved one, poverty, isolation, or the pressure to perform at work or in relationships. If a person already has bipolar disorder, stressful events can trigger a mood episode or make symptoms harder to manage.

Anyone can develop bipolar disorder, and it appears to affect both men and women in equal measure.

According to the World Health Organization (WHO), men are more likely to develop Bipolar I, while women account for more cases of Bipolar II (see below). The disorder also affects people of different races and ethnicities equally. About 40 million people suffer from bipolar disorder worldwide.[1]

The main symptoms of bipolar disorder are manic and depressive episodes.

Manic Episodes

Some common symptoms of manic episodes are:

• Feeling excited, happy, or euphoric
• Decreased need for sleep
• Talking faster than usual
• Distractibility
• Increased energy
• Multitasking
• Increase in risky behavior
• Feeling jumpy

Hypomanic symptoms are similar, but less extreme, and they last only a few days rather than a week or more, as in manic episodes.

Depressive Episodes

Some common symptoms of depressive episodes are:

• Feeling down, unhappy, or depressed
• Low energy
• Inability to make decisions or concentrate
• Lack of interest in activities
• Sleeping too much
• Talking slowly or forgetting what you were going to say
• Suicidal thoughts or ideation

All these symptoms need to be out of the ordinary for an individual to be considered symptoms of the disorder.

There are three kinds of bipolar disorder: Bipolar I, Bipolar II, and Cyclothymia.

• Bipolar I: Bipolar I is diagnosed when a person experiences at least one manic episode. Many people with Bipolar I also have depressive episodes.
• Bipolar II: Bipolar II is diagnosed when a person experiences at least one major depressive episode. They may experience hypomania but have not had a manic episode.
• Cyclothymia: Cyclothymia is a milder form of bipolar disorder that involves mood swings, but the moods are not as extreme as in Bipolar I or II.

Bipolar disorder can affect every area of a person’s life. During manic and depressive episodes, a person may find little purpose in continuing with their everyday tasks, which sometimes makes it difficult for them to hold a job or attend school. Relationships are disrupted, and depressive episodes can lead people to consider suicide. Depressive episodes are also linked to greater substance abuse.

The World Health Organization asserts that those with bipolar disorder have a life expectancy that is about ten years shorter than the average life span.[2] This might be because there is a stigma associated with bipolar disorder that makes it difficult for some individuals to receive the proper diagnosis, care, or treatment, especially in developing or lower-income countries.

Substance Abuse and Its Interaction With Bipolar Disorder

Bipolar disorder and substance abuse create a dangerous combination that significantly complicates both conditions and increases the risk of severe consequences. People with bipolar disorder are approximately three to five times more likely to develop a substance use disorder compared to the general population, with studies showing that around 60 percent of people with bipolar I disorder also struggle with drug abuse or alcohol use disorder.[3] During manic episodes, the elevated mood, racing thoughts, and poor judgment characteristic of this condition often lead to impulsive substance misuse, particularly with dual diagnosis bipolar and alcohol or stimulants.

Conversely, during depressive episodes, people may self-medicate with opioids, alcohol, or other substances to numb emotional pain or escape overwhelming depressive symptoms.[4] This Bipolar dual diagnosis creates a vicious cycle where substance abuse triggers more frequent mood episodes, while untreated bipolar symptoms drive continued substance misuse.

Diagnosing bipolar disorder can be difficult, as some people don’t realize their symptoms are part of a larger pattern. Those experiencing manic phases may not feel that something is wrong; in fact, they often feel like they are on top of the world. Depressive episodes are more concerning, so a person is more likely to go to the doctor, but this increases the likelihood that they will be misdiagnosed with depression.

However, once an individual realizes the larger pattern, he or she will meet with a doctor, psychologist, or psychiatrist who asks about their symptoms, medical history, and mental health history. Bipolar disorder is diagnosed depending on the length and severity of the manic and depressive episodes (see above).

Bipolar disorder can be treated and managed, usually with a combination of medication and therapy, allowing those with the disorder to live fulfilling and productive lives.

• Medication: Mood stabilizers like lithium are the most common medications given for bipolar disorder, although they need to be avoided if a person is pregnant or breastfeeding. Antipsychotic medications are also used to treat bipolar disorder.
• Therapy: Therapy, like Cognitive Behavioral Therapy, can be useful for those with bipolar disorder. It is also often helpful for individuals to attend group therapy or family therapy.
• Lifestyle: Living a clean, healthy lifestyle can improve the symptoms of bipolar disorder as well. Getting enough sleep, eating nutritiously, and avoiding substances can minimize the triggers for manic or depressive episodes.