Can Drug use cause Bipolar Disorder?
Substance addiction and bipolar disorder are two mental health conditions often linked. They share similar side effects, symptoms and root causes. But can drug use cause bipolar disorder? Or vice versa? The answer can be more complicated than you think.
Many people with a substance use disorder also have co-occurring mental health conditions including bipolar disorder. They both share common underlying genetic and neurobiological factors. The relationship between the two conditions is intertwined.
On one hand, substance abuse can trigger the onset of bipolar episodes. On the other hand, some distressing symptoms associated with the condition can push individuals to self-medicate with the use of drugs and alcohol.
To fully understand the connection between the two, it is crucial to separate what can trigger a disorder from what can truly cause a disorder. For some, an underlying risk factor for bipolar disorder may already exist. In this case, heavy substance use can act as a spark and ignite the first manic or depressive episode.
What is Bipolar Disorder?
Bipolar disorder is a mood disorder characterized by feelings of depression and mania. It can be caused by genetics, an imbalance in brain chemicals, a traumatic environment and traumatic experiences.
Manic episodes occur when a person becomes excessively cheerful or hostile. It can last about a week or more and in some extreme cases may require hospitalization. Symptoms of manic episodes include hyperactivity, decreased need for sleep, extreme talkativeness, racing thoughts, short attention span, engaging in risky behavior, and high self-confidence.
Major depressive episodes occur when a person is overcome by a depressed mood that can last up to 2 weeks. Symptoms of depressive episodes include feelings of hopelessness, a sense of worthlessness, weight gain or loss, restlessness, insomnia, loss of interest in things once loved, fatigue, inability to focus and thoughts of suicide or death.
Which came first: Substance Use or Bipolar Disorder?
Adding to the complexity of the situation of which came first: the chicken or the egg? In this case, did the substance use trigger bipolar episodes or did bipolar symptoms trigger the need for substance use?
Many mental health experts believe bipolar disorder and self-medication are often linked. They are very strongly correlated, appearing together so often that it’s easy to assume one is the direct result of the other. However, this isn’t always the case. For many people, substance use doesn’t create bipolar disorder out of thin air.
Individuals may turn to drugs or alcohol to cope with undiagnosed symptoms of mania and depression, which can make it seem the substance use came first. While drugs cannot create bipolar disorder, research has found that substance abuse worsens bipolar symptoms. It can make moods more unstable and treatment more challenging.
Can Drug Use cause Bipolar Disorder?
Is it possible for drug misuse to cause symptoms of mood disorders like bipolar disorder? A powerful drug or period of heavy substance use can act as a potent stressor and can trigger the first manic or depressive episode. This is often referred to as substance-induced mood disorder. It is depressive, psychotic or manic symptoms that occur from the consequences of drug abuse.
This can happen because substances like stimulants or alcohol can drastically disrupt the brain’s chemical balance. For a brain that is already predisposed to instability, this jolt can be enough to short-circuit the systems that regulate mood, pushing them into a state of extreme highs (mania) or lows (depression).
While many substances can pose a risk, mental health experts point to several common triggers. The most powerful are often stimulants like cocaine and amphetamines, which can directly induce mania or psychosis. Sometimes it can make it difficult to distinguish between drug-induced euphoria and true manic episodes.
However, heavy alcohol use or withdrawal, hallucinogens like LSD, and high-THC cannabis are also frequently linked to first episodes. Alcohol is a depressant that can worsen mood swings and increase impulsivity, making people engage in risky behaviors during manic episodes. Alcohol can also elevate the risk of suicidal ideation, which is a concern for those with bipolar disorder.
The drug use didn’t necessarily create the condition from scratch; it revealed what was already there. This distinction is vital because it helps explain why stopping the substance doesn’t always make the mood episodes go away, leading to the complex question of diagnosis.
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Self-Medication: Using drugs to cope with an Undiagnosed Disorder
While it often looks like substance use comes first, there’s another common scenario that completely flips the script. In many cases, the use of drugs or alcohol doesn’t trigger the first episode; it begins as a desperate attempt to cope with early bipolar symptoms that haven’t yet been diagnosed.
This idea is known as the self-medication hypothesis. It suggests that individuals experiencing confusing and distressing mood shifts instinctively reach for a substance to feel “normal” again. For someone whose brain chemistry is already off-balance, this can feel like a logical solution to an invisible illness. The complex relationship between bipolar disorder and self-medication is often rooted in this struggle to regain control when your own mind feels like it’s betraying you.
Alcohol is a common substance used to self-medicate. The temporary calming effects of alcohol on bipolar moods can feel like a necessary brake pedal. Conversely, a person mired in a deep depression might turn to stimulants like cocaine or amphetamines simply to find the energy to get out of bed. Self-medicating can provide the user only a temporary sense of control, mask underlying symptoms, worsen symptoms, cause addiction and delay treatment.
The substance use can be seen as a symptom of the underlying disorder, not its cause. This is precisely why effective, co-occurring bipolar and substance use disorder treatment is so critical. It addresses both issues as connected parts of a whole.
Dual Diagnosis Treatment is the Gold Standard
The connection between substance disorders and bipolar disorder is not a simple case of cause and effect. Instead, it must be determined if one condition triggered the other or if it was made worse by the other. Co-occurring disorders involve having two separate conditions already existing and developing independently of each other, but still exist together and influence each other.
Symptoms of bipolar disorder often resemble symptoms of drug abuse. For example, someone going through manic episodes can act like a person on cocaine. In both cases, a person experiences elevated mood and energy. Those who are experiencing depressive episodes can carry the same symptoms as a person who may be going through substance withdrawal.
It is important to be able to distinguish between co-occurring disorders and determine which one has caused the other because they can have overlapping symptoms.
Effective dual diagnosis treatment for substance use disorder and bipolar disorder includes:
- A team treating both conditions
- A combination of medication-assisted treatment and targeted therapy
- A focus on building healthy coping skills
- A support system such as group and family counseling
Reach out to Hotel California by the Sea
We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.
Treatment for Co-occurring Mental Health Disorders
Substance abuse and bipolar disorder are conditions that often occur alongside one another. Whether one condition triggered the other, professional dual diagnosis treatment is needed in order to help the client navigate both conditions.
Professional behavioral treatment centers, Hotel California by the Sea provides a comprehensive program for addressing co-occurring disorders. We provide treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based methods such as CBT, DBT and group therapy. Hotel California by the Sea is dedicated to helping our clients reach their goals in sobriety and overcome their addiction.
References:
https://www.addictioncenter.com/dual-diagnosis/bipolar-disorder
https://psychiatryonline.org/doi/full/10.1176/foc.9.4.foc428
https://ibpf.org/the-ripple-effect-how-substance-use-exacerbates-bipolar-disorder
