Bipolar Disorder and Drug Abuse

According to a national study, more than 55% of people with bipolar disorder have experienced alcohol or drug addiction during their lifetime. Bipolar disorder and substance abuse are common co-occurring disorders. Many people who have bipolar disorder look to regulate their mood or symptoms with substances. Though it may give short-term relief, these co-occurring disorders may lead to adverse outcomes.

What is Bipolar Disorder?

Bipolar disorder, formerly known as manic depression, is a severe mental disorder identified by instant and intense alterations in behavior, mood, and energy levels. Individuals with bipolar disorder have a higher chance of economic instability, relationship problems, accidental injuries, substance abuse, and suicide compared to the general population.

Most people experience emotional ups and downs through life. A person with bipolar disorder tends to shift between abnormally high and low emotional levels. These mood alterations may leave the individual feeling energetic or excited for a period, then deeply depressed soon after. The valleys and peaks may last for weeks or months.

Bipolar 1

An individual must have had at least one manic episode to be diagnosed with bipolar 1 disorder. Bipolar 1 is not always characterized by major depressive episodes. Manic episode symptoms may be so intensive that they require hospital care. Manic episodes typically involve some of the following symptoms:

  • Restlessness
  • Trouble concentrating
  • Exceptional energy
  • Poor sleep
  • Risky behaviors
  • Feelings of euphoria

Bipolar 2

Bipolar 2 disorder is characterized by a depressive episode lasting at least two weeks. For a bipolar 2 diagnosis, an individual must also experience at least one hypomanic episode. Individuals suffering from bipolar 2 disorder generally do not experience intense manic episodes requiring hospitalization.

Bipolar 2 is commonly misdiagnosed as depression. This is mainly because depressive symptoms are a significant symptom of bipolar 2 disorder.

Symptoms of Bipolar Disorder

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Everyone goes through episodes of anger, despair, sadness, and joy throughout life. A significant difference in the symptoms of bipolar disorder is that the episodes are uncontrollable and life-consuming.

The four main mood characteristics of bipolar disorder are mania, hypomania, depression, and mixed episodes.


Mania is considered to be on the high end of the mood spectrum. Symptoms of mania include:

  • Rapid talking
  • Moments of optimism followed by overt pessimism
  • Grandiose feelings
  • Little sleep
  • Irrational behavior and impaired judgment
  • Hallucinations
  • Delusional behavior


Hypomania symptoms are similar to those of mania symptoms, just less intense. Individuals suffering from hypomania symptoms can manage their day-to-day lives – but may experience intense levels of irritability, happiness, or energy. If you are experiencing these symptoms, you may feel capable of more responsibility or that you require less sleep. You may be more apt to participate in risky activities.


Bipolar disorder may push an individual to experience highs and lows. Depressive symptoms are characterized as the lows of bipolar disorder. Depressive cycles in bipolar disorders may last for days or weeks. In terms of dual diagnosis individuals, these periods may be dangerous. Bipolar disorder and substance abuse often go hand in hand, which is dangerous during an individual’s low points. Common symptoms of depression include:

  • Fatigue
  • Loss of interest in hobbies or things you typically enjoy
  • Hopeless feelings
  • Appetite changes
  • Suicidal thoughts
  • Self-loathing

Mixed Episodes

Bipolar disorder symptoms are difficult to define clearly. Mixed episodes may involve symptoms from a combination of hypomania, mania, and depression. If you are experiencing a mixed episode, you may lose interest in activities, suicidal thoughts, pressured speech, and difficulty sleeping.

Bipolar disorder and drug use are dangerous for individuals dealing with symptoms. Many people will use substances to balance their mood swings, but this is only a short-term fix that leads to addiction and bad outcomes in the long run.

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Bipolar Disorder and Substance Abuse Treatment

Bipolar disorder and substance abuse used to be treated as separate conditions. Over time, treatment centers found that treating these conditions together is much more beneficial to the patient. Patients may now seek help for their co-occurring disorders at the same treatment facility.

Dual diagnosis treatment includes treatment for addiction and substance use. This treatment is supported by therapy programs, counseling sessions, support groups, and holistic therapies. All of which are intended to help the patient through their addiction and co-occurring mental disorder.

Comprehensive care is essential if you have bipolar disorder and substance abuse issues. Professional treatment is beneficial initially, and it also helps teach relapse prevention skills and coping mechanisms.

Therapy Programs

Therapy programs play a critical role in both substance use treatment and dual diagnosis treatment. At Chapel Hill Detox, we offer proven treatments that help guide our clients to recovery. 

Cognitive Behavioral Therapy

Cognitive behavioral therapy, or CBT, helps patients regulate their emotions and stabilize their mood through dramatic changes. CBT helps with many mental health disorders like depression, anxiety, bipolar disorder, and addiction. In CBT, a licensed therapist works one-on-one with their patient to work through their behavior and thought patterns. Some strategies used in CBT include:

  • New understanding of how emotions and behaviors can create issues
  • New skills to reframe and shift thinking to sustain a better sense of reality
  • Problem-solving skills to cope with uncomfortable situations and problem-solving skills
  • New self-confidence in the patient’s abilities

Dialectical Behavior Therapy

Dialectical behavior therapy, or DBT, is another form of psychotherapy that utilizes the CBT approach. In DBT, the therapist will help their patient accept negative behaviors and thoughts instead of changing them. Dialectical behavior therapy is best suited for circumstances where the individual has complex conditions to treat. DBT was initially put to use to aid with any limitations CBT may have.

The primary skills DBT focuses on building include:

  • Emotional regulation
  • Mindfulness
  • Interpersonal effectiveness
  • Distress tolerance

Dual Diagnosis Treatment

When dealing with bipolar and drug use or bipolar and substance use in general, dual diagnosis treatment is critical. Both disorders are challenging to treat. Understanding how they both work in conjunction with each other allows the patient to heal and regulate their emotions. It is not uncommon for people dealing with a mental health disorder to use substances to cope. Unfortunately, self-medicating with drugs or alcohol typically leads to an addiction cycle.

Co-Occurring Disorder Signs

  • Inability to stop using alcohol or drugs
  • Development of a high tolerance to any drug or substance
  • Compulsive behaviors involving the use of alcohol and drugs
  • Lies about the use of substances or other illegal or dangerous behavior

Co-Occurring Disorder Symptoms

  • Lack of motivation for activities you once enjoyed
  • Lasting feelings of worthlessness or hopelessness
  • Severe mood swings affecting home life, job performance, friendships, and relationships
  • Cut off of relationships and overall decreased time spend with friends and family

At Chapel Hill Detox, we offer several programs catered to treat our client’s unique situations. Our levels of care range from low-level treatment to severe dual diagnosis treatment. Our experienced therapists and staff strive to offer our clients the support and guidance needed to have a long-term and successful recovery.


When committing to treatment, detox is typically the first step. A successful detox does not only set the foundation for recovery, but it rids your body of any toxins left from your use of substances. We want to make sure that you start treatment off in a sober mind state, both physically and mentally. 

Detox, or detoxification, is typically guided by a medical professional to ensure any withdrawal symptoms are counteracted with treatment and sometimes medication. Medical professions work to make this process as comfortable as possible for their patients. Following a successful detox, we direct patients to a program that will best fit their needs.

Inpatient Treatment

Inpatient treatment, sometimes called residential treatment, is a live-in program many people utilize to work toward recovery. Residential care offers a secure and safe environment for patients to develop new skills and learn about addiction. Those dealing with bipolar disorder and substance abuse have catered treatments designed to treat both co-occurring conditions. Residential care is beneficial for people with moderate to severe addictions.

Outpatient Treatment

Outpatient treatment is a program often utilized by individuals following the completion of inpatient treatment. This is not always the case, though, as many people enroll in outpatient treatment to recover from mild substance use issues. People in outpatient programs generally live at home; otherwise, they may live in a sober home with other individuals in recovery. In outpatient treatment, you will have all of the support offered in inpatient treatment, including counseling sessions and therapy. 

Outpatient programs work well for people who need to return home at night to continue their responsibilities such as childcare, work, or schooling.

Get Help Today With Chapel Hill Detox

Coping with bipolar disorder and substance abuse is complicated and often overwhelming. You do not need to face it alone. At Chapel Hill Detox, we offer the support and programs you need to recover from your co-occurring disorders. We believe that every person deserves a chance at recovery. Our professionals are standing by to give you the help you need to make a full recovery. If you or a loved one is suffering from addiction, please contact us today.