Substance abuse and bipolar disorder: The advantage of early treatment
Substance abuse is a fast-progressing and chronic diagnosis that can affect mental and physical health. The combination of substance addiction and bipolar disorder poses particular challenges. It’s important to intervene and start therapy for both conditions as soon as the diagnosis has been made because early intervention and a combination of treatments improves outcomes for both bipolar disorder and substance use disorder.
It’s not rare for substance abuse to deepen manic and depressive phases, making them long-lasting and more intense, so that patents need hospitalization.
Scientists have concluded that co-occurring bipolar disorder and substance use disorder are highly associated with an increased risk of suicide as well other forms of unnatural death. Substance abuse leads to suicide in females more often than in males, who are more likely to die from other unnatural causes like driving under the influence, overdose, or drowning, among other things.
It may sound scary, but life expectancy for people with bipolar disorder is reduced by nine to 20 years and they are 15 times as likely to commit suicide when compared to the general population, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This is why it’s important to treat patients not only for bipolar disorder but for other conditions that tend to come in combination with this debilitating disease, especially substance use disorder.
Medications that can help treat substance use disorders
The National Epidemiologic Survey on Alcohol and Related Conditions concluded that alcohol abuse comes in combination with bipolar II disorder more commonly than with any other type – affecting 37 percent of patients.
A few drugs not only manage bipolar disorder, but have shown useful in the treatment of substance abuse, as well. Divalproex sodium is a renowned mood stabilizer that has been connected with a decrease in alcohol intake when used in combination with another mood stabilizer – lithium. Lately, another antipsychotic called Quetiapine has been talked about in medical circles for its alleged efficacy in the treatment of alcoholism, but more research is needed in both cases.
Psychosocial treatments for substance use disorders in combination with bipolar disorder
There are three main treatment approaches when it comes to comorbidities:
- Integrated
- Sequential and
- Parallel
There’s an integrated treatment called Integrated Group Therapy – people who see comorbidity between bipolar disorder and substance abuse as one issue – bipolar substance abuse. The treatment outcomes within this group are quite good; they believe that not taking bipolar medications leads to relapses in substance abuse.
Sequential treatment is all about tackling the more serious condition first – in this case bipolar disorder. Once it is under control, it’s time to tackle the substance abuse.
Parallel treatment is considered the best among the medical circles. Treating bipolar disorder and SUD in combination means that both issues are addressed at the same time, only in different settings.
Why bipolar disorder and substance abuse go hand in hand
Some studies have suggested that there’s a genetic connection between bipolar disorder and substance use disorder. Apparently, around half of the genetic variance in bipolar sufferers is predisposed to alcohol use disorder. Some people use alcohol or drugs only in their depressive phases, to find that exhilarating and pleasurable mania-like feeling.
It’s still relatively unknown why bipolar disorder comes in combination with substance abuse so often, but some scientists have suggested it’s a form of self-medication, especially in patients with early age onset, where they misuse intoxicants to try to relieve psychological pain. It’s a vicious cycle really, because they are only making the condition worse in the long run.
For example, prolonged use of certain prescription and recreational drugs such as ketamine, cannabis, amphetamine (Speed), metamphetamine (Crystal meth), and cocaine can lead to paranoia, delusions, as well as auditory and visual hallucinations – all known as psychosis. Psychosis is a common part of bipolar disorder, and for someone battling a mental illness, it can be hard to figure out whether these delusions come from intoxicants or their psychiatric condition.
The bottom line
It’s important to find a therapist that you feel comfortable with so that they can help you with both guidance and medications. Finding a support group such as Alcoholic Anonymous (AA) or any other group of people who share good and bad experiences can also be beneficial because it can be comforting knowing that you’re not alone. It maybe sounds like a cliche, but it works!
Collaboration and respect between therapists and those who lead behavioral health services and group therapies is crucial because patients are likely to see these people more frequently than their doctors. Patients with co-occurring conditions have to be aware that they need twice as much strength and willpower than peers diagnosed with "only" bipolar disorder. Getting better depends on many aspects and it’s a process that requires work and dedication every single day.