In my 20 years experience as an addiction specialist, I have seen many of my clients who have bipolar disorder also struggle with substance use disorders (SUDs). They use alcohol, cannabis, cocaine, gaming or porn to escape the intense mood swings. Unfortunately, they use them as self-medication instead of taking their prescribed medication. There is a great risk in relying on external means to regulate a serious mental illness.
Bipolar disorder and SUDs often go hand in hand, with individuals facing a significantly higher risk of developing substance abuse issues compared to the general population. According to research studies, approximately 60% of those with bipolar disorder also escape and medicate with alcohol and drugs.
The allure of substances to alleviate the extreme mood swings and depressive episodes characteristic of bipolar disorder is undeniable. However, the temporary relief provided by substances ultimately exacerbates the symptoms of bipolar disorder, impacts efficacy of medications and leads to a vicious cycle of dependence and addiction.
Addiction and its impact
Addiction is a complex brain disorder characterized by continued substance use or behaviour despite past harmful consequences. When coupled with bipolar disorder, addiction further complicates the management of symptoms and poses a significant barrier to recovery. Individuals with co-occurring bipolar disorder and addiction often experience more severe mood swings, increased impulsivity, and greater difficulty adhering to treatment regimens.
The role of trauma
Trauma, whether experienced in childhood or adulthood, is a common underlying factor in the development of both bipolar disorder and SUDs. Traumatic events can possibly trigger the onset of bipolar symptoms and contribute to the adoption of substance use and unhealthy behaviour as a coping mechanism. Moreover, individuals with a history of trauma may be more susceptible to addiction.
Integrated treatment approaches
Addressing the complex interplay between bipolar disorder, SUDs, and trauma requires a holistic and integrated treatment approach. This approach involves simultaneous treatment of all co-occurring disorders, with an emphasis on psychotherapy, medication management, and support services. Interpersonal and Social Rhythm Therapy (IPSRT), Cognitive Processing Therapy (CPT), trauma-informed care and inpatient addiction treatment are particularly effective in helping individuals manage their symptoms and maintain sobriety.
Recovery and beyond
While the road to recovery may be challenging, it is not insurmountable. With the right support system and comprehensive treatment plan in place, individuals with co-occurring bipolar disorder, SUDs, and trauma can achieve long-term stability and improve their overall quality of life. It is essential to prioritize self-care, establish healthy coping mechanisms, and cultivate resilience in the face of adversity. Treating co-occurring bipolar disorder, substance use disorders, addiction, and trauma requires a multifaceted approach that addresses the unique needs of each the individual. By understanding the interconnected nature of these conditions and providing tailored treatment interventions, we can empower individuals to reclaim control of their lives and embark on a journey of recovery and healing.
Greg Rennie, Bipolar Disorder Specialist
Greg Rennie is a bipolar disorder specialist with 20 years’ experience as a therapist in the field of mental health and addiction. In addition to his professional experience, he was diagnosed with bipolar disorder II in 1997. As an entrepreneur, he founded the startup, ‘Focus Mental Wellness’ in 2015, one of Canada’s first online therapy companies. In 2023, he left the company to build his private practice, Rennie Clinical Services and the brand, ‘Bipolar Disorder Therapy’.