The Link Between Bipolar II Disorder and Substance Abuse

Bipolar II disorder often comes hand in hand with addictions. In many studies, 35% to 60% of participants who struggled with a bipolar disorder also struggled with a substance use disorder. Studies have found that those struggling with a mental disorder are more likely to be heavily impacted by substances. This is true even if only a small amount of psychoactive substances are abused.

Understanding how both of these diseases play off of one another is crucial to getting sober. Those who struggle with co-occurring disorders need to be treated for both disorders. Otherwise, they may be prone to relapses or may have a more difficult time getting sober.

There's a strong link between bipolar 2 disorder and addictions although the exact relationship between the two disorders are still being researched. There are many theories behind how the two disorders play into one another.



What Is Bipolar II Disorder?

Bipolar II disorder is a type of mental illness that affects about 2.5% of the general U.S. population, or about 6 million people. This means that this mental illness is much more common than you'd think.

A person who is diagnosed with a bipolar 2 disorder will have rapid cycling of emotions. They experience hypomanic episodes, otherwise known as "highs", and depressive episodes, also known as "lows".

But, doesn't everyone feel manic or depression at times?

There's a difference between a healthy individual and someone with a bipolar 2 disorder. Those with a bipolar II disorder experience uncontrollable and extreme moods. They also typically have excessive energy. These individuals may find it difficult to control their own emotions.

On a daily basis, they may feel depressed or manic for seemingly no reason at all. They may have no explanation themselves for how they feel. Some of these episodes may last for days. In most cases, a bipolar 2 disorder is diagnosed as having:

  • Depressive episodes that last at least two weeks; and,
  • Hypomanic episodes that occur at least once

While these mood disorders can be quite extreme, they do not need hospitalization. In addition, a bipolar 2 disorder can be misdiagnosed as depression, when the hypomanic episodes don't occur within the same period of time.

While people with bipolar II disorder often lead normal lives, some may self-medicate with alcohol or drugs. Unfortunately, studies show that those struggling with these mental illnesses are more likely to abuse substances and get addicted.

Bipolar 2 vs. 1

Many people are confused about the differences between bipolar I and bipolar II disorders. The main difference lies in the severity of the manic episodes. Only those struggling with bipolar I disorder will experience manic episodes. These episodes may be so intense that they need hospitalization.

Bipolar II disorder involves hypomania. This is a significantly less severe form of mania. It is still severe enough that others should notice that there's something wrong; however, it is not as severe as mania. A manic episode may change a person’s personality and behaviors completely.

Those who are addicted to drugs or alcohol may exhibit abnormal behaviors that are similar to hypomanic episodes. They may act irrationally or engage in risky behavior. In these situations, an addiction may mask a bipolar 2 disorder.

In addition, the biggest risk factor for bipolar II disorder is genetics. Those who have immediate family members who struggle with type 2 bipolar disorder are much more likely to struggle with the same mental illness. The same cannot be said for type 1 bipolar disorder.

Am I Bipolar or Just Moody?

When someone is struggling with an addiction, it can be particularly difficult to figure out whether they are just moody or are struggling with a bipolar 2 disorder as well. The best way to find out where your mental health stands is to get a thorough assessment.

A mental health assessment from a psychiatrist or a therapist may provide helpful insight.

If you're still on the fence, consider getting a free drug assessment from us. Our counselors may be able to give you the information you need to make an informed decision.

But, still, how can you tell whether you're struggling with bipolar 2 disorder or you're just moody?

There are several assessment tools that screen for adult bipolar disorder. The two most popular assessments include:

  • The Structured Clinical Interview for DSM-IV (SCID); and,
  • The Schedule for Affective Disorders and Schizophrenia (SADS)

There are also some self-assessments and tests that you can do yourself. Take a look at some of the symptoms involved with various types of episodes below.

A hypomanic episode is defined as feeling elevated, irritated or annoyed for at least 4 days. Those who are experiencing a hypomanic episode will:

  • Believe that they are able to accomplish a lot of things at once
  • Be more likely to engage in risky behavior, like have reckless sex
  • Have a lot of energy and an increased activity level
  • Have difficulties sleeping
  • Feel agitated, irritated or moody, and may easily snap at others
  • Feel as if their thoughts are running through their minds
  • Feel "jumpy" or even "wired", as if they had too much coffee
  • Feel "high" or elated during the entire episode
  • Talk faster than normal, and be overly talkative

Those struggling with hypomanic episodes often act similar to those who are on stimulants, like cocaine. They have a lot of energy.

Bipolar depression episodes are also common in bipolar 2 disorders. Feelings of intense sadness or hopelessness may linger. Those who are struggling with depressive episodes will:

  • Be unable to concentrate on even menial and simple tasks
  • Eat significantly more or less food and either gain or lose a significant amount of weight
  • Experience feelings of excessive guilt for no reason at all
  • Feel depressed or hopeless for the majority of the day
  • Feel fatigued every day or extremely exhausted
  • Feel restless throughout the day, and may even have difficulties sleeping
  • Lose interest or enjoyment in once pleasurable activities
  • Think about suicide or death constantly

It's not unusual for the depressive episodes to be diagnosed as depression, especially if it is not accompanied with hypomanic episodes.

Facts and Statistics of Bipolar II Disorder and Addictions

Bipolar disorder 2 is not only linked to addictions, but also to a higher rate of relationship problems, economic and financial instability, suicide and more.

Bipolar Disorder and Addiction

Many studies have explored the relationship between bipolar disorder 2 and various substances. The data collected has been mind-blowing. Here are some of the more shocking statistics:

  • Approximately 56% of those struggling with a bipolar disorder will have been addicted to either drugs and/or alcohol
  • Up to 45% of those who struggle with a bipolar disorder will also struggle with an alcohol use disorder
  • Up to 64% of those with a bipolar disorder will "self-medicate" with cannabis

Alcohol is one of the most frequently abused substances among bipolar individuals. Substance use and abuse will interfere with treatments for a bipolar II disorder.

It's also important to point out that bipolar individuals are more likely to experience heightened moods. This emotional stability can interfere with their addiction treatment plan. Intense mood swings can make it difficult to follow various treatments.

What Is the Relationship Between Bipolar II Disorder and Addictions?

There's a high rate of substance abuse and drug dependence among bipolar individuals. Many scientists are trying to unravel why this happens. There's no clear-cut answer, but there are several theories.

The first theory is that bipolar individuals are much more likely to turn to drugs and alcohol when self-medicating. Drugs and alcohol may be able to help numb some symptoms. For example, type 2 bipolar individuals are more likely to experience symptoms like:

  • Anxiousness
  • Depression
  • Insomnia

Alcohol and certain drugs may be able to offset the symptoms of bipolar II. The effects are only temporary. As a result, people who self-medicate will develop reliance and a tolerance to their drug of choice. This, then, becomes dependences.

Another theory is related to age and gender. Young men are more likely to develop bipolar types of disorders. Bipolar 2 causes an individual to engage in riskier behavior. As a result, these individuals are more likely to experiment with drugs and alcohol. Constant risky behavior may lead to abuse, dependence and addiction.

Not surprisingly, studies show that older individuals with bipolar II are less likely to have a substance abuse disorder.

The last theory has to do with brain chemistry. Bipolar 2 is a result of certain changes in one's brain chemistry. The same changes that cause bipolar disorders also cause to substances abuse disorders. Those who struggle with a bipolar 2 disorder are more likely to have abnormal levels of the following neurotransmitters:

  • Dopamine
  • Norepinephrine
  • Serotonin

These neurotransmitters are critical to the human body. They regulate metabolism, sleep, appetite and more. They can also affect an individual's mood and emotions. Much like with bipolar II, heavy drug or alcohol use will also affect these neurotransmitters.

To regain balance to one's brain chemistry, a constant intake of drugs and alcohol is needed. Unfortunately, the more that someone abuses drugs or alcohol, the more imbalanced these neurotransmitter levels become. The overlapping neurobiological pathways involved make an individual vulnerable to both disorders.

The Effect of an Addiction on Bipolar Disorder 2

Drug or alcohol use will have a negative impact on bipolar types of disorders.

The impact is almost unavoidable, which is why those who are struggling with co-occurring disorders should seek help as soon as possible. An addiction can:

  • Intensify and enhance the severity of bipolar II disorder symptoms
  • Increase the frequency of suicidal thoughts and attempts
  • Increase the length of both hypomanic and depressive episodes

As a result, it's important to take great care in treating both bipolar disorder 2 and substance abuse. The relationship between the two is very complex. 

Here, at AspenRidge Recovery, we aim to treat both conditions at the same time. This is one of the most effective approaches to take. Our staff are cross-trained in both mental health care and addiction treatments, so they’ll help you find the best treatment for your situation.

Treatments for Both Bipolar Disorder 2 and an Addiction

Due to the potentially dire consequences of co-occurring disorders, they need to be treated at the same time. This is the best approach, and will be the most effective. It’s like killing two birds with one stone.

Both residential treatment programs and intensive outpatient treatment programs are available. The type of treatment that may work best for each patient will depend on their unique circumstances and conditions. A thorough assessment should be conducted beforehand.

In most cases, doctors will prescribe medications that help with both disorders. The most common types of medications used to treat both bipolar disorders and substance use disorders include:

  • Anticonvulsants
  • Antipsychotics
  • Benzodiazepines
  • Lithium

In most cases, anticonvulsants are recommended before lithium therapy. The type of medications recommended will help ease the severity of manic and depressive episodes. They will also help lessen the intensity of withdrawal symptoms and curb cravings.

The dosage of the medication and the frequency of the administration will vary with each patient. It will also depend on each person's biological makeup. The staff will provide around-the-clock supervision to determine how each patient is coping.

Counselling and Therapy

In addition to medications, most rehab centers will also recommend therapy and counselling. Therapy and counselling can help patients learn how to deal with their mental illness and the stresses that trigger relapses. Many different types of therapies have been proven to be effective. Some of the most popular therapies recommended for a dual diagnosis include:

  • Cognitive Behavioral Therapy (CBT). This type of therapy helps patients identify triggers and learn how to avoid unhealthy habits and behaviors. It not only deals with how to cope with a substance abuse, but how to approach mood disorders as well.
  • Group therapy. Support from others can incredibly motivating. Many patients find joy in being able to relate with others. They also feel empowered when working with others to lead a healthier life. The group holds each person accountable for his or her actions, and provides support when it's needed.
  • Individual psychotherapy, also known as talk therapy or counselling. At times, mental illnesses may need to be quietly discussed. Those who are more private may wish to have a safe place to discuss their personal matters. This is an area that individual psychotherapy excels in. A therapist can help each patient develop courage, compassion and self-esteem. The patient will also create specific goals for their recovery.

The right type of therapy can make a huge difference in one's recovery. Many rehabs will recommend that patients try several therapies to find one that works for them. Not every therapy may be effective for each patient.

Treat Both Bipolar Disorders and Substance Abuse Disorders

Those who are struggling with co-occurring disorders, or a dual diagnosis, should get both disorders treated at the same time. This is the most effective approach to take.

If they only treat one disorder at a time, the disorder that is not treated will impede the treatment plan. It will also prevent the individual from leading a healthier life, both mentally and physically.

Get a full psychiatric assessment, as well as a drug assessment, before checking into a recovery center. It's a good idea to know what you're working against. It's also beneficial for the staff to know what treatment plan will work best for you.

With perseverance and a little help, you can get your addiction and the bipolar 2 disorder under control. Don't let your disorders define who you are and control your life. Instead, seek help from an addiction treatment facility, so you can regain control over your identity.

Talk to a Rehab Specialist

Our admissions coordinators are here to help you get started with treatment the right way. They'll verify your health insurance, help set up travel arrangements, and make sure your transition into treatment is smooth and hassle-free.

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