Patients with Bipolar Disorder More Likely to Self-Medicate with Drugs or Alcohol

Research suggests people with bipolar disorder may be, in short, hit with a “double whammy.” The severely life disrupting mood swings, stress, anxiety and social consequences of the disease are linked to a greater chance patients will seek relief with drugs or alcohol, leading to substance abuse problems.

Put this together with studies showing that bipolar patients could have unique biological or physiological tendencies for drug or alcohol abuse, even more so than people with other mental illnesses, and the situation becomes more complex as experts try to map out the road to recovery.

Studies showing a connection between bipolar disorder and likelihood to self-medicate through substance abuse are prompting doctors and patients to learn more about this complicated relationship. From prescription drugs not given by their doctor, to cocaine, marijuana and alcohol, some bipolar patients report using substances to combat pain, insomnia and anxiety; they also report getting trapped in a cycle that only makes the situation worse.

In 1996, Dr. Kathleen Brady reported at the U.S. Psychiatric and Mental Health Congress that 30 to 60 percent of people with bipolar disorder also have issues with drug or alcohol abuse. Dr. Brady also stated that substance abuse is more likely to occur for people with bipolar disorder than other mental disorders, such as compulsive eating, schizophrenia or anxiety disorders.
From a bigger picture perspective, Dr. Agnes B. Hatfield says up to 50 percent of people with mental illnesses also struggle with abuse of substances like drugs and alcohol.

Researchers are investigating why the problem of self-medicating is especially high for patients with bipolar disorder. A preexisting physiological or biological problem may lend answers, creating a greater likelihood for some people to not only have mental illness, but to turn to drugs or alcohol to cope. Dr. Brady identifies a list of symptoms that coincide for people who have problems with both substance abuse and bipolar disorder. Patients with these overlapping conditions take longer to recover, spend more time in the hospital and seem to contract the conditions at a younger age. For half of these patients, other problems like migraines, attention deficit disorder or personality disorders will occur simultaneously with substance abuse and bipolar disorder. For up to 90 percent, restlessness, agitation or malaise is noted during certain bipolar phases.

Because they seem likely to suffer more symptoms and conditions in conjunction with bipolar disorder, these patients may look for relief from drugs or alcohol more often than others with mental illness. However, the relief from self-medicating is brief, and the core issues causing the illnesses are not treated.

Furthermore, the side effects from drug and alcohol abuse and subsequent withdrawal can resemble other disorders, complicating the patient’s recovery. Service providers may not be equipped to help patients who have both bipolar disorder and substance abuse, causing the patient to be moved from one provider to another or turned away from treatment altogether.

Self-medicating with drugs and alcohol isn’t connected only to bipolar disorder; it’s gaining new attention as an alarming trend among teens with depression, often leading to addiction. Research continues to try to unravel the complex relationship between mental illness and substance abuse. Patients are urged to try other ways to reduce the stress of their illness, ranging from exercise to diet modifications or counseling and natural therapies.

Posted on June 10th, 2010

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