Substance-Induced Bipolar Disorder

Substance-Induced Bipolar Disorder

Bipolar is a mood disorder characterized by alternating emotional episodes, which can include the following:

  • Depressive episode – Extreme state of sadness, despair, hopelessness and apathy
  • Manic episode – Emotional high featuring overconfidence, restlessness, and irritability
  • Mixed state – Symptoms of manic and depressive states appearing concurrently

The Schizophrenia Bulletin journal in 2007 cited several studies that noted a “particularly high” association between bipolar disorder and addiction, while a 2006 Journal of Substance Abuse Treatment article found that mood disorders are present in 40% to 42% of co-occurring mental health and substance use disorders.

While many people abuse drugs to suppress symptoms of manic-depression, the Diagnostic and Statistical Manual of Mental Disorders notes that drug use and dependence can also induce bipolar symptoms.

Drug Use and Mood Disorders

According to the health website Medscape, substance-induced mood disorders (SIMDs) involve the onset of symptoms during drug use or withdrawal, and several types of medication can contribute to bipolar, including the following:

  • Illicit, prescription, and over-the-counter types of drugs can all induce bipolar
  • Interferon (IFN)-alpha, corticosteroids and digitalis/digoxin are linked to depression
  • Antidepressants are commonly associated with mania

Specific drugs that may contribute to mood disorders or related symptoms include steroids, opiates, cocaine, amphetamines, anticonvulsants, appetite suppressants, antihypertensives, MDMA, antipsychotics, and sedatives. While the onset of symptoms may be a side effect of a particular drug, substance abuse can also exploit mental health vulnerabilities in several ways, including the following:

  • Substance abuse leads to chemical imbalances and changes in the neural circuitry
  • Addiction-related neurological changes share elements with mental health abnormalities
  • Sedatives and stimulants partly mimic symptoms of different bipolar episodes
  • Predispositions to addiction and mental illness involve similar areas of the brain

Medications can also trigger episodes in people who already have the disorder. In 2003, the Bipolar Disorder journal estimated that one-quarter to one-third of bipolar patients are susceptible to antidepressant-induced manias.

Effects of Bipolar Disorder

Untreated bipolar disorder can affect people in many possible ways, including the following:

  • Disinterest in activities and hobbies that once brought joy
  • Behavior becomes more risky, impulsive, or obsessive
  • Changes in eating, sleeping, grooming, and other habits
  • Crippling psychological stress from extreme mood swings
  • Growing isolation from friends, family, and coworkers

Drug use may have induced the mood disorder, but as the symptoms grow worse, substance abuse and addiction become more common. Integrated addiction and mental health treatment can help.

Addiction and Bipolar Treatment

Rehabilitation centers provide screenings for co-occurring mental disorders, and they integrate necessary care into a comprehensive treatment program. Medically supervised detoxification is followed by a number of potential therapies, including the following:

  • Psychotherapies to address trauma, denial, guilt, and unhealthy coping mechanisms
  • Behavioral therapies that improve conduct by adjusting maladaptive thought processes
  • Relapse-prevention tools for relaxation, anger management and conflict resolution
  • Motivational interviewing to help patients find their own impetus for change
  • Group therapies to verbalize experiences and apply recovery principles

If the bipolar disorder is substance induced, some symptoms should dissipate after the primary withdrawal period. Despite removing the drug agent, however, other symptoms may persist while the body reverses the neurological changes the substance use caused. There is no set timeframe for all bipolar symptoms to end, and many individuals will become permanently more susceptible to relapse.