Bipolar Disorder & Addiction

Man with sad face

Do you have mood swings, sometimes feeling way “up” and other times struggling to get out of bed? Are there times when your levels of creativity, productivity, and energy feel superhuman and other times when life feels meaningless and without hope? If these descriptions describe you, then you might have Bipolar Disorder.

Formerly called Manic Depression, this condition is characterized by periods of increased energy over a period of time, which then collapses into feelings of exhaustion and depression. These distinct periods of increased energy and activity are called manic episodes. Symptoms during these episodes include:

  • Abnormally upbeat, jumpy or wired
  • Increased activity, energy or agitation
  • Exaggerated sense of well-being and self-confidence (euphoria)
  • Decreased need for sleep
  • Unusual talkativeness
  • Racing thoughts
  • Distractibility
  • Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

Of all psychiatric disorders, Bipolar Disorder has one of the highest rates of comorbidity (diagnoses occurring together) with Substance Use Disorders (SUDS). [1] One review of bipolar and substance abuse in clinical settings between 1990 and 2015 concluded that co-occurring Bipolar and SUDS is so common that it “may almost be regarded the norm” rather than the exception. [2]

Another study surveyed a representative sample of over 42,000 respondents in the United States and found that mania was associated with very high rates of SUD. Those with mania were six times more likely to be alcohol-dependent and 14 times more likely to have drug dependence over the previous 12 months. [3]

sad lady looking out window dealing with bipolar disorderBipolar Disorder is understood to be a brain-based disorder that is treated primarily with mood-stabilizing drugs such as lithium. Deciding on the correct lithium amount for a patient is a delicate task that requires the close supervision of a psychiatrist.

Medications and other substances can sometimes trigger manic episodes in those with Bipolar Disorder. Sometimes this may trigger the first manic episode a person experiences. Additionally, symptoms of manic episodes can be difficult to distinguish from the highs or hallucinogenic effects of the drugs themselves.

If you suspect you may have signs of Bipolar Disorder or you are already diagnosed and are using drugs or alcohol, reach out to a psychiatrist as soon as possible. Treatment can provide a significant improvement in your quality of life.


1. Ihsan M. Salloum & Edson Sherwood Brown (2017) Management of comorbid bipolar disorder and substance use disorders, The American Journal of Drug and Alcohol Abuse, 43:4, 366-376, DOI: 10.1080/00952990.2017.1292279

2. Hunt, G., Malhi, G., Cleary, M., Lai, H., & Sitharthan, T. (2016, July 09). Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: Systematic review and meta-analysis. Retrieved June 15, 2020, from

3. Grant BF, Dawson DA, Stinson FS, et al. The 12- month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001- 2002. Drug Alcohol Depend. 2004;74:223-234.

About the Authors:

Travis StewartTravis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Travis’ website is

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Reviewed and Approved by Jacquelyn Ekern, MS, LPC on June 16, 2020
Published June 16, 2020, on

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.