Bipolar disorder is usually influenced by genetics, brain chemistry, and environmental factors, but can drugs cause bipolar disorder? The short answer is no, drugs don’t cause the condition. However, they can unmask hidden symptoms, mimic mood episodes, or worsen the course of the illness.
Here’s an in-depth look at the relationship between drugs and bipolar disorder, as well as your treatment options.
Bipolar Disorder and Substance Abuse
Substance abuse is more common in those with bipolar disorder than others without the condition. Many people with bipolar disorder use alcohol, cannabis, stimulants, or other substances to self-medicate symptoms like insomnia or emotional numbness. Others may use drugs to prolong the euphoric feelings experienced during manic episodes, or to feel something outside of their depression.
Unfortunately, research shows that people with both bipolar disorder and a substance use disorder (SUD) tend to experience an earlier onset of symptoms, more frequent mood episodes, higher hospitalization rates, and a greater risk of suicide.
Statistics on Bipolar Disorder and Substance Abuse
The following statistics on bipolar disorder and substance abuse provide a clearer visual of these often comorbid conditions:
- Men with bipolar disorder are at a higher lifetime risk for developing SUD compared to women.
- People with bipolar disorder and co-occurring SUD have more intense mood instability and lower treatment compliance.
One study found that 44.8% of hospital admissions for bipolar disorder involved comorbid substance abuse, mostly cannabis or alcohol.
What Drugs Can Trigger Bipolar Disorder?
No single drug can cause bipolar disorder, but many can mimic or provoke its symptoms. In those with a predisposition to mood disorders, drug use may not just intensify existing conditions, but it can also trigger a first manic or depressive episode.
It’s also important to distinguish between drug-induced mood symptoms and a true bipolar diagnosis. Substance-related symptoms usually go away with sobriety, while bipolar symptoms last without the drug.
Let’s take a look at some of the most commonly used substances amongst those with bipolar disorder:
Alcohol
Comorbidity rates of bipolar disorder and alcohol use disorder range from 40-70%, with men more commonly affected. While it may be a temporary fix for bipolar symptoms, alcohol can disrupt sleep, destabilize mood, and impair judgment, all of which can contribute to manic episodes or depression. When alcohol use disorder coexists with bipolar disorder, people are more likely to:
- Struggle with medication compliance
- Experience aggressive behavior or legal issues
- Be hospitalized more frequently
- Suffer from more severe mood instability
Marijuana
Cannabis use is often overlooked due to its increasing availability as a medical or recreational substance. However, in individuals with bipolar disorder, cannabis use can increase mania, episode length, and suicide risk.
According to a scientific review, almost 25% of people with bipolar disorder report problematic cannabis use. Although some claim that cannabis reduces anxiety or improves mood, it can actually impair cognition and contribute to treatment resistance in bipolar disorder.
Stimulants
Stimulants like cocaine, methamphetamine, and prescription ADHD medications (when misused) can trigger manic episodes or mimic mania. These substances are sometimes used to counteract low energy or depressive moods, but they carry big risks, such as:
- Aggression and irritability
- Hallucinations and psychosis
- Increased likelihood of a mood switch into mania
People with bipolar disorder should be cautious when taking stimulants, even with a legitimate prescription. Medical supervision is necessary to avoid destabilizing mood.
Hallucinogenics
Substances like ketamine, psilocybin, LSD, and ayahuasca are being studied for therapeutic use, but these drugs can provoke psychotic symptoms (e.g., delusions or dissociation) in people with a personal or family history of bipolar disorder.
Research into their medical benefits is ongoing; however, current evidence suggests that hallucinogens may do more harm than good in cases of bipolar disorder. The risk is even higher if they’re taken without medical supervision or in unsafe settings.
How Are Co-Occurring Disorders Treated?
Roughly 26% to 43% of people with bipolar disorder also have a substance use disorder. These conditions feed off of each other and create a feedback loop where substance use worsens mood symptoms and vice versa. Treatment requires an integrated approach that targets the mood disorder and the addiction at the same time.
Inpatient and Outpatient Programs
Depending on your symptoms, treatment may begin with medical detox or inpatient stabilization. Following detox, patients may step down to:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Ongoing outpatient therapy
These levels of care provide continuous support while reintroducing daily structure.
Combination of Medication and Behavioral Therapy
Integrated treatment for bipolar disorder and SUD includes psychiatric medications, psychotherapy, and relapse prevention tools:
- Medications like Cariprazine have shown promise for managing both bipolar symptoms and substance cravings. As an atypical antipsychotic, it’s effective for manic, depressive, and mixed episodes. It also seems to reduce cravings in some individuals with co-occurring substance issues.
- Cognitive Behavioral Therapy (CBT) helps patients challenge distorted thinking, manage triggers, and build coping skills.
- Integrated Group Therapy (IGT) has been shown to reduce alcohol use and bipolar relapses. It combines psychoeducation, relapse prevention, and emotional regulation.
Other helpful strategies include:
- Motivational Interviewing
- Contingency Management
- Family therapy
- Peer support groups
Get Integrated Treatment for Bipolar Disorder and Substance Abuse
Substance use and bipolar disorder can be a dangerous combination, but recovery is possible with the right care. If you’re living with both conditions, you’re not alone.
Cura Behavioral Health offers integrated, evidence-based programs that help patients manage mood swings, overcome addiction triggers, and rebuild their lives. Call us today to learn more about our treatment options for bipolar disorder and substance abuse.
Sources:
- Substance Misuse Trajectories and Risk of Relapse in the Early Course of Bipolar Disorder – Frontiers in Psychiatry
- Bipolar Disorder and Comorbid Use of Illicit Substances – Medicina
- Co-occurrence of bipolar disorder and personality disorders in the United States: Prevalence, suicidality, and the impact of substance abuse – Journal of Affective Disorders
- Comorbid Bipolar and Alcohol Use Disorder—A Therapeutic Challenge – Frontiers in Psychiatry
- Many People with Bipolar Disorder Use Cannabis. It May Sometimes Help – Scientific American
- Longitudinal associations between psychedelic use and psychotic symptoms in the United States and the United Kingdom – Journal of Affective Disorders
- How Do Treatments for Bipolar Disorder and SUD Affect One Another? – Psychiatric Times
- Cariprazine in Bipolar Disorder and Substance Use: A Dual Approach to Treatment? – Pharmaceuticals
