Bipolar By-Product: Substance Abuse

Bipolar By-Product Substance Abuse

Bipolar disorder and substance abuse often go hand in hand. Learn more about the link between the problems and why teens may be at special risk.

Within a two-month period, Alex flunked out of college, got evicted from his apartment and was arrested for DUI. Alex has bipolar disorder, a condition that causes extreme high and low moods. He started abusing alcohol as a teen. “Drinking was a way to slow my brain down,” he said. “But it just made my problems worse.”

Now 20, Alex is in an alcohol treatment program, taking his bipolar medications faithfully and trying to put his life back together.

Sadly, bipolar disorder and substance abuse often go hand in hand. What puts people with bipolar at risk for substance abuse isn’t clear yet, but the risk seems to start early. In one recent study of adolescents with bipolar, 34 percent of them had a substance use problem (smoking, drinking or using drugs). The average age at which kids enrolled in this study was 14.

Bipolar disorder, also known as manic depression, is marked by changes in mood from extreme highs (mania) and extreme lows (depression). Symptoms of bipolar often appear during childhood or the teen years, but they can start in adulthood. Children and teens with bipolar tend to have more frequent and severe mood swings than adults with the disorder.

Bipolar and substance abuse: what’s the link?

Experts are not sure what accounts for the tie between bipolar and substance abuse. Ideas include:

  • Genetics. Both bipolar and substance abuse seem to run in families, so it’s likely that they are to some degree inherited. Experts think there may be a genetic link between the two conditions. They may be caused by the same gene or genes or affect the same brain chemicals.
  • Self-medication. Some people with bipolar may develop a substance use problem from using drugs and alcohol to treat their symptoms. They may feel that drugs or alcohol mellow a manic episode, ease symptoms of depression or help them sleep.
  • Poor judgment. People who have bipolar may be more likely to be risk-takers and use poor judgment, especially in a manic phase. Teens may be at extra risk because they are still in the process of developing judgment and self-control.They may fall into substance abuse without taking into account the damage it can cause.

What is known is that substance abuse has a negative effect on people with bipolar disorder. Their mood swings are likely to be worse, and they are more likely to be hospitalized and to consider suicide. Not surprisingly, having two mental health problems makes treating either of them more difficult.

I’m worried about my child. What should I do?

The teen years are a danger zone for substance abuse because drugs and alcohol become more available. Teens whose bipolar has not been diagnosed may be at high risk for abusing alcohol and drugs. And those first diagnosed in the teen years seem to be at greater risk for substance abuse than those diagnosed in childhood.

The teen years are also a time when kids are naturally more moody and withdrawn, so spotting either problem can be tough. Experts suggest:

  • If your teen has bipolar, he or she should be carefully watched for clues to substance abuse.
  • If your teen has a substance abuse problem, he or she should be evaluated for bipolar and other mood disorders.
  • A teen who has both bipolar disorder and substance problems needs treatment for both conditions.

Parents also play an important role in preventing substance abuse. If your child has bipolar, see that he or she gets good treatment and sticks with it. Treating bipolar disorder seems to reduce the risk of substance abuse.

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