What is Bipolar Disorder?
Bipolar disorder is a mental illness responsible for extreme and sudden changes in behavior, mood, and/or energy levels. There are many common misconceptions regarding bipolar disorder as well as its symptoms. It is wrong to think that bipolar disorder only causes mood swings, for instance. In fact, it is also incorrect to think there is only one disorder.
A person who suffers from bipolar disorder experiences these "mood swings" in what are called episodes. These can last a few days or even weeks, and there's not necessarily an "average". As for the frequency with which they happen, that can be as often as every week or only a few times a year.
Besides the known mood changes, it is the energy level switch that can be the root of many symptoms. The effects of these symptoms impair functionality and decision making. Day-to-day problems might stop people from leading normal lives. And what's worse, the characteristic impulsiveness is what makes bipolar and addiction disorders so often related.
Episodes of Bipolar Disorder
Bipolar disorder episodes also vary depending on the person. The different types of episodes one can experience are as follows:
Mania - Referred to as the "high" or the "up" of the mood spectrum. Unlike what some may think, it doesn't mean being "happy". Mania makes the person more impulsive and prone to erratic behavior because of an increase in energy. While they can be excessively optimistic, they can also become more irritable. They'll start talking faster, require less sleep, and can even experience hallucinations.
Hypomania - Similar to mania, except they can be shorter, and the symptoms, not as intense. Individuals might require less sleep because of the extra energy. However, they might also be somewhere between too cheerful or too irritable. In this case, individuals don't present psychotic behavior, and can actually be quite productive. This productivity might make many think there is nothing wrong.
(Major) Depression - The "low" and "down" of the mood spectrum, it's the second type of episode people tend to associate with bipolar disorders more often. During this episode, one might display a lack of interest, energy, and even hope. Tiredness and changes in eating habits are common as well. These episodes can be extreme to the point of leading someone to have self-loathing and even suicidal thoughts.
Mixed - As much as there are different kinds of episodes, they don't always come as a "defined package". People might experience a mix of symptoms common to multiple types of episodes. These mixed episodes are exactly that, a mix of traits from different episodes. For example, lack of interest and self-loathing mixed with lack of sleep and high energy.
One Disorder, Many Variations
There are a few variations of bipolar disorder. Each is characterized by different durations, intensities, and effects on people who suffer from it.
Bipolar I - Varying between mania and depression, the mood changes are the most extreme in this variation. The manic episodes last at least a week, and the depressive ones can last up to two. In some cases, individuals might need to be hospitalized for their own safety.
Bipolar II - Typically, individuals will experience alterations between hypomanic and depressive episodes. However, depressive episodes might last for more than two weeks. Because they are more intense, they might affect productivity.
Bipolar with mixed features - This variation is characterized by mixed episodes, where mania and depression are the most common pair. Changes in mood might be quicker in this variation.
Cyclothymia - Similar to Bipolar I, except the episodes are shorter and less severe. However, one might experience fluctuations of mild episodes for two years or so. While not profound, the cyclical changes are typical of bipolar disorders.
Rapid-cycling bipolar - Probably the hardest to manage, as people might experience all four types of episodes in 12 months. The episodes change quickly, but can be very severe, especially the depressive ones.
Bipolar And Addiction Disorders
Just like bipolar disorders, addiction is considered a mental illness, called a substance use disorder. It also affects the way the brain and the nervous system work. It is capable of impairing judgment, decision making, behavior, and chemical balances, just like a bipolar disorder can. Bipolar and addiction disorders are not only similar in how they act, but they are also often related.
Some attribute this link to neurotransmitters and hormones in the body. People with bipolar disorders suffer from imbalances in dopamine, serotonin, and norepinephrine levels. These are all altered by frequent substance abuse, as the brain is rewired. Additionally, these imbalances might drive someone to self-medicate as a response to the levels of stress and the symptoms. The person then falls into a cycle of self-medication and worsening of the symptoms.
As addiction rewires the brain, areas responsible for mood or behavior can suffer changes. This directly affects bipolar and addiction disorders. Excessive substance use can make the person more impulsive, moody, unpredictable, and even dangerous. So while substance abuse is done as self-medication, it can also trigger episode symptoms.
It can be hard to say which disorder was the initial trigger. Symptoms of bipolar disorder can drive someone to substance abuse. Nonetheless, other factors might actually trigger the condition itself. Early consumption of drugs or alcohol can speed up the development of bipolar disorders, especially in the occurrence of addiction.
Other factors that increase the chances of someone suffering from both bipolar and addiction disorders are:
- family history and genetics
- chemical and neurological imbalances
- trauma and stress in unhealthy environments
The Statistics on Bipolar and Addiction Disorders
Multiple studies concluded that around 40% to 70% of people with bipolar disorders also had a history of substance abuse. A study by the National Alliance on Mental Illness concluded that about half of people with bipolar disorder used illicit drugs (56%) or were dependent on alcohol (44%).
An estimated 4.4% of adults in the U.S. suffer from bipolar disorder. As for teenagers, it is possible that one-third of the 3.4 million teens diagnosed with depression might be experiencing early onset of bipolar disorder. The average age for the onset of bipolar disorder is 25 years old. However, symptoms can start even in toddlers, although they might be harder to diagnose.
Maryland is affected by both bipolar and addiction disorders every year. It is easy to point out a few risk factors in the state. Substance-related deaths almost doubled in 3 years, going from 1,259 deaths in 2015 to 2,406 in 2018. This and the fact that 59.5% of adults have not received treatment for mental illnesses is a problem. That puts many at risk of developing what is called a dual diagnosis condition.
Is There Treatment For Bipolar And Addiction Disorders?
Experiencing both a psychiatric and a substance use disorder means being a dual-diagnosis patient. Basically, it is a condition where two disorders happen at once. These are called "co-occurring disorders" (CODs) and can come in many pairs, such as anxiety and drug addiction, depression and alcoholism, and the list goes on. About 1 in every 4 adults in the U.S. with a mental health disorder suffer from a substance use disorder.
Just as there is a treatment for both disorders, there is also treatment available for dual diagnosis, including bipolar and addiction disorders. Both disorders should be addressed separately but treated as closely as possible to avoid relapses. Only a licensed practitioner can say which treatment program is best for anyone. Still, they usually fall under two categories: inpatient and outpatient programs. They can only start after detoxification of the patient if needed.
Residential or inpatient programs require patients to stay at their rehab center through the duration of the treatment. There, they will have medical and psychiatric help and supervision as they complete their program. Usually, programs also include therapy, group sessions, and/or other extra therapeutic activities. They last at least a month or so but they may take some time depending on the patient's needs.
Outpatient programs won't need continuous stay to be completed. Patients get to go home every day, only having to go back to the clinic for sessions of treatment. There are different service settings depending on the intensity of the symptoms.
For those that need closer attention, there's partial hospitalization (PHP). During these, patients have almost daily sessions, lasting several hours. For mild to moderate cases, there are options like intensive outpatient treatment (IOP). In IOPs, visits happen less often and are shorter, the minimum average being three hours, three times a week.
You Can Get The Help You Need
If you or a loved one suffer from bipolar and addiction disorders, know that there is hope. Treatment is not only available, but it is a reality for both conditions. We at The Freedom Center offer program options where a dual diagnosis plan can be implemented. From initial aid to group activities and holistic treatment, we can help you recover and get treatment. Visit our website for more information and contact us today by calling (888) 530-5023. Our team is ready to help you and welcome you into this next phase of a better time in your life.