Bipolar and Addiction: Treatment & Therapy

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

a person dealing with bipolar and addiction

Authored By: Joe Gilmore

Table of Contents

Bipolar and addiction are both debilitating conditions, but when they co-occur in a dual diagnosis, you’ll need specialized treatment to get back on track.

Bipolar disorder was previously known as manic depression, and it is characterized by dramatic mood swings between emotional extremes. For those dealing with dual diagnosis addiction problems, treatment programs like our Orange County rehab can help.

We’ll look today at what happens when bipolar and addiction intersect, and we’ll also outline the most effective forms of treatment and therapy you can find to fight back against this twin scourge.

The Overlap Between Bipolar Disorder and Addiction

There is a robust body of research into the interrelationship between bipolar disorder and addiction.

The most significant of these studies were performed as part of NESARC (National Epidemiologic Survey on Alcohol and Related Conditions). The study explored the prevalence of co-occurring substance use disorders in over 43,000 respondents in the United States with bipolar I and bipolar II disorders – more on this distinction below.

In the above study, 58% of respondents experienced bipolar and alcohol addiction, while 38% experienced bipolar and drug addiction.

It is still unclear why bipolar disorder increases the likelihood of alcohol abuse and substance abuse. Indeed, both drugs and alcohol typically inflame the symptoms of bipolar disorder.

Beyond this, some people with no prior mental health issues can develop bipolar as a direct result of substance abuse.

Before we look at how bipolar disorder is treated when co-occurring with addiction, a glimpse at what bipolar disorder means in plain English.

Bipolar disorder is chiefly characterized by extreme mood swings. Episodes sometimes last for days and sometimes linger for weeks on end. These episodes can occur a few times a week or on more isolated occasions.

In addition to these pronounced mood swings, bipolar disorder also brings about significant changes to both energy levels and focus.

Bipolar disorder can be caused both by imbalanced brain chemistry and by genetics. Traumatic environments increase the risk of developing bipolar disorder.

The distressing and wide-ranging nature of symptoms means that up to 6 in 10 of those with bipolar will self-medicate symptoms with alcohol or drugs.

Those with bipolar disorder are prone to 4 distinct varieties of episodes:

  • Major depressive 
  • Manic 
  • Hypomanic 
  • Mixed 

Major depressive 

Major depressive episodes leave you feeling depressed and detached from or uninterested in general daily activities.

Your depressed mood needs to last for at least a fortnight to qualify as a clinical major depressive episode.


At the other end of the emotional spectrum, manic episodes can lead you to become either excessively friendly or outright hostile.

Manic episodes usually last for a week, sometimes more. These episodes often lead to hospitalization.


The difference between manic episodes and hypomanic episodes is subtle and nuanced.

Hypomanic episodes are less severe and briefer, lasting at least 4 days, but seldom any longer.


If you experience mixed episodes as a result of bipolar disorder, this will involve episodes characterized by traits of major depressive, manic, and hypomanic episodes.

According to DSM-5 (the current edition of the Diagnostic and Statistical Manual of Mental Disorders), there are two distinct types of bipolar disorder:

  • Bipolar I: At least one manic episode or mixed episode, followed by either hypomanic episodes or major depressive episodes.
  • Bipolar II: At least one major depressive episodes, followed by a hypomanic episode.

Bipolar I is the most severe type of this disorder.

Regardless of the category, symptoms of bipolar vary radically from person to person. For those with co-occurring addictions to drink or drugs, bipolar symptoms are often even more intense. Resultantly, many people with bipolar reach for substances to self-medicate symptoms that appear otherwise unmanageable.

Dual Diagnosis: Bipolar and Addiction

As well as differing from person to person, the symptoms of bipolar can also strongly resemble the markers of addiction and drug use. If you witness someone undergoing a manic episode, for instance, they will often look and act similarly to someone abusing cocaine. Both of these experiences involve elevated energy levels and mood. If you see someone undergoing a major depressive episode, by contrast, this can mirror the symptoms of someone going through drug detox and withdrawal.

When someone with bipolar disorder has a co-occurring addiction to drink or drugs, this is known as a dual diagnosis or co-occurring disorder.

With symptoms of each condition overlapping, it’s vital to consult an experienced specialist to give you an accurate diagnosis. From here, you can look at unpacking both of these conditions head-on and simultaneously, but how is dual diagnosis treated?

Bipolar and Drug Abuse Treatment

The most effective dual diagnosis treatment centers will help you to address both bipolar disorder and addiction at the same time using broadly similar therapies. You can seek either inpatient or outpatient treatment as appropriate.

MAT is delivered in combination with counseling – both individual and group – as well as psychotherapies like CBT and DBT. CBT in particular is especially effective for treating dual diagnosis as the techniques of cognitive behavioral therapy can be applied to both addiction and bipolar disorder with proven success.

Through psychotherapies, you’ll explore the thoughts and feelings leading to depressive and manic episodes. You will discover that your thoughts and feelings do not necessarily need to lead to automatic behaviors, and you’ll formulate healthier coping mechanisms in place of substance abuse.

Is Bipolar Medication Addictive

MAT (medication-assisted treatment) can help those with co-occurring bipolar disorder and addiction, helping to soothe the intensity of cravings, while also streamlining withdrawal symptoms. The medications prescribed are FDA-approved and depend on the substance of abuse. These medications are safe and non-addictive.

How about bipolar medication, though?

Well, MAT is a vital component of treatment for most people with bipolar disorder, with medications helping to restore some equilibrium to emotional turmoil. These medications include:

  • Lithium
  • Antipsychotics
  • Anticonvulsants
  • Benzodiazepines

Benzodiazepines or benzos should only be prescribed short-term and used as directed. Benzos have a strong potential for abuse and addiction, although they can effectively counter both withdrawal symptoms and manic episodes.

Overcoming Bipolar and Substance Abuse at Renaissance

If you are grappling with a dual diagnosis of bipolar and addiction, we’re here to help you fight back at Renaissance.

Our highly structured outpatient treatment programs include both IOPs (intensive outpatient programs) and PHPs (partial hospitalization programs), giving you the support and structure of residential rehab without the costs or the restrictions.

To find out more about our evidence-based dual diagnosis treatment programs, reach out to admissions at 866.330.9449.

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Pat C

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“Great staff who took the time to get to know me. They have a lot of experience in this field and have first hand experience with what I was going through. IOP is outstanding and really built up a ton of great relationships and found this program to be a ‘breath of fresh air’.”

Diana Vo, LMFT

Diana is an addiction expert and licensed marriage and family therapist who has been in the field of mental health for over 10 years.

Joseph Gilmore

Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country