Studies have shown that it is common for substance use disorder to co-occur with bipolar disorder, with more than 40 percent of those with bipolar disorder also misusing alcohol, 20 percent misusing cannabis, and smaller percentages misusing various other drugs.
While men and women develop bipolar disorder at roughly equal rates, more men than women have co-occurring substance use disorder with bipolar disorder. Those with co-occurring bipolar and substance use disorders typically have an earlier onset of the bipolar disorder, on average about 20 years old rather than 24 years old.
Both varieties of bipolar disorder — the second of which is milder — are equally associated with substance use disorder. The way these two disorders interact and influence each other is complex and makes them particularly difficult to treat successfully.
Cause and Effect
Treatment professionals are unsure which of these co-occurring disorders causes the other or whether cause and effect is even part of the picture. In some cases, it seems that the early symptoms of bipolar disorder may cause sufferers to misuse substances in an attempt to self-medicate and get back to a point of equilibrium.
On the other hand, the brain changes that often take place when substances are misused during formative years could lead to a prevalence of bipolar disorder among those with substance use disorder. Differences between men’s and women’s brains could account for the greater likelihood of substance use disorder in men who are also bipolar.
Another difference observed between men and women with bipolar disorder is that men are more likely to have mania and to act out their psychological state than women. For these reasons, more men than women may initially decide to misuse substances, behavior that later turns into a substance use disorder. Men are also 10–15 percent more likely to commit suicide, which should be considered when treating these disorders.
Unraveling the plausibilities in each situation can lead to greater understanding and help those with co-occurring disorders to respond better to treatment opportunities, leading to better treatment outcomes.
Special Considerations for Bipolar Disorder in Women
Bipolar disorder can be particularly difficult to treat in women because of the hormonal fluctuations they go through on a monthly basis and during pregnancy. Women are more likely to see exaggerated symptoms of bipolar disorder around the time of menstruation and during pregnancy, which can make the disorder more difficult to manage. Women who become pregnant are limited in the medications they can take during this time as well.
Recent meta-studies that looked at existing research have shown some promise in treating co-occurring bipolar disorder and substance use disorder with medications and therapy. Treating co-occurring disorders together gives the best chance for success.
The Recovery Village Palmer Lake offers Colorado addiction treatment along with treatment for disorders that co-occur with substance use disorder, such as bipolar disorder. Contact us to learn more about our programs.