The Relationship Between Addiction and Bipolar Disorder

addiction and bipolar disorder

Substance use disorders and mental health issues are often intertwined. One may lead to the other or one may significantly impact the other. There is a relationship between addiction and bipolar disorder that can lead to serious consequences if both conditions are not properly treated.

Bipolar Disorder

Everyone has ups and downs at some point in their lives. You may feel happy and then something might happen that will make you sad or angry. These types of mood swings are normal and typically don’t affect you for extended periods of time. However, bipolar disorder causes unusual shifts in mood, energy, and can impact your ability to function for months at a time. In years past, bipolar disorder was also known as manic-depressive illness; it is a condition with potentially severe symptoms.

When bipolar disorder is not treated, it can result in poor job performance, damaged relationships, and even suicide. When the disorder is treated appropriately, people who have it can lead full and productive lives. There are approximately 5.7 million adults in the US – about 2.6 percent of the population – who have been diagnosed with the disorder.

Addiction and Bipolar Disorder

Substance use disorders are common among people who have been diagnosed with bipolar disorder. In fact, some researchers have found that addiction and bipolar disorder are so often diagnosed together (a phenomenon known as comorbidity) that it may almost be regarded as the norm. The relationship between addiction and bipolar disorder is something of a vicious cycle.

Addiction to alcohol has been found to be most prevalent (42%) among individuals with substance use disorders, followed by those who use cannabis (20%), and those who use other illicit drugs, such as opioids (17%). Although bipolar disorder is diagnosed equally in males and females, males have higher rates of lifetime substance use disorders.

Addiction to drugs or alcohol has also been found to be one of the causes of bipolar disorder. People who have had no prior history with bipolar disorder have been known to develop it after years of substance abuse. Extended and excessive use of drugs or alcohol rewires parts of the brain and can severely affect mood and behavior.

Likewise, people who have bipolar disorder are seven times more likely to develop a substance use disorder. Over half of the individuals diagnosed with bipolar had a substance abuse issue at some point in their life.

Worsening Symptoms

For someone with bipolar disorder who is addicted to drugs or alcohol, the mood swings associated with the disorder can become severe. In addition, individuals diagnosed with both disorders experience a higher number of poor judgment decisions, longer episodes of emotional instability, and an increased number of suicide attempts. Their worsening emotional swings could include severe irritability and hostility toward those around them.

Diagnosis Challenges

The relationship between addiction and bipolar disorder is so closely linked that it can be difficult to diagnose co-occurring bipolar disorder and substance use disorder. Bipolar disorder alone has multiple different subtypes and varied presentations. Many patients are incorrectly diagnosed with depression alone.

When someone is addicted to central nervous system stimulants such as cocaine and amphetamines, it can lead to a sense of euphoria along with an increased energy level. These symptoms are very similar to those in an individual experiencing mania and hypomania.

On the other hand, misuse of alcohol and benzodiazepines can imitate depressive symptoms. When someone who is addicted is experiencing withdrawal, those symptoms can also be very similar to the depressed or mixed phases of bipolar disorder.


Not only is diagnosis sometimes difficult for people with addiction and bipolar disorder but finding effective treatment can often be just as challenging. The two co-occurring disorders can result in devastating consequences, including social and economic issues, making treatment for both even more critical. Treatment should integrate medication management, cognitive and behavioral therapies, and a continuity of care that will help ensure both disorders are treated together successfully.

Dual Diagnosis Support for Men

At PACE Recovery, we optimize your recovery success with integrated treatment that will address both your addiction to drugs or alcohol and mental health issues, such as bipolar disorder. We address your whole person, including your spiritual, medical, psychosocial, and relational facets.

The professionals at PACE understand the challenges you are facing during this period of isolation and uncertainty. We’re here to help. Our men’s-only programming has transformed hundreds of lives over the years, and we believe that you can recover. To learn more about our mental health and addiction services, contact our Admissions team.