Substance use disorder is more common in people with bipolar disorder.
One of the risk factors for developing a substance use disorder is having a mental illness. People with bipolar disorder are especially at risk of substance misuse. About 30 to 50 percent of people with bipolar disorder develop substance use disorder at some point in their lives, according to the Substance Abuse and Mental Health Services Administration.
One reason people with mental illnesses have an increased risk of substance misuse is because drugs and alcohol can become a coping mechanism. The substances can help numb, delay, or avoid dealing with stress, anxiety, depression, and negative thoughts and feelings.
How Bipolar Disorder Increases the Risk of Substance Misuse
Bipolar disorder has unique risk factors when it comes to substance misuse. Manic episodes can cause impulsiveness and recklessness, and it’s common to binge-drink and experiment with drugs during a manic episode.
Substance misuse may go beyond a manic episode. First of all, addictive drugs may become a habit. Also, poor judgment during a manic episode can lead to risky actions. These may have serious consequences, such as injury or loss of a job or relationship. This can hurt quality of life and add stress, and higher stress levels can worsen the urge to drink or use substances.
Plus, some substances can increase the risk of manic and depressive episodes. Stimulants may trigger manic episodes, and alcohol may trigger depressive episodes.
The Consequences of Substance Misuse
Substance misuse comes with many risks to health and well-being, including:
- Worsening symptoms of the mental illness
- Risky behaviors
- Legal consequences
- Long-term health problems, such as liver disease
- Death by risky behavior or overdose
Luckily, treating bipolar disease can reduce the risk of substance misuse and substance use disorders. Treatment may help by:
- Stabilizing mood, which may reduce the urge to use substances
- Learning healthier coping mechanisms, such as yoga or creative outlets
- Getting connected to mental health professionals and having a support system
If you have bipolar disorder and think you may be misusing drugs or alcohol, talk to a doctor or mental health professional. They can offer support and refer you to sources and programs that can help you.
If you or someone you know is thinking about suicide, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK for free and confidential help 24 hours a day.
Marc Lener, MD, is a psychiatrist and founder of the Singula Institute in New York City
- An introduction to bipolar disorder and co-occurring substance use disorders. Substance Abuse and Mental Health Services Administration, 2016. (Accessed on March 23, 2021)
- Bipolar disorder. Bethesda, MD: National Institute of Mental Health. (Accessed on March 23, 2021)
- Pediatric bipolar disorder: clinical manifestations and course of illness. Waltham, MA: UpToDate, 2021. (Accessed on March 23, 2021)
- Sidebar: the many consequences of alcohol and drug misuse. Washington, DC: U.S. Department of Health and Human Services. (Accessed on March 23, 2021)