Bipolar Disorder & Substance Use Disorder | Symptoms, Risk Factors, & Treatment

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on July 27, 2023

If you suffer from a mood disorder and substance use disorder (SUD), you may require dual diagnosis treatment. Symptoms associated with co-occurring bipolar disorder and SUD can include risky behaviors and severe mood swings.

If a person suffers from a co-occurring bipolar disorder and substance use disorder (SUD), they may experience various symptoms that interfere with daily life. Those with a mental health disorder or substance use disorder (SUD) should consider treatment for their dual diagnosis.

There are several types of Bipolar Disorder and related mood disorders. In addition to this, there is more of a prevalence of specific drug use in those with these disorders.

Bipolar Disorder & Co-Occurring Substance Use

As stated by the National Alliance on Mental Illness (NAMI), there are four types of Bipolar Disorder:

  • Bipolar I Disorder (in which a person has experienced one or more manic episodes at some point during their life as well as manic depression)
  • Bipolar II Disorder (in which a person experiences hypomanic episodes, referred to as hypomania, and bipolar depressive episodes which are considered “lows”)
  • Cyclothymic Disorder (a form of bipolar disorder which takes place for at least two years and involves mood swings)
  • Unspecified (in which a person experiences mood episodes)

Those with any type of bipolar disorder may turn to drugs to self-medicate symptoms associated with the disorder. Popular drugs abused by those with bipolar include: 

  • cannabis
  • stimulants like cocaine
  • opioids
  • alcohol

Co-occurring bipolar disorder and alcohol use disorder (AUD) is common. Those with bipolar disorder who engage in alcohol abuse may have an increased risk of developing health problems that can require hospitalization.


The lifetime prevalence of SUDs is at least 40% in bipolar disorder type I patients. Those suffering from bipolar disorder have a higher risk of turning to substance abuse than the general population.

Get Started On The Road To Recovery.

Get Confidential Help 24/7. Call Today!

(419) 904-4158

Symptoms Of Co-Occurring Bipolar Disorder & Substance Use Disorder

A person suffering from this type of dual diagnosis may experience a wide range of symptoms.

Symptoms Of Bipolar Disorder

A person living with any form of bipolar disorder may:

  • have a lack of impulsivity
  • experience severe mood swings
  • experience manic or depressive symptoms
  • engage in risky behavior such as driving recklessly or having multiple sex partners
  • experience an increase or lack of energy
  • experience unusual talkativeness or lethargy
  • experience serious mental health issues such as psychosis or hallucinations

Symptoms Of Substance Use Disorder

Symptoms associated with substance use disorder (SUD) can include:

  • inability to control drug use
  • changes in sleep patterns
  • lack of grooming habits
  • weight gain or weight loss
  • impaired coordination

Risk Factors For Co-Occurring Bipolar & SUD

There are several risk factors associated with bipolar disorder, including genetics, stressful or traumatic events, and heavy alcohol or drug use. 

If a person experienced sexual abuse or childhood trauma, they may also have a higher risk of developing bipolar disorder. Mental health conditions can expand when extra stress is added to the person’s life, including self-medicating with alcohol or drugs.

Self-medication often leads to drug or alcohol addiction, which is why some with bipolar disorder receive a dual diagnosis.

Dual Diagnosis Treatment For Bipolar & SUD

If you suffer from co-occurring bipolar disorder and substance use disorder, there are treatment options for this type of dual diagnosis. 

According to the National Institute of Mental Health (NIMH), integrated treatment plans may need to be implemented to help treat both the mental health condition and the substance use disorder at the same time.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), types of treatment may depend on the level of functional impairment. During treatment, a person may experience cravings for the drug of choice, complicating mental health.

However, co-occurring bipolar and SUD can be effectively treated with behavioral therapy and medication in either inpatient or outpatient settings.

Behavioral Therapy

Interpersonal psychotherapy or group therapy can be helpful for adolescents and adults. Discussing your reasons for abusing drugs with a professional can be helpful in better understanding which treatment plan may be right for you.

Those suffering from mental illness can benefit from cognitive behavioral therapy (CBT) as well. Your primary healthcare provider may determine which treatment options are best suited to tackle your dual diagnosis.


Many who suffer from bipolar disorder may require certain medications, including mood stabilizers such as divalproex sodium (Depakote), lithium, or lamotrigine (Lamictal). Additionally, antipsychotics such as quetiapine (Seroquel) may be useful.

For some, antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs) can cause negative effects in those with bipolar disorder. 

If the person with bipolar suffers from alcohol or opioid addiction, then medication-assisted treatment options may also be available.

Ohio Recovery Center

If you or a loved one are living with co-occurring mental illness and alcohol/drug abuse, contact Ohio Recovery Center. At our mental health and substance abuse treatment center, we provide evidence-based care, medical detox, and therapy in an inpatient/residential setting. 

Contact us today to learn more about our specific treatment plans.

  1. Medicina - Bipolar Disorder and Comorbid Use of Illicit Substances
  2. National Alliance on Mental Illness - Bipolar Disorder
  3. National Alliance on Mental Illness - Understanding Bipolar Disorder
  4. National Institute of Mental Health - Substance Use and Co-Occurring Mental Disorders
  5. National Library of Medicine: MedlinePlus - Bipolar Disorder
  6. Substance Abuse and Mental Health Services Administration - Mental Health and Substance Use Disorders
  7. Substance Abuse Treatment, Prevention, and Policy - The prevalence and significance of substance use disorders in bipolar type I and II disorder

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

Prefer Texting?
We've got you covered.

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.

Sign up for text support

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.
Let us walk you through the treatment process. We're here to help.
For 24/7 Treatment Help:
100% Free & Confidential. Call (419) 904-4158
(419) 904-4158