“I’m better than everyone else.” “I’m on top of the world.” “I’m winning!” Statements of grandiosity like this are often par for the course for some people with bipolar disorder, and the pendulum can swing just as far in the other direction, allowing these same people to feel worthless and hopeless days, or even mere moments, later.
While living with bipolar disorder can be difficult, and the Depression and Bipolar Support Alliance suggests that people who have bipolar disorder tend to spend 10 years trying to handle the problem on their own before they receive appropriate help, therapies can provide people with this condition with real relief. With proper medications and supportive therapies, people can obtain control of the wild swings of bipolar disorder.
Understanding the Condition
People who have bipolar disorder swing between moments of extreme energy, also known as mania, to moments of extreme sadness, also known as depression. Obtaining a diagnosis can be somewhat complicated, as there is no one set of symptoms that can truly define the disorder. In fact, there are many different variations of symptoms that are included under the general heading of “bipolar disorder,” and the condition a person is diagnosed with depends heavily on how quickly the person moves from mania to depression (if at all), and how severe the symptoms might be. Some people experience clear and exaggerated swings in mood that are easy to spot, but others might experience slow and subtle shifts that they might not even recognize as a symptom of disease.
Mania is often described in glowing terms, implying that people in a manic state feel intense joy, immense power and a burst of creative energy. While this might be true for some people, others experience mania as a burst of anger and irritability, and they may explode with rage. This is far from pleasant. Other symptoms of mania include:
- Rapid, incoherent speech
- Difficulty with concentration
- Impulsive spending
- Reckless sex
- Grandiose thoughts
Signs of depression found in bipolar disorder are similar to the symptoms experienced by people with major depression. People feel:
- Disinterested in friends, family members or activities
- Lethargic and slow
- Worthless or hopeless
- Unable to make decisions
- Numb or sad
People with bipolar disorder might shift between these two extremes quite slowly, or they may move from one state to the other amazingly quickly. Some people experience blended episodes in which they feel both sets of symptoms at the very same time. Some people experience only mania and some only depression. Others experience no symptoms at all for long periods, until the disorder manifests again.
Prevalence and Risk Factors
The number of people who have been diagnosed with bipolar disorder remains quite low, with the National Institute of Mental Health (NIMH) reporting that about 2.6 percent of the adult population of the United States has the disorder. Interestingly, NIMH also reports that of those who have been diagnosed with bipolar disorder, 82.9 percent have been classified as having “severe” cases. This seems to suggest that only people with very significant sets of symptoms and extreme levels of dysfunction are receiving a diagnosis of bipolar disorder. Since it’s known that the disease can cause mild discomfort and mild symptoms, it’s quite possible that there are far more people who have the disorder and have not yet obtained a diagnosis.
In studying the disorder, researchers have found that its prevalence can be linked quite closely to genetic factors. In studies of identical twins, the National Institutes of Health reports, an identical twin with a sibling who has bipolar disorder also has the disorder 60 to 80 percent of the time. When the twins are non-identical, that risk drops to 20 percent.This seems to indicate that genes play a major role in the development of bipolar disorder.Simply having the right set of genes isn’t enough to completely explain the risk, however, otherwise the identical twin studies would show a 100 percent correlation between a twin and the disease. There must be some sort of trigger that turns that genetic propensity on and allows the disease to take hold. The trigger could be stress, the environment, drug use or some form of psychic trauma. That trigger might be different for each and every person who has bipolar disorder.
Self-Medication and Addiction
Since people with bipolar disorder are asked to live with the condition on their own for so many years, they may come up with a variety of different techniques they can use to keep their symptoms under control. Unfortunately, many of those techniques involve the use of drugs and/or alcohol. A study of the issue in the Journal of Affective Disorders found that comorbidity between substance abuse and bipolar disorder stood at 72.3 percent. In other words, almost two-thirds of those who had bipolar disorder had a substance abuse disorder at some point in life. It’s striking that the two conditions would occur so frequently within the same group of people. Some people turn to drugs of abuse in order to help them deal with depressive episodes.
Drugs like heroin, prescription painkillers or methamphetamine can cause these people to experience a brief, fleeting period of euphoria, and that might be a feeling they simply cannot experience while they’re in the depths of a bipolar depressive cycle. Others might turn
to drugs or alcohol to help them tamp down their manic episodes, so they can navigate the world without seeming hopped up or strange to those around them. The impulsivity that comes with a mania might also spur people to take very high doses of drugs or alcohol, simply because they believe they’re powerful and nothing bad could ever happen to them. When the mania takes hold, it’s hard to plan for the future. It’s easy to understand why people with bipolar disorder would lean on addictive drugs too, as these people often feel as though their emotions are completely outside their sphere of control. Taking drugs seems to provide people with the opportunity to put their hands back on the controls and regulate their own emotions as they see fit. Unfortunately, that control might be only temporary, as taking drugs tends to shift people with bipolar disorder from one extreme to another. A person with mania on drugs could become a person with depression, in just the blink of an eye. This isn’t the type of change anyone would want.
The Impact of Addiction
Anyone can develop an addiction to drugs or alcohol. In fact, these substances are designed to cause chemical changes in the brain that make it difficult, if not impossible, for people to stop using these substances, even when they want to do so. People who have addictions can experience disruptions in almost all areas of life, including:
- Personal relationships
- Personal finance
- Physical well-being
- Mental health
People with bipolar disorder can experience all of these negative consequences as well, and they may have a much lower quality of life than people who have addictions and do not have bipolar disorder, according to a study in the journal Bipolar Disorders. Researchers found that people with both conditions had lower scores of general well-being and higher scores of addiction severity, when compared to addicted people without bipolar disorder.
It’s clear that putting addiction and this disease together can mean significant impairment for the person involved. Addictions can also place a roadblock between an impacted person and an appropriate diagnosis of bipolar disorder. Addictive drugs can cause many of the same signs and symptoms as bipolar disorder, and people who take drugs may simply mask their symptoms to such a degree that it’s impossible for experts to peel back the mask of drugs and see what’s really going on underneath the surface. This could mean added years of stress and distress, all because the person continues to abuse addictive drugs.
Managing bipolar disorder often means taking medication at specific times of day, never missing a dose. People who are addicted to drugs, and who do have an appropriate diagnosis of bipolar disorder, may struggle to remember to take their medications, or they may not take their medications at all. Addictions tend to inject an element of chaos into a person’s life, making it hard for the person to truly stick to a schedule and make good decisions in the moment, and that could have an impact on the future. It’s not an ideal setting in which to manage bipolar disorder.
Bipolar disorder is considered a chronic condition, meaning that it can be controlled but never really cured. People who have the disorder will need to spend the rest of their lives taking medications and perhaps participating in therapy in order to truly get better. Once they take these steps and make the commitment, however, there’s no reason that a complete and full recovery can’t take place. There are many people who live with the disorder every day, and they manage to lead healthy and productive lives.
People who have addictions and bipolar disorder often need to get help in specialized treatment programs known as Dual Diagnosis programs. These treatment programs are run by clinicians who are able to treat both the addiction and the mental health issue at the same time. Therapies typically used for addiction are tweaked and amended to benefit people with bipolar disorder. Therapies typically used for bipolar disorder are also provided, tweaked in a way to help people with addictions.
Medication use is also closely monitored, ensuring that people aren’t tempted to abuse their therapeutic drugs, or augment their medications with other substances. With the help of programs like this, people with both addictions and bipolar disorder can gain full control of all of the issues that are impacting them.
At The Oaks at La Paloma, we specialize in providing bipolar disorders and addiction treatment. We provide in-depth counseling sessions that both educate and empower, and we’re skilled at using medication management to help people to gain control of their mental illnesses, as well as their cravings for drugs. We know that no two people are alike, so we also customize our plans based on the specific needs of the people who come to us for care. We’d like to help you too. Please call our toll-free line to speak to a professional about our programs.