Evidence Suggests Adolescents with Bipolar Disorder at High Risk for Addiction


We’ve learned a lot about addiction over the past century. Through research and observation, addiction has gone from an enigma to a decidedly complex brain disease for which there are many potential causes. However, there’s still much left to learn, especially when it comes to understanding susceptibility to addiction.

Addiction is an indiscriminate disease that can develop in men and women of all ages and from all walks of life, encompassing virtually the entire demographic spectrum. According to statistics, only 11 percent1 of those suffering from addiction are receiving treatment and of those who are receiving treatment, between 40 and 60 percent will relapse.2 With recovery rates so disappointingly low, the most effective way to curb addiction rates is to prevent addiction from developing in the first place. In other words, we need to know what could put someone at risk for developing a substance abuse problem so that the appropriate preventative steps can be taken.

When it comes to demographic groups at risk for addiction, there has been a major focus on adolescents and teens. Today, it’s increasingly common for individuals to begin experimenting with alcohol and drugs during adolescence, which means putting themselves at risk of developing substance use disorders. While there are a number of reasons why youths experiment with recreational substance use — such as being exposed to substance abuse at home or being in peer groups consisting of other substance users — a recent study offers evidence that adolescents with bipolar disorder are at high risk of early-onset addiction.

Bipolar Disorder Among Adolescents

Previously known as manic-depressive disorder, bipolar disorder is a psychological disorder that’s characterized by unusual, unpredictable or unprovoked shifts in mood as well as energy and activity levels, making it difficult to fulfill one’s daily obligations.3 When a person has bipolar disorder, he or she will alternate between periods of depression and periods of mania, which is a state of inexplicably high energy, elation, impulsivity, insomnia and excessive risk-taking behavior. Typically, bipolar disorder first manifests during late teens or early adulthood, but it’s possible for symptoms to emerge even earlier.

It’s estimated that 3.9 percent of American adults meet the diagnostic criteria for bipolar disorder at some point in their lifetimes with 2.6 percent meeting the diagnostic criteria in a given year.4 Among adolescents, bipolar disorder tends to develop at lower yet comparable rates. About 2.5 percent of adolescents have experienced symptoms of bipolar in their lifetimes and 2.2 percent experience symptoms in a given year. However, when considering only adolescents in their late teens, there was an increase to 3.1 percent having experienced symptoms of bipolar disorder in their lifetimes.

Teens with Bipolar Disorder More Likely to Become Addicted

Researchers at Massachusetts General Hospital recently investigated whether bipolar disorder in adolescents might be a predictor of later alcohol or drug problems. The study began with an assessment of two groups: 105 adolescents with bipolar disorder and 98 adolescents who didn’t have bipolar disorder and who served as the control group. Initially, about 34 percent of the adolescents with bipolar disorder had problems with substance abuse while just 4 percent of the control group had alcohol or drug problems. From the very start, the two groups showed a major discrepancy in the frequency of substance abuse.

Five years later, the researchers followed up with 68 of the original bipolar adolescents and 81 members of the control group. Almost half (49 percent) of the bipolar group had developed alcohol or drug problems while just 26 percent of the control group had developed substance abuse problems, a difference of nearly half. Additionally, symptoms of conduct disorder — a blanket term used to described aggressive, destructive, defiant or deceitful behaviors exhibited by youths5 — were usually present in bipolar individuals with alcohol or drug problems at the time the follow-up interviews were conducted.

Dr. Timothy Wilens, chief of Child and Adolescent Psychiatry at Massachusetts General Hospital and a lead author of the study, said, “[T]hose originally diagnosed with bipolar disorder who continued to have symptoms five years later were at an even higher risk for… substance use disorder than those whose symptoms were reduced either because of remission from bipolar disorder or from treatment.”6

The implications of this study are enormous. In teens and young adults suffering from both bipolar disorder and a substance use disorder, it’s likely that symptoms of bipolar disorder developed before alcohol and drug problems. Although substance abuse is widely considered a symptom of bipolar disorder, the present study confirms this is true for bipolar adolescents, too. As well, this study shows that when the symptoms of bipolar disorder are treated effectively and managed, the likelihood of developing a substance use disorder is greatly reduced.

“Since symptoms of bipolar disorder usually appear before substance use disorder develops, clinicians following youth with bipolar disorder should carefully monitor for… substance use, along with treating bipolar symptoms.”

Written by Dane O’Leary


  1. http://www.drugfree.org/new-data-show-millions-of-americans-with-alcohol-and-drug-addiction-could-benefit-from-health-care-r/
  2. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  3. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
  4. https://www.nimh.nih.gov/news/science-news/2012/rate-of-bipolar-symptoms-among-teens-approaches-that-of-adults.shtml
  5. http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Conduct-Disorder-033.aspx
  6. https://www.eurekalert.org/pub_releases/2016-08/mgh-bac082616.php

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