The Value of a Dual Diagnosis Approach to Bipolar Disorder and Addiction Treatment

Due to the intertwined nature of bipolar disorder and addiction, those with a dual diagnosis may find obstacles in the path of treatment, including difficulty determining the boundary between each condition. Only by receiving integrated treatment for both co-occurring conditions will you have the best chance of recovery.

Nina was twenty-seven when she first started experiencing severe and frightening mood swings. A legal assistant at a busy corporate law firm, she initially chalked up her bouts of deep depression and lingering feelings of hopelessness to work stress and dissatisfaction with her job. A car accident a year earlier had left her with recurring back pain and a dependency on the prescription opioid oxycodone. Taking oxycodone, Nina found, gave her a feeling of peace and euphoria, which would alleviate the grip of her deep depression and make her feel happier about life.

At least for a little while.

What Nina didn’t realize at the time was that her severe mood swings—a prolonged period of lethargy and depression followed by another prolonged period of unnaturally high energy—were caused by bipolar disorder, a condition that causes alternating manic and depressive episodes. With her condition left undiagnosed, Nina tried to self-medicate, consuming both oxycodone and significant amounts of alcohol in an effort to feel stable enough to carry out her daily routines. This, unfortunately, only created more difficulties for Nina. Not only did she still have an undiagnosed and debilitating mood disorder, she was now dealing with serious drug and alcohol addictions as well.

Nina’s not alone: It’s estimated that 7.9 million people in the United States suffer from both a mental disorder and a substance abuse disorder at the same time. When a mood disorder co-occurs with an addiction to alcohol or drugs, it’s known as a dual diagnosis. If you find yourself in a situation like Nina’s, recovery is possible, provided you receive integrated treatment from qualified mental health professionals.

The Intertwined Nature of Bipolar Disorder and Addiction


Research indicates that 56% of people with bipolar disorder have been addicted to drugs or alcohol at some point in their lives. The frequency of these co-occurring conditions has an obvious cause: Drugs and alcohol may temporarily relieve some of the most disruptive or painful symptoms of bipolar disorder, such as sleeplessness and anxiety. Just as Nina did, many people with bipolar disorder self-medicate with alcohol or drugs to ease their symptoms.

In addition, some individuals with bipolar disorder have brains that produce unusually high levels of the chemicals dopamine, serotonin, and norepinephrine, affecting the body’s ability to manage stress responses and sleep patterns. Alcohol and some drugs interfere with the way the brain processes these chemicals, which might temporarily provide some stabilization of mood swings.

If you’ve attempted to self-medicate to relieve the symptoms of bipolar disorder, be aware that any short-term benefits come with excessive risks: In addition to the very real likelihood of developing an addiction, using alcohol or drugs to balance the mood swings that accompany bipolar disorder will only worsen your problem, ultimately aggravating your symptoms and heightening the negative effects. In their search for relief from their symptoms, individuals with bipolar disorder who eschew professional care in favor of self-medicating with drugs or alcohol only end up making their situation worse—possibly much worse: Those with a dual diagnosis are considered high-risk patients, with an increased likelihood of suicide attempts and violent behavior.

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Obstacles in the Path of Treatment


If you have a dual diagnosis of bipolar disorder and addiction, you face certain obstacles on your road to recovery. If only one of the conditions making up your dual diagnosis is treated while the other is neglected, the risk of a relapse is heightened, making proper diagnosis a crucial first step. Due to a handful of shared symptoms—depression, euphoria, increased energy, decreased appetite—it can be difficult to determine the boundary between a substance abuse disorder and bipolar disorder, and the specialists at clinics focused solely on addiction rehabilitation might not be trained to recognize the telling signs of mood disorders. The severe mood swings that accompany bipolar disorder, and in particular the feelings of hopelessness and apathy characteristic of the depressive state, might make it difficult to appropriately respond to addiction treatment, which would interfere with recovery. Only by understanding and concurrently treating both your bipolar disorder and your substance abuse disorder will you have the best chance of recovery.

Finding Integrated Treatment and Recovery for Bipolar Disorder and Addiction


Recovery from a dual diagnosis of bipolar disorder and addiction comes in the form of an integrated treatment for both disorders, customized to your specific needs and the nature of your conditions. It requires collaborative treatment from a team of professionals, including psychologists to address the mood disorder and addiction specialists to address the drug or alcohol use.

A residential addiction treatment center is the ideal place in which to begin the long path to recovery, as it provides a dedicated and immersive environment where you may receive comprehensive and around-the-clock mental and medical care and support. A medical detox, in which you’re provided with consistent medical supervision to manage your withdrawal symptoms while toxins from the addictive substances are given sufficient time to leave the body, is generally the first step in the process. Following that, inpatient rehabilitation begins: You’ll receive therapy and ongoing support, along with any medications necessary to treat your conditions. Psychotherapy may be useful to help you explore the underlying causes of your disorders and to change old habits and ways of thinking. A residential treatment center suited to care for dual diagnosis patients will have an onsite staff with multidisciplinary backgrounds and the necessary resources to adjust the treatment regimen to suit the needs of each patient.

Recovery is a long process, so it’s important treatment proceed at a pace you find comfortable. Treatment for a dual diagnosis is often especially difficult, as determining which symptoms are caused by the mental or behavioral health disorder and which are caused by the substance use disorder can be a complicated matter. However, with time, care, and support, you’ll be able to ease the crippling grip of your twin conditions and lead a healthier, happier life.

Alta Mira offers comprehensive treatment for people struggling with drug and alcohol addiction as well as co-occurring mental health disorders and process addictions. Contact us to learn more about our renowned Bay Area programs and how we can help you or your loved one start the journey toward lasting recovery.