Bipolar and Addiction: The Common Confusion
What is bipolar?
Bipolar disorder is a mental health condition that was formally called manic depression. It may cause emotional highs and lows. People who suffer from bipolar disorder can experience symptoms such as depression, lethargy, mania or irritability. These emotional outbursts can last for several weeks or longer unlike mood swings or depression. Having bipolar disorder can interfere with a person’s everyday life. There are many treatment options for bipolar disorder and the aim is to control the effects of an episode or mood swings which can be done in many ways such as medication, learning to identify the triggers, psychological treatment and lifestyle advice. Bipolar disorder can be caused by extreme stress, overwhelming problems, life-changing events and genetic or chemical factors. There are two types of bipolar disorder. Bipolar I : one major manic episode which may require hospitalization, bipolar II disorder involves a major depressive episode that lasts more than 2 weeks and may not require hospitalization as it is not intense enough. Why is this information important? Bipolar disorder can often be confused with addiction.
What is addiction?
Addiction is known as a psychological and physical inability to stop consuming a chemical drug, activity, or substance, even though it is causing psychological and physical pain. There are many different forms of addiction, such as food, gambling, sex, drugs, and alcohol. Addiction is related to the obsession of the mind and leads to many behavioural problems. Somebody who has an addiction may have mood swings, be irritable or depressed. An addict of any kind may not be able to control their actions, for example – using a substance or using any other external source that may make them feel better about themselves. Addiction may contain a genetic or chemical component. It is also known to disrupt the regulation of the chemicals within the brain such as dopamine or serotonin. The brain chemicals cannot normalize themselves, meaning that the person is unable to regulate these chemicals themselves and will constantly feel down, therefore needing more of the substance or activity to feel “normal”. When the brain chemicals are unable to regulate, the person may experience manic mood swings or depression.
What is the common confusion?
A lot of times I hear people who come into treatment or for an assessment say, “I am not an addict, I just have bipolar”, or there are people who seek out help from psychiatrists and lie about their addiction problem, the result being that they are incorrectly diagnosed with bipolar disorder. The two conditions may co-occur. The symptoms of bipolar disorder can be very similar to those of addiction. Someone going through a manic episode can look and act like someone on cocaine. Both experience elevated mood and energy levels. A person experiencing a major depressive episode can also have the same symptoms as someone in withdrawal. If a person with an addiction has a co-occurring bipolar disorder, they need the help of someone trained in making a dual diagnosis -because symptoms of both conditions can overlap, it is important to see an experienced specialist. Someone with experience can distinguish between symptoms of addiction and bipolar disorder.
Treating bipolar disorder and addiction
The most important factor here as mentioned above, is that professional help is sought out to determine if the individual does in fact have bipolar disorder, addiction, or both. In this case it would be considered a dual diagnosis. The most successful way of treating bipolar disorder is through cognitive behavioural therapy. Cognitive behavioural therapy (CBT) helps people with addiction and co-occurring bipolar disorder. CBT addresses the thoughts and feelings that people with these conditions face. By examining the thoughts and feelings that lead to manic and depressive behaviours, addicted people with bipolar disorder can better understand their actions. This helps them prepare for cravings and episodes, so they can manage their behaviour.
If you feel that you or your loved one may be suffering with any of the above, please seek out professional help to determine your best way forward before making assumptions. Be honest with your therapist if you are suffering with an addiction problem so that they can diagnose you correctly.
Dominique Le Claire Rossouw
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