When we think of comorbid diseases, we often look for a clear common link, such as with high cholesterol and heart disease. With addiction, however, the links aren’t always so clear. As research is showing, there is a particularly high comorbidity between addiction disorders and bipolar disorder.
The National Institute of Health (NIMH) recognizes bipolar disorder as a brain disorder characterized by “unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.” The defining feature of bipolar disorder is shifting between high-energy (manic) and low-energy (depressive) states, which is why it’s also referred to as “manic-depressive illness.” In the manic states, patients may feel anxious, paranoid, their thoughts may race at a hundred miles an hour and they can embark on many different, sporadic projects without seeing any through. While depressed, they may feel sluggish, miserable, empty, and with little energy to concentrate. In either state, many frustrating symptoms could occur, with no clear end in sight.
Decades of studying and treating addiction disorders have debunked several myths about these diseases. First and foremost, the “chemical-hook” theory, that certain drugs are more addictive than others, only explains a small fraction of why we become addicted. During the Vietnam War, there was a growing fear in the US about soldiers returning home addicted to heroin, because so many soldiers were using the drug to cope with the immense stress of the war. However, upon returning home, only a small fraction of veterans continued using. In Vietnam, these soldiers were under constant threat of enemy fire, deadly booby traps, ambushes, and were surrounded by similarly young, terrified, and miserable soldiers using heroin to cope with all these “triggers.” When they returned home after the war, suddenly all these triggers disappeared. Their families weren’t using drugs to cope. They weren’t under threat of violence 24/7. The factors that made them dependent on heroin simply melted away.
Just like victims of bipolar disorder, Vietnam veterans were going through interchanging rushes of paranoid anxiety and cold, dark dread. Neither could know what was going to happen a week, a day, or even an hour later, or if things would ever get better. Drugs and alcohol were an immediate and welcome, if desperate, solution to very severe problems caused by their environment. For veterans, the jungle was full of dangerous and lethal triggers. For people with bipolar disorder, their brains are a journey through a minefield of symptoms that could stretch for days, months, or years without provocation. When drugs offer immediate relief to these constant threats, it becomes clear why so many people suffering from bipolar disorder also grow dependent on drugs and alcohol.
Treatment of Substance Use Disorders in coordination with Bipolar Disorders can be tricky. The manic phase can make staying focused and determined difficult, making the long detox period particularly challenging. The depressive period in bipolar disorder can make it difficult to find and maintain motivation. A skilled therapist can help patients manage both the depressive and manic symptoms through techniques like Cognitive Behavioral Therapy, giving them control of their recovery journey. If you or someone you know is considering drug or alcohol rehab in Orange County or is suffering from addiction and a comorbid bipolar disorder, please call Experience Recovery at (714) 782-3973.
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