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Bipolar Disorder and Substance Abuse
In a multimedia cyber world, awareness of Bipolar Disorder continues to grow. You can go on the internet and search for “Celebrities with Bipolar Disorder” and some names that will come up are Britney Spears, Mel Gibson, Ben Stiller, Kurt Cobain, Ozzy Osbourne, Macy Gray, Axl Rose, Virginia Woolf, Linda Hamilton, Sting. , Jean-Claude Van Damme and many more. Because celebrities are in the public eye and constantly under the media’s attention, any unusual behavior is seen and scrutinized.
Many people with mood disorders can remember years or years of manic and depressive behavior. They did not seek help until there was a marked impairment in the function of their daily activities. Before seeking help, some people with mood disorders try to cope with their manic-depressive mood swings through exercise, hobbies, yoga, art, music, or talking to close friends or family. Unfortunately, most people choose to self-medicate with alcohol and illicit drugs. 60% of people with bipolar disorder will develop a substance abuse disorder at some point in their lives.
Bipolar disorder is classified as a mood disorder in which a person will switch between a manic state (hyperactivity, distractibility, decreased need for sleep, grandiose behavior, running away from ideas, racing thoughts, rapid speech / pressured, impulsivity, bad judgement, hypersexuality, spending). partying, risky behavior, and unrealistic optimism) and depressed mood (sadness, crying, decreased sleep, loss of interest or pleasure in activities or hobbies, excessive guilt, low energy/motivation, weight gain, feelings of helplessness/hopelessness /uselessness, restlessness). or irritability, poor concentration and suicidal thoughts or attempts).
The prevalence of bipolar disorder in the United States is 1-2% of the general population. The age of onset is around 19 years and most cases occur between the ages of 15 and 20. The incidence among men and women with bipolar disorder is equivalent with no overall association with socioeconomic class or ethnic group. Only a third of people with a mood disorder are formally diagnosed by a doctor and of the third, about 25% are actually treated. Untreated bipolar disorder has a 15% lifetime total risk of suicide.
A person with a mood disorder can look very different when they are manic or depressed, so the disorder is frequently misdiagnosed. When it comes to substance abuse, a person can often deal with their depression by using cocaine to lift their mood. When dealing with their mania, an individual may consume alcoholic beverages, benzodiazepines, or opiates to lower their mood. The question to ask is whether substance abuse is a consequence of bipolar disorder or whether the signs and symptoms of bipolar disorder (mood swings from mania and depression) are the result of substance abuse. These individuals may be bounced back and forth from psychiatric hospitals or drug rehabilitation centers. Individuals are often denied treatment or are so frustrated with the system that they no longer pursue treatment.
To help better manage this issue, dual diagnosis or mental illness and substance abuse (MICA) units were developed. These units recognize both ‘mental illness’ (major depression, bipolar or schizophrenia) and ‘substance abuse’. These units are made up of psychiatrists, nurses, psychologists, therapists, social workers and other support staff. These programs provide a safe and medically supervised detoxification process; individual treatment plan that addresses both psychiatric illness and substance abuse and a central location that limits interruption and improves continuity of care.
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