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Depression & Mental Health Blog
July 25, 2016
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Dual Diagnosis: Bipolar Disorder and Substance Abuse

Dual diagnosis is the term used when a person is experiencing both a mental health issue and an addiction problem. The range of combinations is quite broad for dual diagnosis, but one commonly seen type is bipolar disorder with drug or alcohol abuse.

Bipolar disorder is a major affective disorder also known as manic depression. It's a brain disorder that's characterized by shifting moods, varying activity levels and energy-level swings. All of these drastic and varying shifts impact the person's ability to carry out daily tasks.

Signs and Symptoms of Bipolar Disorder

The signs and symptoms of bipolar disorder will be different depending on if the person is having a manic episode or a depressive episode. Let's review what happens in each type of episode.


  • Feelings of elation
  • Having lots of energy
  • Increased activity levels
  • Feeling "jumpy"
  • Insomnia
  • Talking fast, jumping from topic to topic
  • Agitation and irritability
  • Racing thoughts
  • Trying to do many things at once
  • Risky behavior like spending too much money or having reckless sex


  • Feeling sad, depressed or hopeless
  • Low energy
  • Experiencing low levels of activity
  • Insomnia, then excessive sleeping
  • Difficulty enjoying anything
  • Feelings of worry and emptiness
  • Concentration problems
  • Forgetfulness
  • Eating excessively or hardly at all
  • Tiredness
  • Thoughts of death or suicide

People with bipolar disorder who abuse alcohol or drugs may mask the symptoms of the disorder. Family and friends, as well as the person experiencing the dual diagnosis symptoms, may not recognize these problems as signs of bipolar disorder.

It's important for anyone experiencing any type of bipolar symptoms who is also abusing substances to seek professional help in a dual diagnosis treatment program.

Treatment Options for Dual Diagnosis

Effective methods of treatment include addressing substance abuse problems simultaneously with bipolar disorder.


The first step is an inpatient detox. The person is monitored by medical professionals 24/7 while the substance of abuse is purged from the body. Medications are sometimes used to help offset unpleasant and sometimes dangerous withdrawal symptoms.

Inpatient Rehab

A high level of care in an inpatient addiction program is recommended to treat dual diagnosis. Therapy for substance abuse and bipolar disorder is provided in an integrated treatment plan. Emotional and mental health support, medication and health services are provided, with the goal of treating addiction, mental health issues and their underlying causes.


Prescription medications for treating a mental illness like bipolar disorder are useful tools in most cases. In some situations, medications can also help with maintaining sobriety.


Psychotherapy is a typical component of an effective and comprehensive treatment plan for dual diagnosis. It helps the person discover and explore thoughts and feelings. Cognitive behavioral therapy (CBT) to change thinking patterns is also an effective component of a dual diagnosis treatment plan.

Self-help and Support Groups

When dealing with a dual diagnosis, support groups help people share feelings and resources to stay healthy and remain sober. A few types of support groups are outpatient group therapy sessions, 12-step meetings and Smart Recovery programs.

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