I haven’t seen the Marci episode yet, but I thought her comments and behavior in the previews I saw seemed eerily familiar. I’m glad that there are popular shows like Intervention where people can at least be introduced to the idea of something like bipolar. Mental illness doesn’t excuse destructive behavior, of course. Now after reading your comments, I’m especially looking forward to watching this episode. Thanks!

I don’t have bipolar disorder. I became dependent on prescription drugs during a time of deep depression. I used them to try to keep myself performing and to suppress my mental anguish. It took a while, but after I was diagnosed as having Dissociative Identity Disorder I could see why I had been self-medicating. I do not use this dx as an excuse for my addictive behavior. Now I just know why life was so awful and now I do not abuse drugs. To be honest, I still am tempted and occasionally do exceed proper dosage when things get scary or physical pain gets overwhelming.

Long story short, my dx of D.I.D. did come before the addiction.

Sad but true, the Dr that addressed my family member’s depression was also an alcoholic like my family member.

My family member died to young. He the Dr survived another 20 years or more.

There needs to be accountability in the medical profession, as in all professions. It’s a little off topic, however somewhat related in that her diagnosis was probably close to depression and she drank.

I am feel very close to this situation. I had bipolar (not diagnosed until 27) and all of a sudden in my 20’s while I was in law school I started drinking a lot and doing drugs I never thought I would ever do. I think that self medicating is a serious sign to bipolar disorder. If I hadn’t hidden my drug issues from family, then I could have been helped much sooner.

I began drinking in college like most young people who enjoy drinking. But I also was susceptible to deep depressions. To make a very long story short, by the time I was 32 years old, I had to be hospitalized and was diagnosed with Major Depression, Recurrent. But the antidepressants never seemed to work for very long periods of time. They would work for a while and then a deep depression would set in and I would have to change to another antidepressant to see if it worked better. Along the way, I realized that my drinking had gotten out of hand, mostly drinking alone in my home at night, isolating. One day I decided that I needed to stop the drinking and attended my first AA meeting. The drinking stopped for nine years. During that period of time, I gained a tremendous personal faith that I rely on to this day. However, four years ago, a new doctor took a very close look at my medical history and told me that she truly believed that I had been misdiagnosed all along and I was actually bipolar. I told her that I had never had psychotic episodes. She said it was not a requirement of a bipolar diagnosis that psychotic episodes be present. I told her that back in the day when I was first diagnosed, it was indeed a requirement. We then started a new medication plan that included a mood stabilizer and a small dose of antidepressant. I felt much better on the new medications. I studied and researched bipolar illness and came to the conclusion that I have been bipolar most of my life and the drinking was a form of self-medication that was heaviest during the manic stages. Today, 24 years after my first hospitalization, I live a managable life on bipolar medication.

Hi,

I too had substance abuse problems, but only during mania…I drank a lot. I was having fun, though. I realize now, since I was dx’d a few months ago at age 29 that it was self medicating. A lot of people, apparently drink or smoke when they’re having mania, either to calm down or keep the fires stoked. We also take in too much sugar and caffeine for the same reason.

At first they too thought it was unipolar depression, but no ADs worked on me except for the ones designed to increase dopamine (very bipolar thing) not serotonin…which either made me feel terrible, have the shakes, or else go manic/psychotic. My dx was first hinted at with the meds reaction, but then I went through my past and saw that almost everything from age 4 onward was a depressive/manic/hypomanic/or mixed episode…and it just got worse with time such that I needed to self medicate or else realize I had a problem (the depression seemed to be the problem to me always) and get help, which I did finally last year…not just therapy but meds too, which I was afraid of due to knowing drug addicts.

Anyways, I’m on the road to recovery like Marci and others who’ve posted here. I totally relate.

Thanks for this posting.

My husband and I abused drugs and alcohol together for many years. We were young and having fun. I cleaned myself up four years ago, but my husband has been unable to break the hold the drugs have on him. His drug use actually worsened after I quit. His sister is diagnosed bipolar, and in the past three years has destroyed her family and can not even so much as speak on the phone with her children anymore. During a school project I had last year, I learned of cyclothymia, a somewhat lesser form of bipolar disorder. A year later, my husband has filed for divorce and left his two small sons to move in to his dad’s house. His primary reason for leaving us as he expressed to me was that he needed a bigger house with a bigger yard (that doesn’t make a whole lot of sense, does it?). I’ve expressed to him in the past that I felt he had a problem because he could not get off the drugs without suffering major mood episodes, but he refuses to believe bipolar is even a disease.

I wholeheartedly agree that a screen for mental illness would be seriously indicated in people who abuse drugs and alcohol. My husband has twice been arrested for possession, and if he had been diagnosed after the first arrest, we’d be living very different lives right now.

I hope that you will write more posts on mania. My friend is having a manic episode and I don’t know what to do or say. She loves her mania, she says it makes her smart, have good ideas. What she doesn’t see is it makes her argumentative and mean.

I self-medicated away my late teens and 20s. I was treated for depression with Zoloft through my late 20s and way into my 30s. I was diagnosed as Bipolar II when I was 37. I am now 45 and I have a life finally. I am almost done with a BA degree. I don’t start a dozen projects and not finish them. I don’t stay up all night watching TV anymore. I don’t binge drink to the point of oblivion anymore. I take Trileptal and Zoloft but in the lowest dose possible and still keep me functioning. If I take a higher dose of either I loose that special something that makes me who I am. I am creative, I am intelligent, I am successful (maybe not by the world’s standards but by my own). I can tolerate crowds a little better and can enjoy my extended family in short doses without major anxiety. If I look back I realize I was truly bipolar since around age 16. I stayed up all night once and cleaned the house and cooked breakfast for my family. I cooked for 20 although my family was only 6 people. I OD’d and spent a few days in the medical wing of a hospital and the one psych visit I had during those four days determined that I was “attention seeking.” If I dwell too long on the “what if” I become stuck so I just move on and try not to think about the things I did that cause me and my family shame. I praise God (although I am a follower of Christ I am not religious) that I lived in that state as long as I did and I praise God that someone paid attention and I now can really live.

It’s so funny that this article was posted because this is something that I have been dealing with and talking to people about for a very long time. I have Bipolar II and I am also an addict. I have always known that my Bipolar came first and I knew this for a couple of reasons. First and foremost is the fact that I have been suffering from depression (that turned into Bipolar, I believe, by the series of traumas that was my childhood) as far back as I can remember. Depression played a part in even my earliest memories when I was about 3. Secondly, my drugs of choice were always narcotics. Heroin, percocet, vicodin, any narcotic - but ONLY narcotics. Yes, I experimented with all drugs as a teen, but as I got older, I would turn down everything and anything except for narcotics. This is because, at that point, it wasn’t about getting high for me - it was about the way narcotics affected my brain, how it counteracted with the Bipolar, and how it felt like they allowed me to function in a way that I never could without them. Of course, addiction and those kinds of drugs tend to fool you into thinking that they are the answer to all of your problems, which, of course, they aren’t. But there was no denying that the narcotics did have some kind of positive affect on my brain. First, I became addicted to heroin and after trying to self-detox many times, I finally went to an actual detox and got clean of it (next month will be 15 years off of heroin for me). I stayed completely clean of everything for about 5 years, but ended up on prescription narcotics for many years after that (also trying to self-detox more times than I can count throughout all that time). Throughout all of those years, since I had detoxed off of heroin, I was also on meds for the Bipolar, (even when I wasn’t using any narcotics), but they only ever worked to a point. It wasn’t until I went on methadone to get off of the pills that I finally felt like I had found a real solution for myself. The methadone acted as an anti-depressant for me. I’m sure that there will be those that will completely argue with me about this, and I have to stress that I can only speak for myself and for that reason, this is not something that I would advocate for anybody else, but, in combination with the meds for the Bipolar that I am on, the methadone has been amazing for me. Since the day that I went on it, I have had absolutely no desire to use any kind of narcotics. Like I said before, except for my teenage experimentation years, it hadn’t been about getting high for a very long time, and I would turn down everything except for narcotics, but because methadone is a narcotic (but you do not get high off of it), it has had that positive affect on my brain that the heroin, etc. had, but without all of the horrible, negative sides of addiction.
What all of this comes back to is that addiction (and yes, I am an addict) was definitely only ever a symptom of the Bipolar - I was self-medicating - the Bipolar definitely came first.

For me, the illness came first, though it wasn’t recognized. The substance abuse exacerbated the illness. I believe the symptoms started in childhood, and I abused drugs and alcohol at ages 18-19, but I wasn’t diagnosed as bipolar until 23 or 24.

My son was 17 and was diagnosed with being bipolar . He also was self medicating. Now at 19 he is deceased , he went to sleep after partying and never woke up , please don’t mix your medication with alcohol or other drugs . My son is now gone and I miss him dearly .

i want to tell you about my experience as a clinician as well as a patient. i worked for the state mental health office here in louisiana as a counselor until about 2 years ago. i have a masters in social work. during the last year and a half of my employment, our policies changed from the highest authority to require treating mental illness AND substance abuse together rather than closing the door and sending our patients all over town to other clinics. there were so many people who would identify substance use during a mental health eval and would be told “we don’t treat that you’ll have to go to addictive disorders.” well if that happened to me i’d get frustrated probably and just forget about it. too much hassle! so in an effort to treat all those who were falling through the cracks, all staff were cross trained to screen for both areas, mental illness and sub abuse. the state office of addictive disorders was also required to screen for mental illness on their patients. if the screens were positive in either clinic we then set up treatment in an appropriate facility and we continued mental health treatment while they got help for the sub abuse from persons specifically trained in that arena. we even opened a new inpatient facility specifically for dually-diagnosed individuals only. the “catch phrase” we heard so often in mental health during this cross training phase was, “substance abuse in mentally ill patients is an expectation Not an exception.” meaning- make sure to screen for both disorders every time! not to say all mentally ill are users just reiterating the importance of asking the right questions and covering all bases. so even though its changing slowly, screening processes are leaning more towards evaluating for both disorders which is what we need more of.

on another note, i can relate to so many of the other posts about this- i began drinking at age 13-hard liquor. about a year and a half ago my mood got so bad i finally broke down and went to a psychiatrist for myself for the first time. i found out something that i had never heard of before, even while i was in college. i was told that mania can increase urges to use. when i first started drinking i would carry whiskey in a bottle in my back pack to school and hide it in my locker and sip on it between classes. i had severe depression since even before then and sometimes i would even cut myself. i hid it all, the drinking the cutting, everything. i was never treated for any of it. i was never diagnosed with anything. when i was about 22 i saw a general practitioner for physical complaints, tests were done and there were no medical problems and he diagnosed me with anxiety and depression. like so many other ppl i only got partial relief from the meds and ended up quitting them. about 3 years ago and after years of off and on trials with different anti depressants one physicians assistant suggested i try something for mood stability. i took it for a month and gave up after no change. i know now it wasnt the right med or dose i needed. even after all this time i still never made any connection with the drinking and my mood or behavior. i just never thought it was a big deal-alcoholism is all over my family. and yes i was self medicating. about a year and a half ago i was tried on mood stabilizers for the first time due to excessive rage, suicidal thoughts, and homicidal thoughts. the worst ever. my psych said that it was mania even though i never thought i experienced the “elation” i always thought defined a manic episode. over time i admitted to my doc the “risk taking” behavior typical of mania- promiscuity, shoplifting, drunk driving, you name it. i never once in my life identified those as manic symptoms because they always happened when i was intoxicated. in 2006, i was with my family in dallas, tx at a nascar race- we’re talking 100,000+ people there. i kissed a total stranger in front of my husband then left with him. some dangerous things occurred and i had a blackout. i finally found my family again hours later. this is not something i would ever do just so you understand the degree of what i’m getting at. the psych explained that although these events occurred during intoxication it was indeed mania. she said that the mania increases the urges to use. after even more analyzing i realized the pattern associated. for as long back as i could remember, a couple of times a year i would have these uncontrollable urges to go out of town for a drinking binge during which this behavior occurred. i have family in new orleans so i’d get one of my girlfriends and we’d go for a “girls night out.”i used to plan my drinking binges like i was going on a 3 week vacation. from where i was going to who i was bringing with me to a full itinerary all revolving around getting drunk and other things i’m embarrassed and ashamed to mention. to put it simply- the mania increased the cravings to use and i obsessed about it constantly. in early 2008 at age 31 after trial and error i finally found a good med combo for me and since then my anger/rage is under control, i haven’t had any suicidal thoughts but most surprising of all and what really solidifies what the dr told me was that i no longer have those crazy urges to get drunk out of my mind. i hope that by my telling all of this will somehow be an example of what can happen when mental illness and substance abuse are not treated appropriately. if you have friends or family that use and need help/or appear symptomatic of bipolar i suggest you stress the importance of screening for Both disorders at the same time!!!!! it is good to know a lot of states are focusing their policies on treatment for co-occuring disorders. if you don’t feel like your dr is giving you the proper treatment for BOTH of your problem areas then please keep searching for a dr who will!!! it is definitely a life or death situation.

I’m so happy to have come across this site, particularly this article, as I checked out different areas of my news reader.

I’ve been in and out of recovery (from alcohol abuse mostly) for about 20 years, now just two-and-a-quarter years sober again. Not too long BEFORE I got back to recovery in 2007 I was diagnosed with bipolar II. The description fit me perfectly, particularly as I went over a long list of incidents and periods of uncharacteristic behaviour during hypomanic periods. In fact the diagnosis of bipolar II was an ‘aha!’ moment for me and made so much sense of the preceding years and years when, at best, I was treated for episodes of depression only - leaving me to conclude that hypomanic periods were merely un-depressed.

Having seen others in recovery roll their eyes when they’ve heard about members speak of being bipolar I have been careful about choosing who I talk to about it, other than my psychiatrist.

I cannot deny that my symptoms have improved since getting sober again, but they have not been completely eliminated despite faithfully taking my prescribed medications. (This does not surprise my p.doc. who assures me that alcoholism and bipolar can and do occur at the same time.)

So my doc is more than okay with me being both alcoholic and bipolar. So am I. It’s mainly, it seems to me, the untrained minds in ‘recovery’ circles who are prejudiced about psychiatric care and diagnoses of different kinds over and above substance abuse.

OMG, i haven’t read all of the comments but still.. i can totally relate to what others has commented here. Im a male, 18 year old student who’s going through the very same thing. I thought i was suffereing from depression but last yeaer i found out that im actually suffering from bipolar disorder. I honestly thought that i was crazy. One moment, i was intoxicated with pretty much everything. The next, im completely depressed by the smallest of things. To cut the story short, i think the cause(BD) came first before the effects(substance abuse)

How can you tell if someone else has had BD or alcholism or drug abuse first? I think my boyfriend is just trying to use BD as an excuse. I have been with him 13 years and all of a sudden he says the dr. has been telling him he has BD since he was a child! This man tells me everything, except about his alcohol and drug abuse! He is never at fault for anything, especially drugs and alcohol. He never even admits to using, except after he has been locked up! and then sometimes it is still not his fault! He says he was “holding” the drugs for someone else is his favorite line! He is never “drunk” and has always only had 1 beer (somtimes a 6 pack really)! He is in complete denial of everything he does wrong and I am afraid he is just looking for another excuse for the drinking and drugging. I know him, he will not stop drinking to get the BD under control if that is really what he has. He will mix the medication with alcohol and create a whole new problem! How do I help him? I don’t feel he wants to stop drinking, and I am so tired of trying to help him.

I have the same problem with my daughter. I hope someone has some information for us

My father is a psychopharmacologist professor who is currently writing a book for psychologist/health professionals (non Drs.) to better explain medications for various mental illnesses. Ironically, I was diagnosed with bipolar II in drug rehab treatment after a 9 month period of prescription drug abuse, unbenounced to my father. I was using drugs to cope with issues of depression and mood swings as well as to cope with manic phases not knowing that I had bipolar. I am now sober over 10 months, working in management at a very successful non-profit and following a regiment of medications to control my mental illness and addiction. One of the major medications I am on is Suboxone, used to control opiate withdrawal symptoms and adverse effects such as anti-anxiety. Following this regiment has worked as I am healthier, more alert and emotionally stronger than I was prior to my drug abuse and diagnoses of bipolar. I am uncertain if my drug abuse was a direct correlation to bipolar or have I had this disease forever and never had any issues until my diagnoses. One thing for certain is mental illness and drug abuse are very common in cases of drug abuse and the NIH and DSM need to update or add a section about the direct correlation between the two (mental illness & drug abuse).

I saw the episode on Marci. While I fought(fight) my own battle with substance abuse it was always clear that this was a way of avoiding the pain of the trauma suffered as a young child. Yesterday my psych doc told me that my “ups”(when I felt normal) were actually hypomanic states and I was Bi-Polar 2; If my ‘normals’ are labeled as “manic” I don’t want to be any lower, I would rather go on with my suicide plan- let the depression take me out if the good times are too good. I believe the chicken and the egg applies here- did the mental illness cause the substance abuse or did the substance abuse cause the mental illness?? I am told “keep it in the today”. Today is lousy, give me my pills and let me done and over with it.