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Addiction and Bipolar Disorder: From High to Low and Back

Have you ever stopped to think about how the mental health stigma doesn’t make sense? So many of us walk around feeling ashamed of our struggles, trying to hide them from the rest of the world.

Yet functioning with these immense internal difficulties actually evinces our strength!

As actress Carrie Fisher wrote in Wishful Drinking:

“Being bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of.”

Plus, try this statistic on for size: according to the CDC, nearly 50% of U.S. adults will struggle with at least one mental illness in their lifetime. In this post, we’ll focus on the dual diagnosis of addiction and bipolar disorder.

What Is Bipolar Disorder?

Bipolar is a mood disorder characterized by emotional swings from high to low. People with bipolar deal with depressive “down” phases and manic “up” phases, and they struggle to find a healthy middle ground.

In a depressive state, a person might be immobilized, unable to take care of their usual responsibilities. But in a manic state, that same person might work around the clock.

One quick definition for bipolar is “experiencing extremes”.

This disorder does have a genetic component, but an individual’s environment matters a great deal as well. Growing up in a physically, mentally, or emotionally traumatic environment is a strong risk factor.

Why an Accurate Diagnosis Can Be Difficult

Here are a few key reasons why bipolar disorder can be difficult to diagnose accurately:

  • First, if a person is under the influence, it’s extremely challenging to provide an accurate diagnosis. Having people detox prior to diagnosis is ideal.
  • Next, the bipolar label has increased in popularity in recent years. This is great for awareness, but it can also lead to misdiagnosis. For example, sometimes people who are dealing with clinical depression are misdiagnosed with bipolar because of the dramatic difference between their low-functioning depressive state and their usual functioning state. Similarly, rigid, black-and-white thinking can be confused with bipolar symptoms, and so can the aftereffects of trauma.
  • Finally, when people have a great deal of conflict in their lives, they may be labeled as bipolar. But when they gain the tools they need to resolve those conflicts, often the level of internal tension changes significantly.

In short, understanding bipolar disorder and addiction is critical for accurate diagnosis and treatment.

True bipolar disorder involves an imbalance in brain chemistry, and it’s certainly a serious condition.

Yet in our experience in running a residential addiction treatment center, we see people misdiagnosed as bipolar when in reality they have mental and emotional issues causing a lot of upset in their lives.

That’s not brain chemistry; that’s just upset. We find that when such people heal those issues, the upset in their lives decreases dramatically.

The Connection Between Addiction and Bipolar Disorder

Bipolar disorder is part of a family of mood disorders, including depression, anxiety, and seasonal affective disorder (SAD).

While mood disorders can be caused or exacerbated by drug use, more often people with mood disorders use addictive substances to self-medicate. Many people with bipolar turn to substances during their depressive states.

There is a particularly strong connection between bipolar and addiction. Statistics from suggest that 56% of people with bipolar disorder have experienced drug addiction.

Healing from Bipolar and Addiction

September is National Recovery Month, and it’s also Self Awareness Month. This is fitting, as you can’t really have one without the other.

Self awareness is an essential component of recovery, especially when you’re dealing with a dual diagnosis.

That said, medication certainly has its place as well. If you find that you continue to struggle with emotional extremes after you’ve detoxed from substances, then medication may give you the support you need to maintain emotional stability.

However, don’t shortchange yourself by skipping over the mental and emotional issues that contribute to mood disorders. Finding and addressing the root causes of physical disorders can minimize (or eliminate!) the need for medications to treat symptoms, and the same is true for emotional disorders.

What Counseling Strategies Work Well with Bipolar?

Specific strategies that work well with bipolar include:

  • On the mental level, Rational Emotive Therapy (RET) allows people to work with the judgments, the limiting beliefs and the projections in a person’s life.
  • On the emotional level, Gestalt and Developmental Psychology are particularly helpful for people that went through a trauma and are reliving that trauma over and over.
  • On the spiritual level, learning about compassionate self-forgiveness empowers people to reconnect with their Authentic Selves.

A trained therapist can help you to work with these counseling strategies, but no one else can force you to do the kind of mental and emotional work necessary to recover.

You yourself must be motivated to question your limiting beliefs and feel the feelings of anger, sadness, and fear that you’ve held at bay for years.

It sounds daunting, and in some ways it is. But we’re willing to bet that you’ll be surprised by your own strength.

Addiction and Bipolar Disorder: From High to Low and Back

Joe Koelzer

Joe Koelzer is a co-founder and CEO of The Clearing. He has years of counseling experience and a master’s degree in Spiritual Psychology from the University of Santa Monica.

After observing how depression and substance abuse impacted his wife Betsy’s life, Joe realized how broken our current system is for addiction and related mental health treatment.

He witnessed firsthand how an evidence-based approach coupled with Spiritual Psychology saved Betsy and enabled her to gain control of her life.

In co-founding The Clearing, Joe realized his dream of creating and sharing this innovative approach with others in a structured clinical setting.

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APA Reference
, . (2017). Addiction and Bipolar Disorder: From High to Low and Back. Psych Central. Retrieved on October 1, 2020, from


Last updated: 28 Aug 2017
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