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I Have Bipolar. I Use Substances. Do I Have a Dual Diagnosis?

DrugsThe U.S. Substance Abuse and Mental Health Services Administration estimates that about a quarter of adults with mental illness also have a substance abuse issue.

This accounts for about 2.8 million Americans.

Even before I was diagnosed with bipolar disorder, I knew substance abuse and mental illness are linked. With a family of mentally-ill alcoholics, it’s a no-brainer.

The mood swings, depression, and anxiety that come with mental disorders are almost unbearable.

Some people are able to channel their symptoms into positive activities. Others find drugs as a way to numb the pain, make situations less scary, and quiet the mind.

Bipolar Disorder and Substance Abuse

People with rapid cycling bipolar disorder or mixed states have the highest rate of danger from substance abuse.

Chaotic mood swings are so uncomfortable, all we want to do is make them stop.

There is no single drug that a person with a mental illness  and a substance disorder may use. From marijuana to alcohol to ecstasy to cocaine, a substance user with mood swings may use one drug or multiple drugs for varying uses.

Some drugs seem to temporarily blunt the effects of mood issues. Others can provide warm and happy feelings—but they also may exacerbate mania. There are drugs that provide an escape for the person with bipolar—but they also may cause psychotic symptoms afterward.

At a young age, resorting to substance use may be able to be prevented by providing support, counseling, and re-framing to allow the child or young adult to engage in positive self-soothing activities.

It becomes more difficult when we reach adulthood. Perhaps we didn’t have the guidance we needed when we were younger. Now, we have no one to check us when we are tempted. Our friends are doing it too.

Soon, we may be dependent on the substance—or at least attached to it.

When someone is struggling with both a substance abuse issue and a mental illness, they are considered as having a Dual Diagnosis, or co-occurring disorder.

Co-occurring disorders make treatment more challenging. Instability can make it tough to comply with a treatment program, making it harder to get well and stay well.

The National Institute of Mental Health warns that engaging in substance use can have the opposite effect of what the individual with bipolar is trying to do—make themselves feel better.  This is because, NIMH says, drinking and using drugs can trigger mania and depression.

What Should I Do If I Think I Have a Co-Occurring Disorder?

Ask yourself  these questions:

  • Do I use alone or in secret?
  • Am I unable to limit the amount of substances I consume?
  • Have I lost interest in activities or hobbies that I used to enjoy?
  • Do I feel a need or compulsion to use?
  • Am I irritable when I can’t use?
  • Do I feel that I need to cut back on my substance use?

If some of these sound like you, you may want to seek advice for your substance use and/or abuse.

For further self-assessment, there are several online screenings to determine if you may have a substance abuse problem, such as the quiz on

Talk to your doctor, therapist, family member, or friend if you need to seek treatment for your substance abuse issue. There are many treatment centers and programs available to assist you.

Do you have a co-occurring disorder? Tell us about your experience and if you’ve ever sought treatment.



Bouchez, C. Mental illness and substance abuse. WebMD Bipolar Disorder Resource Center, Retrieved on September 19, 2013, from

Mcgregor, S. (2007). Substance Abuse and Bipolar Disorder. Psych Central. Retrieved on September 19, 2013, from

Medline Plus. Dual diagnosis. Retrieved on September 19, 2013, from

NAMI. Substance abuse and co-occurring disorders. Retrieved on September 19, 2013, from


Photo Credit:  Chris Goldberg via Compfight

I Have Bipolar. I Use Substances. Do I Have a Dual Diagnosis?

Kat Dawkins

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APA Reference
Dawkins, K. (2019). I Have Bipolar. I Use Substances. Do I Have a Dual Diagnosis?. Psych Central. Retrieved on October 20, 2020, from


Last updated: 20 Mar 2019
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