Recovery is not just about managing symptoms; it is about building a life where a person can handle what each day brings and feel steady doing it. Understanding the connection between mood instability and substance use is the first step toward healing. At Therapy Now, we build treatment plans around your life, not the other way around. This is so you get the support that actually fits your situation.
Clinicians typically categorize this condition into three primary forms: Bipolar I, Bipolar II, and Cyclothymic Disorder. Knowing the type of bipolar disorder is important, as it shapes both the treatment plan and the risk for addiction. Data suggests that as the severity of mood episodes increases, so does the likelihood of substance use. But every individual case of bipolar is different, and treatment plans are customized to suit individual needs.
Bipolar I is typically diagnosed when someone has had at least one manic episode lasting seven days or longer, or one so severe they needed hospitalization. Depressive episodes usually occur as well, typically lasting at least two weeks.
Bipolar II disorder involves a pattern of depressive episodes and hypomanic episodes. Hypomania is a less severe form of mania that does not typically result in hospitalization but still impacts daily functioning.
While the “highs” may be less extreme, the depressive periods can be debilitating. Individuals may turn to substances to cope with lingering low moods. Research shows that while the risk is lower than in Bipolar I, people with Bipolar II still face a 3.3 times higher risk of substance use disorders compared to the general population.
Cyclothymic disorder (also called cyclothymia) is defined by periods of hypomanic symptoms and periods of depressive symptoms lasting for at least two years in adults. However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
With cyclothymia, the constant up-and-down makes it tough to maintain jobs or relationships. When the person’s mood keeps shifting (even if it’s not as extreme as Bipolar I or II), they might turn to using drugs or alcohol just to feel normal.
Symptoms of Bipolar Disorder
During a manic episode, energy skyrockets — or intense irritability and agitation take over, often with feelings of invincibility.
Common indicators of a manic episode include:
- Elevated Mood: Feeling intensely euphoric, “high,” or unusually irritable.
- Decreased Sleep: Feeling fully rested after only a few hours of sleep.
- Racing Thoughts: Jumping rapidly from one idea to another or speaking very quickly.
- Grandiosity: Having an inflated sense of self-importance or unrealistic beliefs about one’s abilities.
- Risky Behavior: Engaging in impulsive activities like excessive spending, reckless driving, or substance abuse.
Depressive episodes bring crushing lows where even basic tasks feel impossible. Key symptoms of a depressive episode include:
- Persistent Sadness: Feelings of emptiness, hopelessness, or worthlessness.
- Fatigue: Profound tiredness and a lack of energy, even with adequate sleep.
- Loss of Interest: No longer finding pleasure in hobbies or activities once enjoyed.
- Cognitive Difficulties: Trouble concentrating, remembering details, or making decisions.
- Physical Changes: Significant changes in appetite or sleep patterns (insomnia or oversleeping).
The Connection between Bipolar Disorder and Addiction
Bipolar disorder and addiction often feed off each other, with each one able to trigger or worsen the other. Dual diagnosis treatment in New Jersey addresses both conditions together. According to the National Institute on Drug Abuse, approximately 40–60% of people with bipolar disorder experience a substance use disorder at some point in their lives.
What starts as a way to cope quickly turns into another problem to manage. Alcohol is the most commonly abused substance, accounting for 42% of substance use comorbidities in this group. Cannabis follows at 20%, with other illicit drugs accounting for 17%.
Many individuals turn to drugs or alcohol to manage the intense symptoms of bipolar disorder. This is often referred to as “self-medication,” though it typically exacerbates the underlying issues. It can take a few forms for someone with bipolar disorder:
- Managing Mania: During manic episodes, individuals may use depressants like alcohol to slow down racing thoughts or calm agitation.
- Coping with Depression: During depressive episodes, stimulants may be used to combat fatigue and elevate mood.
- Sleep Regulation: Substances are frequently used to induce sleep during periods of insomnia or restlessness.
Research shows the connection may run deeper than self-medication — brain chemistry itself can drive both conditions. Studies indicate only about 25% of people with bipolar disorder increase alcohol use during manic episodes, suggesting neurobiological rather than purely behavioral factors.
Using substances throws your mood off balance and can make your medications stop working. Stimulants like cocaine can trigger manic episodes, while alcohol and other depressants can deepen depressive symptoms.
The impact of substances on bipolar disorder includes:
- Treatment Interference: Substances can reduce the efficacy of mood-stabilizing medications.
- Increased Severity: Co-occurring substance use is linked to more severe manic episodes and rapid cycling.
- Safety Risks: There is a higher incidence of suicide attempts and hospitalizations among those with dual diagnoses.
- Diagnostic Challenges: Substance use can mask true bipolar symptoms, making accurate diagnosis difficult for providers who do not specialize in dual diagnosis.
Our Approach to Treatment at Therapy Now
Individual therapy is where the real work happens in our programs. We use therapies that research has proven work for both bipolar disorder and addiction.
- Cognitive Behavioral Therapy (CBT): This approach helps clients identify negative thought patterns and behaviors that contribute to both mood instability and substance use.
- Dialectical Behavior Therapy (DBT): DBT focuses on emotional regulation, distress tolerance, and interpersonal effectiveness, providing practical skills for managing intense emotions without substances.
- Motivational Interviewing: This technique helps resolve ambivalence about change and strengthens the client’s own motivation for recovery.
We bring in holistic practices, things like mindfulness, breathwork, and movement. This is to help you heal on every level. These practices help you manage stress in real time and bounce back when life gets hard.
- Mindfulness and Meditation: These practices teach individuals to stay present and observe their thoughts without judgment, reducing reactivity.
- Yoga-Inspired Principles: We incorporate breathwork and body awareness to help clients reconnect with their physical selves and release stored tension.
- Lifestyle Coaching: Guidance on sleep hygiene, nutrition, and routine helps create a stable environment for recovery.
Levels of Care for Dual Diagnosis
Outpatient treatment works well if you’ve found some stability and just need regular support to keep it going. This level of care allows individuals to live at home and continue working or attending school while receiving therapy.
Key features may include:
- Weekly or biweekly individual therapy sessions.
- Medication management appointments.
- Continued focus on relapse prevention and life skills.
Our Intensive Outpatient Program (IOP) provides a higher level of structure for those who need more than weekly therapy but do not require 24-hour supervision. An IOP is a good fit if you’re transitioning out of inpatient care or if weekly therapy isn’t cutting it anymore.
Key features of our IOP include:
- Multiple sessions per week, totaling 9-12 hours of treatment.
- Group therapy to build peer support and communication skills.
- Flexible scheduling (day or evening) to accommodate work and family commitments.
Our Partial Care Program offers the most intensive level of outpatient support. It is designed for individuals experiencing significant symptoms who need daily therapeutic structure.
Key features of our partial care program include:
- Daily programming, typically 5 days a week.
- Comprehensive psychiatric monitoring and medical support.
- Intensive group and individual therapy to stabilize mood and address substance use.
- Crisis stabilization services to prevent hospitalization.
Get Support for Bipolar Disorder at Therapy Now
https://www.nimh.nih.gov/health/topics/bipolar-disorder
https://www.samhsa.gov/find-help/national-helpline
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder
https://nida.nih.gov/research-topics/comorbidity/part-1-connection-between-substance-use-disorders-mental-illness
