Bipolar disorder is a condition characterized by both episodes of major depression and episodes of mania or less extreme hypomania. About 4.4 percent of people will develop bipolar disorder in their lifetime. During a depressive episode, someone with bipolar disorder might have depressed mood, fatigue, slow movements, poor concentration, disturbed sleep, weight changes, irritability, and thoughts of suicide or death. These episodes may last weeks or months. However, during manic episodes, someone may have little need for sleep, have excess energy, racing thoughts, paranoid delusions or delusions of grandeur, engage in risky behavior, including drugs and risky sex, start many new projects, and feel jumpy or irritable. In extreme cases, someone having a manic episode may have a psychotic break and have to be hospitalized but it’s more common to have milder manic episodes characterized by little need for sleep, excessive energy, and hyperproductivity.
Bipolar disorder can significantly increase your risk of addiction, partly because people with the condition try to self-medicate and partly because manic episodes cause risky behavior, including drug use. According to one study, people with major depression have about a 16.5 percent chance of developing an alcohol use disorder and an 18 percent chance of developing a drug use disorder. Those are more than twice the rate of substance use issues in the general public but they are still dwarfed by bipolar disorder. People with bipolar disorder have about a 56 percent chance of developing a substance use disorder sometime during their lives. Therefore, it’s crucial for people with bipolar disorder to get professional treatment and to watch out for potential triggers, such as the following.
If you are already recovering from a substance use disorder, you obviously want to avoid drugs and alcohol anyway. If you have bipolar disorder but not a substance use disorder, it’s a good idea to avoid drugs and alcohol both because you have an elevated risk of developing an addiction and because drugs and alcohol can cause a manic or depressive episode. There’s a high overlap between bipolar disorder and alcohol use disorder. One study found that alcohol dependence was about twice as common in people with bipolar disorder than in people with unipolar depression. Why this might be is poorly understood because bipolar is poorly understood but unfortunately, alcohol makes both depressive and manic episodes more extreme. Other drugs, such as cocaine or amphetamines may trigger a manic episode. Drugs and alcohol change your balance of neurotransmitters and the bipolar brain is thought to be extremely sensitive to these kinds of changes and have trouble restoring balance. Not only is substance use a common trigger for bipolar episodes, but withdrawal as well, since withdrawal tips your brain chemistry in the opposite direction.
Stress is another major trigger of bipolar episodes. Any kind of major life stress, such as interpersonal conflict, losing your job, getting divorced, moving house, or the death of a loved one may trigger an episode. Interpersonal stress is especially problematic because you may end up alienating the important people in your life, whose support might otherwise buffer you against stressful events. One study found that stress from interpersonal conflict was a frequent cause of suicidal thoughts and behavior in people with bipolar disorder.
People with bipolar disorder are very sensitive to changes in their circadian rhythm, which is heavily influenced by hours of daylight. Studies have found that the typical cycle for people with bipolar disorder is that manic or hypomanic episodes peak in the spring and summer as the days become longer and and depressive episodes peak in early winter, when the days are shortest. These seasonal changes affect about 20 percent of people with bipolar disorder.
Travel can disrupt your circadian rhythm just as much as seasonal changes, especially if change by several time zones. Jet lag can throw off your sleep cycle for weeks, triggering an episode of depression or mania. In addition to the time change, your schedule may be disrupted by the demands of travel and you will have to sleep in unfamiliar places, which undermines sleep quality and may increase your risk of anxiety and depression. Finally, travel is often stressful, with long waits, missed flights, and unfamiliar territory. While these certainly aren’t as stressful as losing your job or your spouse, they can certainly disturb your mood.
One reason bipolar is so hard to deal with is that it is frequently misdiagnosed. One study found that 69 percent of people with bipolar disorder were initially misdiagnosed and a third of those people remained misdiagnosed for at least 10 years. This is unfortunate in that so many people aren’t properly treated for so long but there’s actually an additional risk in getting the wrong treatment. Bipolar is typically misdiagnosed as unipolar depression because there’s no way to distinguish the symptoms of that from a depressive episode of bipolar. People don’t go to the doctor when they feel especially good. As a result, many people with bipolar are prescribed antidepressants. The problem is that antidepressants alone can cause a manic episode. To be effective in treating bipolar disorder, antidepressants typically have to be paired with a mood stabilizer.
If you have a loved one who is struggling with addiction, Hired Power and our team of dynamic, experienced recovery professionals are here to guide you every step of the way. We offer many services, including helping you choose the best treatment program and transitional services, including interventions, sober monitoring, and personal recovery assistants. Call us today for information on our recovery services: 714-559-3919.