Understanding bipolar disorder and addiction

People who have bipolar disorder are more likely to also have substance use disorder.
March 23, 2022
Group of young people holding hands and sitting all together on group therapy for bipolar and addiction in circle.
If you have bipolar disorder, you are 11 to 13 times more likely to also have substance use disorder, when compared to the general population. Photo: Getty Images.

By Megan Jansson, UCHealth

Sarah Humble was diagnosed with bipolar disorder in 1999. What followed were years of trial and error with different medications to try to stabilize her.

A photo of Sarah Humble, who's bipolar lead to her addiction
Sarah Humble was diagnosed with bipolar disorder. She then used multiple substances to try and dull the pain. She found help for her addiction and has been sober for nine years. Photo courtesy Sarah Humble.

She was living in Maryland at the time of diagnosis but moved to Colorado in 2005. Her mental health was not getting any better, even though her financial and housing situation improved when she moved to Colorado. She started misusing marijuana, stimulants and opioids and overdosing on her benzodiazepines, which were intended to treat her anxiety disorder.

By 2013, Humble was taking so many substances, she wasn’t sure if what she was experiencing was drug-induced or bipolar-induced. She ended up getting a DUI, which eventually brought her to the UCHealth Center for Dependency, Addiction and Rehabilitation, or CeDAR. It took four months at CeDAR for Sarah’s mental health to stabilize. She did every program CeDAR had to offer at that time; a 30-day residential program, a residential extended care program for an additional 60 days, and an intensive outpatient program for 13 weeks, and it worked.

Bipolar and addiction

She’s now celebrating nine years of sobriety.

According to Dr. Patrick Fehling, an addiction psychiatrist at CeDAR, if you have bipolar disorder, you are 11 to 13 times more likely to also have a substance use disorder, when compared to the general population.

Bipolar disorder is a mood disorder that alternates between a manic and depressive state. When in a depressed state, substance use often increases as a coping mechanism. In a manic state, people often have rapid and impulsive thoughts, they may not sleep, or they may spend money they don’t have or sleep with someone they shouldn’t, which can wreck people’s bank accounts and families. Additionally, people in a manic state may be more likely to use drugs or alcohol to try to regulate their mood or rapid thoughts.

a photo of Dr. Patrick Fehling, addiction psychiatrist at CeDAR who sees the connection between bipolar and addition.
Dr. Patrick Fehling, an addiction psychiatrist at CeDAR.

“At CeDAR we do dual diagnosis care, which means we take care of both the mental health issue and the substance use disorder at the same time,” said Fehling.

Treatment often involves a medical detox from substances and/or alcohol, addressing the bipolar disorder with the right medications, family, couples or individual therapy and wellness-focused chronic disease care, which includes focusing on nutrition, exercise, sleep and mindfulness.

Using mindfulness to cope with symptoms of bipolar disorder

“The key for my success is to remain substance-free, continue to practice a healthy lifestyle and use mindfulness techniques to manage my anxiety,” said Sarah.

Sarah learned many mindfulness techniques during her time at CeDAR. One of her favorites is the grounding technique, where you put your feet on the ground and focus on relaxing from your feet to your head. You go up your body one body part at a time, connecting with that part of your body to relax it and then continuing all the way up to your head. She also uses different breathing techniques, as well as temperature therapy, where she puts an ice cube or cold drink in her hand just to feel the cold temperature, this brings her back to a calm state and allows her to be present.

Continuing the work in addiction treatment

Sarah also credits her success to her continued work with providers at CeDAR, which she still works with to this day.

“They help keep me accountable, I still go to meetings, and I still keep in contact with my sponsor,” said Sarah.

Dr. Fehling also emphasizes staying in touch with your providers, therapist and support system.Group of young people holding hands and sitting all together on group therapy in circle

“If someone relapses or has a recurrent in their mood problem, there is usually a connection to them distancing from support systems or stopping their medications. Our goal is long-term health management for our patients. There is a lot of destruction that can happen if someone “drops out,” said Fehling.

Sarah is now a recovery coach herself and she’s able to help others who are in similar positions as she once was. She says the most rewarding part of her work is when people have “ah-ha” moments.

“These ‘ah-ha’ moments are when things finally click, for example, having someone finally realize that they have both a mental health issue and a substance use problem and that it’s serious, or when people realize they can accomplish what they want to accomplish, that’s all very rewarding,” said Sarah. “As a coach, I’ve also seen some amazing relationship reunions too, like seeing a parent reunite with their child, that makes me so happy.”

There are many resources for anyone who may be struggling. If symptoms are milder, Dr. Fehling recommends reaching out to your doctor or psychiatrist to get treatment going in outpatient care. For more severe symptoms, Dr. Fehling’s advice is more for those people’s families.

“If you are a family member and you feel like your loved one is really struggling with active addiction or bipolar and they are not able to get help on their own or they are refusing treatment, see a doctor or therapist for yourself to make sure you are taking care of your own wellness and learn about the best way to help facilitate care for your loved one,” said Fehling. “It’s important to have hope and to know that people, like Sarah, do in fact recover from these severe illnesses and live a life that they are proud of. Recovery is possible and recovery happens every day.”

About the author

Megan Jansson is a Social Media Communication Specialist at UCHealth with a passion for all things health. She worked as a certified personal trainer for many years, earned her bachelor’s degree in strategic advertising at the University of Colorado Boulder and earned her master’s degree in public health at Colorado State University. She has always had a big passion for writing and has written numerous articles and stories for Colorado State University and the Colorado School of Public Health.

Megan called Gothenburg, Sweden home for 12 years and has lived all over the United States. She is bilingual, loves to ski, hike, camp and ride horses, and is a big animal lover.

ADVERTISEMENT