Bipolar Disorder and Dual Diagnosis Treatment

Bipolar Disorder and Dual Diagnosis Treatment

Millions of people suffer from bipolar disorder. Unfortunately, many of these people also suffer from a co-occurring substance abuse problem. Dual diagnosis treatment is the only chance many of these individuals will have of conquering their addiction and the disruptive symptoms of their bipolar disorder.

What is Bipolar Disorder?

Bipolar disorder, or manic depression, is a mental health condition that causes extreme shifts in a person’s mood, energy and ability to cope with daily responsibilities. People with bipolar disorder will shift between episodes of mania and depression that can last from days to weeks to months.

Some of the symptoms exhibited during manic episodes are:

* An extremely elated, happy mood or an extremely irritable, angry, unpleasant mood

* Increased physical and mental activity and energy

* Racing thoughts

* Increased talking, more rapid speech than normal

* Ambitious, often grandiose plans

* Risk-taking

* Impulsive activity such as spending sprees, sexual indiscretion, and alcohol abuse

* Decreased sleep without experiencing fatigue

Some of the symptoms exhibited during depressive episodes are:

* Loss of energy

* Prolonged sadness

* Decreased activity and energy

* Restlessness and irritability

* Inability to concentrate or make decisions

* Increased feelings of worry and anxiety

* Less interest or participation in, and less enjoyment of activities normally enjoyed

* Feelings of guilt and hopelessness

* Thoughts of suicide

* Change in appetite (either eating more or eating less)

* Change in sleep patterns (either sleeping more or sleeping less)

Bipolar and BPD Dual Diagnosis

Bipolar and borderline personality disorder dual diagnosis is another area to be aware of, especially for people coping with a dual diagnosis. This is particularly true because borderline personality disorder or BPD is associated with addiction risk. Furthermore, BPD and bipolar disorder share several important characteristics, making it tough to parse out what’s going on—especially if you’re not an expert.

However, understanding the basics helps a lot. With that in mind, almost 6 million Americans experience borderline personality disorder (BPD), a severe emotional disorder. Some of the many consequences that people with BPD suffer from include chaotic relationships, a distorted self-image, an extreme fear of abandonment, frequent mood swings, impulsive behaviors, ongoing attempts at self-harm, and severe negative emotions (such as shame and rage).

The precise causes of borderline personality disorder are unknown, although various experts have several theories. Most mental health professionals and researchers believe that a variety of factors cause BPD, including biological, environmental, and genetic factors. All of these influences work together, increasing the risk of developing BPD.

Although there is little doubt that genes and other biological factors do play a role in BPD, many people with borderline personality disorder also report surviving childhood events that were very distressing, usually involving caregivers. For example, BPD patients frequently report a history of childhood physical abuse, emotional abuse, neglect, early separation from caregivers, and even sexual abuse.

All of these factors influence the symptoms of BPD—some of which look very similar to bipolar disorder:

BPD Symptom: Extreme fear of abandonment

Patients with borderline personality disorder typically have a serious, irrational fear being abandoned in relationships—including familial relationships—and often think they are being left, even when that’s not the case. This can trigger intense and inappropriate emotions such as fear and rage, even when the abandonment triggering those emotions is wholly imagined, caused by something as inconsequential as a partner forgetting something they said or arriving late to dinner. This can in turn lead to behaviors designed to avoid abandonment, real or imagined, such as physically clinging to a person, or self-harm at a potentially suicidal level.

This symptom can be confused with bipolar disorder, because people with BPD might go from a happy, contented mood to a rage based on feeling abandoned. This “rapid mood swing” might “seem” or “feel” bipolar to a layperson. And what’s more: the same patient might actually have both BPD and bipolar disorder—but that’s hard for anyone who’s not a mental health professional to determine.

BPD Symptom: Emotional instability

Emotional instability is one of the cornerstone symptoms of both BPD and bipolar disorder. In the case of borderline personality disorder, inappropriate or unhelpful reactions to stress cause intense and frequent mood swings. In the case of bipolar disorder, mood swings are triggered by imbalances in brain chemicals.

Whatever is causing a person’s mood swings, they may look remarkably similar to an outsider, involving feelings of intense anxiety, anger, despair, irritability, panic, or sadness. These mood swings can last for minutes, hours, or days in the case of BPD. For some bipolar disorder sufferers, mood swings can last even longer, weeks at a time. For both groups of patients, the pain of the mood swings can prompt a self-medicating habit that leads to addiction.

BPD Symptom: Intense, inappropriate anger

People with BPD will often experience intense anger that is usually not warranted by the situation. They have difficulty controlling their anger, and act out in all kinds of ways—being extremely sarcastic and rude, breaking things, having verbal outbursts, or getting into physical fights. People with borderline personality disorder often believe their partner, parent, or caregiver is abandoning or neglecting them, so they punish that person with bad behavior—only to feel deeply guilty and unworthy of love later.

This kind of lashing out and cycling between love, hate, clinging, and rejection can seem “bipolar” to an observer.

BPD Symptom: Paranoia or dissociation

BPD can cause paranoid thoughts and even dissociation from reality. This can appear to be a lot like bipolar disorder with psychotic features to an outsider, although the “zoned out” numbness of BPD isn’t the same thing.

There are other symptoms of both BPD and bipolar disorder, such as unstable relationships and a tendency to self-medicate and abuse substances, but these are the points that cause so much confusion. Furthermore, psychiatric disorders such a bipolar disorder can and sometimes do cooccur with personality disorders such as borderline personality disorder—and addiction is a frequent feature of all of these problems.

Bipolar Disorder and Substance Abuse

Bipolar disorder is a lonely and isolating condition, especially during depressive episodes. Many times people with bipolar disorder will use alcohol or drugs to numb their painful and difficult symptoms and help them cope with their intense feelings. This can lead to a pattern of abuse that can quickly spiral into dependency and addiction.

Recovering from alcohol and drug addiction can be a difficult journey, but addicts who also have bipolar disorder face even greater hurdles in treatment. Mood disorders, such as bipolar disorder, rarely improve while people are addicted to alcohol or drugs, and long-term sobriety is rarely achieved if bipolar disorder isn’t properly treated. The only way to effectively treat both disorders is through dual diagnosis treatment.

Bipolar Disorder and Dual Diagnosis Treatment

Bipolar disorder and alcohol/drug addiction often go hand in hand, and the symptoms of each disorder overlap is such a way that’s it can be very difficult to recognize that both an addiction and bipolar disorder co-exist. Once both disorders have been identified, dual diagnosis treatment will be the most effective way to treat the symptoms of both disorders and help the patient manage their bipolar disorder without depending on drugs or alcohol. Dual diagnosis helps patients develop the hope, knowledge, skills and support needed to manage their bipolar disorder and substance abuse problem and pursue a life of recovery.

One of the most effective ways to treat co-occurring disorders is through residential substance abuse treatment programs. During residential treatment, the patient will receive several hours of intensive treatment each day or each week that includes substance abuse treatment and mental health support. This treatment typically includes individual and group counseling, cognitive-behavior therapy, dialectical behavior therapy, 12-step programs, and other mental health services.

Without treatment, a person suffering from bipolar disorder and substance abuse will inevitably continue the vicious cycle of self-medicating their mental illness symptoms with drugs or alcohol. If you know someone who has dual diagnosis symptoms, encourage them to seek treatment at a dual diagnosis treatment center where they can be properly diagnosed and effectively treated.


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.