Rehab Treatment for Bipolar Disorder and Addiction

The link between bipolar and addiction is complex and given the symptoms and wider sociological implications of the illness, bipolar and addiction tend to go hand in hand. The below guide provides information and treatment options for those looking to find relief from both.

What Is Bipolar?

Bipolar disorder is a relatively common disorder, and one in every hundred adults will be diagnosed with bipolar at some point in their life. Bipolar disorder can occur at any age, although it often develops in the teenage years and rarely develops after 40.

The pattern of mood dysregulation in bipolar disorder varies greatly from person to person, some people may only experience a few episodes of bipolar in their lifetime while others have many episodes.

Bipolar episodes are characterised by two states;

  • Depression – feeling very low and lethargic
  • Mania – feeling very high and overactive (less severe mania is known as hypomania)

There are several types of bipolar disorder with different characteristics. These are:

  • Bipolar I disorder. At least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. Mania can trigger a break from reality (psychosis).
  • Bipolar II disorder. At least one major depressive episode and at least one hypomanic episode, but no manic episodes.
  • Cyclothymic disorder. At least two years of many periods of hypomania symptoms and periods of depressive symptoms

The symptoms you experience will depend on which mood state you are in. For most people mood swings can last for hours or minutes even, if you suffer from bipolar episodes can last for several weeks or longer.

A variety of things can trigger an episode of bipolar, read on to find out more about the causes of Bipolar disorder.


The exact cause of bipolar disorder is unknown, a variety of things can trigger an episode. Your bipolar may be triggered by extreme stress, overwhelming problems and life-changing events.

Genetics and brain chemistry ae also thought to be a powerful influence on the development of bipolar. Genetic influences are believed to account for 60–80 per cent of the risk of developing the disorder.


The risk of bipolar disorder is almost ten times greater in the first degree-relatives of those affected with bipolar disorder than the rest of the population.

Research on twins and bipolar have been limited by relatively small sample sizes but have indicated substantial evidence for a genetic component to bipolar.

For bipolar disorder type I, the rate at which identical twins who share exactly the same genes will both have bipolar disorder type I (concordance) is estimated to be 40 per cent, compared with about 5 per cent in fraternal twins.


Research shows that environmental factors play an important role in the development of bipolar disorder.

Life events and relationships can contribute to the onset of bipolar. Research shows that around 40 percent of adults diagnosed with bipolar disorder have experienced traumatic or abusive events in childhood. There is a correlation between the number of stressful events experienced as a child and an adult diagnosis of bipolar.


Less commonly, bipolar disorder may occur as a result of another neurological condition or brain injury.


Symptoms of bipolar include mania or hypomania or depression. The unstable moods associated with bipolar can cause significant distress in multiple areas of life.

Mania and hypomania

Mania and hypomania are two distinct types of episodes that share the same symptoms to different degrees. Mania is more severe than hypomania and causes more noticeable disruption. Mania may also trigger psychosis and require hospitalization.

Both a manic and a hypomanic episode include at least three of these symptoms:

  • Overly upbeat, jumpy or wired
  • Increased activity
  • Increased energy or agitation
  • Euphoria
  • Decreased need for sleep
  • Talking quickly and a lot
  • Racing thoughts
  • Difficulty concentrating
  • Poor decision-making — taking risks.
  • Major depressive episode

A major depressive episode can cause noticeable difficulty in day-to-day activities. An episode includes five or more of these symptoms:

  • Depressed mood – feeling sad, empty, irritable, hopeless or tearful
  • Marked loss of interest or feeling no pleasure in things that used to interest you and in daily life.
  • Fluctuations in weight
  • Disrupted sleeping patterns – insomnia or sleeping too much
  • Restlessness or a sense of being slowed down
  • Fatigue
  • Feelings of worthlessness and excessive guilt
  • Difficulty with concentration
  • A difficulty with decision making
  • Thinking about, planning or attempting suicide

Why Is Addiction More Common In Those with Bipolar?

Bipolar disorder is characterised by sudden and intense shifts in mood, behaviour and energy levels. Like substance abuse, bipolar disorder can impact your physical and emotional well-being.
Those who have bipolar disorder are more likely than others to experience relationship problems, economic instability, accidental injuries and suicidal ideation. Those with bipolar are also significantly more likely to develop an addiction to drugs or alcohol.

  • 56 percent of individuals with bipolar who participated in one study had experienced drug or alcohol addiction during their lifetime.
  • Approximately 46 percent of that group had abused alcohol or were addicted to alcohol.
  • About 41 percent had abused drugs or were addicted to drugs.
  • Alcohol is the most commonly abused substance among bipolar individuals.

One reason for the high number of people with a dual diagnosis of addiction and bipolar is that a large percentage of people attempt to self-medicate with substances in an effort to cope with the painful symptoms of their bipolar disorder.

The warning signs that you may be slipping into addiction are;

  • Tolerance. You will need larger amounts of your substance of choice to achieve the same effects.
  • Withdrawal. You experience physical symptoms (nervousness, nausea, tremors, cold sweats or agitation) when you try and reduce your intake or stop using.
  • Relapse. You find it impossible to stop and stay stopped.

If you are suffering with bipolar and addiction you can recover. Bipolar disorder and addiction are inherently intertwined, and this is reflected in the number of treatment services now available for those with a dual diagnosis.

With the right combination of individual counselling, peer group support and family counselling, and appropriate medical treatment you can recover despite the challenges of having a dual diagnosis.

Treatment Options

A dual diagnosis of bipolar and addiction is complex and each person will experience this dual diagnosis differently. There is, therefore, no single best treatment option as each case is unique.
Addiction and bipolar can be treated through residential rehab, medication, and therapy, or through a combination of all three approaches.


Residential rehab programmes offer a number of different treatment strategies including medication where appropriate, one-on-one therapy, group therapy, support groups, family counselling and holistic therapy. Experts agree that residential rehab is usually the most effective approach for treating addiction. Rehabs offer:

  • A rigorous programme and treatment team of specialists that includes psychologists, addiction counsellors, and other professionals trained in Dual Diagnosis care.
  • Individual therapy
  • Group therapy
  • Skills training for managing your emotions and minimising the risk of substance abuse
  • Relapse prevention
  • Detox medication where appropriate and Psychiatric medication when needed
  • Peer group support from others who have similar issues
  • Interpersonal group
  • An introduction to 12 step groups
  • Access to cutting edge therapies

Receiving treatment for both your co-occurring disorders will minimise the chance of relapse. Relapse prevention planning with include skills and tools training to help you to manage and regulate your feelings effectively, without resorting to using substances.

Rehab can help you:

  • develop mindfulness skills
  • process feelings as they come up
  • learn to self soothe in healthy and effective ways
  • to love and accept yourself and your feelings
  • build a repertoire of effective interpersonal skills
  • develop effective self-care tools

We provide a tailored treatment programme at Banbury Lodge for those suffering with bipolar disorder and addiction. Our programme for dual diagnosis encompasses all of the above therapeutic models.


Mood stabilisers for bipolar disorder

  • Lamictal (lamotrigine)
  • Seroquel (quetiapine)
  • Zyprexa (olanzapine)
  • Symbyax (a pill that combines olanzapine with the antidepressant fluoxetine)

Antipsychotic medications for bipolar disorder

If you lose touch with reality during a manic or depressive episode, an antipsychotic drug may be prescribed. Often, antipsychotic medications are combined with a mood stabiliser such as lithium or valproic acid. Antipsychotic medications used for bipolar disorder include:

  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)
  • Ariprazole (Abilify)
  • Ziprasidone (Geodon)
  • Clozapine (Clozaril)

Common side effects of antipsychotic medications for bipolar disorder

  • Drowsiness
  • Weight gain
  • Sexual dysfunction
  • Dry mouth
  • Constipation
  • Blurred vision

Benzodiazepines in the treatment of bipolar disorder

Benzodiazepines are not considered a core medication but you may temporarily be prescribed a benzodiazepine to relieve any symptoms of anxiety, agitation, or insomnia. Because of their high addictive potential, however, benzodiazepines should only be used until your mood stabiliser or antidepressant begins to work. Those with a history of substance abuse should be particularly cautious.

  • alprazolam (Xanax)
  • clonazepam (Klonopin)
  • diazepam (Valium)
  • lorazepam (Ativan)

Calcium channel blockers

Traditionally used to treat heart problems and high blood pressure, they also have a mood stabilizing effect. They may be an option for people who can’t tolerate lithium or anticonvulsants. Calcium channel blockers that have been studied to treat bipolar disorder include:

  • Diltiazem
  • Isradipine
  • Nimodipine
  • Verapamil


There are various therapeutic approaches like Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT) that are useful in helping people to learn to regulate their emotions without the use of drugs and alcohol.

Counselling can help you overcome issues like;

  • Addiction
  • Alcoholism
  • Childhood Issues
  • Trauma
  • Self-esteem
  • Relationships
  • Shame & Guilt
  • Grief & Loss
  • Gender
  • Anger Management
  • Stress Management
  • Relapse Prevention
  • Family Issues
  • Body Image

Overcoming bipolar and addiction is possible. Going to therapy can help you to break the cycle of isolation, addiction, and emotional pain and to not only get clean and sober but to create a life of peace, serenity, and wellness.

Though recovering from a dual diagnosis and addiction can be challenging, therapy can help you deal with your feelings and thoughts as they come up, to understand and let go of the triggers in your past that might feed into your dual diagnosis, and to grow and develop effective strategies for life.

The therapy process is very much unique to each person and will be a collaborative journey with your therapist towards reaching your goals. Your therapist will provide you with a safe and confidential space and your therapy will be tailored to your own unique experiences, circumstances, and goals.

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