Substance use among middle-aged and older adults with bipolar disorder

July 31, 2017/139 Comments/in Mental Health, Substance abuse /by CDDH Team

Bipolar disorder (BD) or manic depression is a chronic affective disorder, characterized by extreme changes in mood. It is uncommon for children or adults over the age of 65 to exhibit the first symptoms of bipolar disorder. Most people experience the initial symptoms of bipolar disorder between 15 and 30 years. The National Institute of Mental Health (NIMH) estimates that nearly 2.6 percent American adults live with this condition.

People with bipolar disorder are vulnerable to misuse alcohol or illicit drugs at some point in their lifetime. A co-occurring condition of a mental health problem and substance use is referred to as dual diagnosis. The common symptoms comprise sudden changes in behavior, risky behaviors under the influence of harmful substances, such as fights and reckless driving, withdrawal from friends and family, physical health problems and low work productivity. According to various studies, 40-60 percent people with bipolar disorder tend to abuse alcohol or drugs. However, there is little clinical evidence to support a correlation between concurrent conditions of substance use and bipolar disorder among older adults.

To bridge this gap, researchers at the Gerontology Research Centre, Simon Fraser University, Vancouver, Canada, studied the experiences and effects of self-reported substance use among adults. The study, published online in the journal Aging and Mental Health in March 2017, analyzed different theories (perceived by the participants) that explained the risk of substance abuse in middle-aged and older adults with BD. The participants who acknowledged the symptoms and admitted to using alcohol or drugs regularly suggested different reasons for substance use. These reasons included elevated confidence, self-medication, rejection of prescribed medications, living in a culture of substance use, easy access to alcohol and early social exposure as a facilitator. The researchers suggest giving due importance to patients’ personal reasons of regularly using a substance in order to manage BD symptoms as well as treat substance-related health problems in a customized way.

A previous study published in the Journal of Affective Disorders also explored the possible association between BD and substance use. The study found that most of the BD patients abused substances out of “personal experience.” In addition, researchers reported that some patients misused alcohol and drugs to either enhance or prolong periods or dampen the symptoms of mania.

Treating substance abuse and bipolar disorder

The most effective treatment approach for co-occurring substance use and bipolar disorder involves addressing both the problems simultaneously. The doctors prescribe medications and psychotherapy to treat the co-occurring conditions to control the situation in time.

Pharmacological interventions

Medications are aimed at helping people with bipolar disorder and addiction control their substance-related cravings and alleviate withdrawal symptoms. Doctors prescribe the medication basis the severity of symptoms and duration of substance use. Bipolar disorder medications can help patient relieve mood shifts and return to normal life. The common medications prescribed to patients suffering from a bipolar disorder include mood stabilizers, antipsychotics, antidepressants and anti-anxiety medications.

Cognitive behavioral therapy (CBT)

CBT helps people with addiction and co-occurring bipolar disorder manage their negative thoughts and anxious feelings. CBT helps patients to:

Overcome false beliefs and control vulnerabilities to substance abuse.
Improve their moods and develop positive outlook toward life using self-help tools.
Face the society with confidence and establish a cordial social behavior with help of effective communication skills.

Other psychotherapies

In addition to CBT, other behavioral therapies may include interpersonal and social rhythm therapy (IPSRT), psychoeducation and family-focused therapy that helps in tackling the symptoms of both bipolar disorder and substance abuse.

Getting help for dual diagnosis

Dual diagnosis is a serious condition that requires proper medical attention. Treatment of one condition cannot be successful without addressing the other. People looking for information on dual diagnosis including details about dual diagnosis treatment centers in California and drug rehab centers in southern California can contact the California Dual Diagnosis Helpline. You can get instant help in your area by calling at our 24/7 helpline number 855-980-1736 or joining our representative over live chat.