Bipolar Disorder Treatment That Addresses Mood Instability and Substance Use

One of the main characteristics of bipolar disorder is cycling through distinct moods, each with its own set of specific symptoms.

Manic episode symptoms

• Elevated, expansive, or irritable mood
• Reduced need for sleep without feeling tired
• Racing thoughts and rapid, pressured speech
• Grandiose self-esteem
• Increased goal-directed activity or agitation
• Impulsive, risky behavior, such as spending sprees, reckless decisions, or sexual indiscretion
• In severe cases, psychosis with hallucinations or delusions

Depressive episode symptoms

• Persistent feelings of sadness, emptiness, or hopelessness
• Loss of interest or pleasure in activities previously found enjoyable
• Fatigue and loss of energy
• Cognitive difficulties — concentration, memory, decision-making
• Changes in eating and sleep habits
• Feelings of worthlessness or excessive guilt
• Thoughts of death, self-harm, or suicide

Mixed features and mood swings: Some people may experience both mania and depression simultaneously, which can be very distressing and clinically more difficult to treat.

It has been well documented in research studies that people diagnosed with bipolar disorder have the highest rate of developing substance use disorders compared to all other mental health disorders. Studies indicate that more than 50% of people with bipolar disorder will develop a substance use disorder at some point in their lives.[3] Bipolar disorder and substance use disorders are among the most common clinically significant dual diagnosis combinations seen in addiction treatment centers.[4]

This relationship between bipolar disorder and addiction is bidirectional and self-sustaining. People who are in a manic phase tend to act impulsively and without thought of consequences, increasing their potential to engage in addictive behaviors such as using alcohol and stimulants. Similarly, during a depressive phase, people use substances to self-medicate their low mood, hopelessness, and anxiety. 

In turn, substances contribute to destabilizing a person’s mood, which further complicates treatment. Alcohol increases the severity of depressive symptoms and disrupts sleep patterns.[5] Stimulants can worsen manic episodes.[6] Many substances interact negatively with mood stabilizers and other psychiatric medications, rendering them ineffective or potentially dangerous.[7] The result is a cycle that worsens both conditions simultaneously.

Attempting to treat bipolar disorder without treating addiction will leave the major mood destabilizer intact. Likewise, attempting to treat addiction without treating bipolar disorder will leave the root cause of substance use unaddressed. Only a dual diagnosis can treat both realities equally.

If you or a loved one is living with bipolar disorder and has turned to substances to manage mood episodes, cope with the exhausting cycle of ups and downs, or for any other reason, then integrated co-occurring disorder treatment is warranted. 

Signs that bipolar disorder and addiction may require concurrent treatment include:

• Using alcohol or drugs during manic episodes due to impulsivity or decreased inhibition
• Using substances to lift out of depressive episodes or manage depressive symptoms
• Mood instability that worsens with substance use but feels unmanageable without it
• Psychiatric medications that aren’t working as expected 
• A history of addiction treatment that didn’t address underlying bipolar disorder — or vice versa
• Thoughts of self-harm or suicide

At Agape Detox Center, bipolar disorder is treated as a central clinical focus within our integrated dual diagnosis program. We offer a collaborative approach where our experienced treatment team — consisting of clinicians, behavioral health specialists, and psychiatrists — works together to stabilize your moods, address your substance use issues, and teach you the coping mechanisms needed for successful long-term recovery.

Below is how we approach treatment:

Comprehensive Assessment: Each client at Agape receives a comprehensive psychiatric and psychological assessment at admission to establish the type and severity of their bipolar disorder, determine their current mood state, assess their risk of suicidal and self-harming behavior, and determine if there are any psychiatric medications that need to be prescribed before therapy can begin. Most commonly, mood stabilization is the first critical step.

Medication Management: Medications play a significant role in the treatment of bipolar disorder and are essential for creating the neurobiological stability required for meaningful participation in therapy.[8] Our team conducts a detailed review of each client’s needs, manages medications, and carefully monitors potential drug interactions with any substances the client has been using.

Evidence-Based Therapeutic Interventions: We incorporate several evidence-based psychotherapy approaches into our treatment, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and individual and group therapy, among others.

Experiential Therapies and Wellness: In addition to the evidence-based psychotherapy models, our program also includes experiential therapies and wellness programming, such as physical activities, mindfulness, stress reduction, and nutrition support, to help promote mood stability and enhance overall wellness during all phases of recovery.