Does Depression go away suddenly if you have Bipolar Disorder?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Can people with Bipolar Disorder have a sudden remission of their depression?

Morning Question #23

YES, YES and More YES. It is common for people with Bipolar Disorder to rebound suddenly from a depressive episode. Taking antidepressants can cause that. So can a lack of sleep. Most likely these sudden recoveries for depression will not take you to “normal” whatever that is. They propel the bipolar person into Mania or at least Hypomania. I suspect that lots of other things can cause that leap from depression.

For more on Bipolar Cyclothymia, Mania or Hyperthymic personality see the categories to the right or check out the blog post – List of Bipolar related posts.  

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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What is Cyclothymia?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Cyclothymia, Bipolar, and Substance Abuse.

Cyclothymia is generally seen as a milder, subclinical form of Bipolar disorder. If it is the milder form we would expect to see a lot more Cyclothymia than Bipolar disorder. We don’t. So why and what is Cyclothymia?

A person with Cyclothymia is considered to be “temperamental, moody, unpredictable inconsistent and unreliable” (DSM-4-TR.) Cyclothymia seems to also be related to or overlaps Borderline personality disorder. Genetic risk factors, as well as environment and learning, may all play a role in creating Cyclothymia.

Cyclothymia, per the DSM, is a disorder characterized by chronic mood swings that do not meet the criteria for Bipolar disorder. Most mental illnesses require that the person, in order to get the disorder must experience a specific number of symptoms from a list of symptoms.

To be Bipolar I disorder you must have had a manic episode. For Bipolar Two, there must be a hypomanic (near manic) episode. That means that the person in addition to having an episode of elevated mood for at least 4 days must also have 4 of 7 listed symptoms. What if they only have three symptoms or if they have five “almost” symptoms. The way we count symptoms and who does the counting makes a lot of difference.

Cyclothymia waves the 4 day rule but requires that the mood swings go on over at least two years. (We make that one year in children.)  So for over two years the person needs to keep having episodes of depression and episodes of almost hypomania but never reaching the full criteria for depressive or hypomanic episodes.

My experience says that no diagnosis, no treatment, unless you have the money to pay and the motivation to push, like having an overly moody child. So rather than wait the whole year for a child or two years for an adult before treatment is begun, people with these almost hypomanic therefore almost Bipolar diagnoses end up with the label Bipolar NOS or Mood Disorder NOS.

The statistics seem to bear that out. Estimates of the prevalence of Cyclothymia run from 4 to 6 people per 10,000. Bipolar One and Two are in the range of 50 to 150 people per 10,000. Meaning that Cyclothymia despite being thought of as mild Bipolar is much rarer. Mostly Cyclothymia gets diagnosed in people who have suffered for a long time – the full two years before something happened that sent them to treatment.

The criteria say someone with Cyclothymia should be experiencing “almost” depression, mania, or hypomania most of the time over those two years. Those episodes should all be just short of the Bipolar or Major Depressive disorder diagnosis but should cause a lot of distress. There also cannot ever be two months when you don’t have mood swings or we don’t think you meet criteria for Cyclothymia.

To be Cyclothymia you should never have had any psychosis, which includes both hallucinations and severe delusional symptoms. And these symptoms can’t be the result of a medical condition.

Medications and Drugs can cause this.

It is not just street drugs but medications, prescribed and over the counter medications, that can cause Hypomania. Failure to sleep has been reported to cause hypomania and some overlooked products can cause the lack of sleep that induces mania.

Stimulants can interfere with sleep and that includes most of the medications for ADHD. But there is a bigger worry in children.

I feel certain I have seen sleep disruptions, and resulting mood disturbances in kids who take in excessive caffeine. Energy drinks are a problem in teens but the little ones, the preschoolers and the early grade student are also at risk.

Most sodas contain not just obesity causing sugar but massive amounts (relative to body weight) of caffeine. That huge amount of caffeine per pound of body weight causes sleep disruption and sleep disturbances which may be causing mood swings and even inducing Bipolar disorder.

The DSM-5 will tighten up the exclusion for any Drug or medication induced hypomania.

Environmental and learned factors

Some of these symptoms, the swings between depression and hypomania look a lot like what we see in children from abusive, neglectful or deprived backgrounds. Adult children of Alcoholics report that one time they would do something and be praised or rewarded for a behavior, the next time they might get hit.

Inconsistent environment would encourage you to be depressed and anxious at times and when it was safe to possible go overboard at seeking pleasure. So being sort of hypomanic could be adaptive in a dysfunctional environment.

Cognitive Behavioral therapy has been reported as effective in treating people diagnosed with Cyclothymia. This suggests to me that some of these symptoms are learned and that there are core beliefs or schemas supporting this fluctuating mood way-of-being.

There are a host of other factors that influence the expression of Cyclothymia. Sleep changes can trigger changes in mood but so can changes in eating. Social support systems and the level of stress all contribute to mood swings.

Studies of Cyclothymia have the same defects as studies of other mood and anxiety disorders. People who act out and get arrested don’t get included in studies. Neither do people with drug or alcohol problems or those who are suicidal. Psychosis and delusions also get you kicked out of research. So those most likely to really be impaired by Cyclothymia are most likely to be excluded.

Information on Bipolar, Hyperthymia, Cyclothymia, Depression and other Mood disorders is scattered through this blog and I will continue to add to those posts. Check the categories list to the right. To make Bipolar Family posts easier to find there soon will be a separate post devoted to links on this blogs and others places on the subjects of mood disorders.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How is Hypomania different from Mania or a Manic Episode?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Hypomanic Episodes.

In a post on Manic Episodes we talked about how episodes, according to the DSM are not diagnoses, they are “building blocks” out of which diagnosis are created. Someone could have either a manic episode or a hypomanic episode. The primary significance is the decision on labeling the condition as Bipolar one or Bipolar two. No Manic or Hypomanic Episode and you will not get the Bipolar label.

The Bipolar Disorder spectrum currently is very confused and confusing. It includes Bipolar I, Bipolar II, proposals for Bipolar III, IV and so on, as well as hypomania, mania, Cyclothymic Disorder, Hyperthymia, Hyperthymic personality disorder and so on. This spectrum is a very divergent group. Disorders involving an elevated mood may be the most Heterogeneous group there is (Van O’s et al. 2007.)

Lumping all these variety’s together may be overlooking the possibility that there are “Types of Bipolar Disorders.”

Hypomania requires a specific time period in which someone has had the symptoms of “elevated, expansive or irritable mood.” The difference is that for full mania the period needs to last for a full week, hypomania need only last for four days.

This creates some problems. What if you have manic-like symptoms for only three days? Do you get left out of the Bipolar spectrum? If someone has serious mania but it only lasts 6 days do they get Bipolar II not Bipolar I?

The effort to separate out conditions by the length of symptom duration may help psychiatrists decide what medication to prescribe but it does not make much difference to the client who has short but intense episodes of manic-like symptoms.

Since some of the changes in Hypomania may be subtle we take the word of others who know you or live with you to make this decision.

Most of the symptoms used to define hypomania are the same as those used to define a manic episode. The primary difference is the duration, four days to six is hypomania and a week or more is mania.

The exception here is that since hypomania is supposed to be a milder or different from mania.

If you have ever had hallucinations or delusions (not caused by drugs) then we skip the hypomania label and go directly to mania.

Here are the hypomania symptoms, then the exclusions. This narrative parallels the DSM but is my less technical, more colorful explanation.

The symptoms list is a lot like the list for Mania. I have italicized some of the differences.

A. For at least 4 days the person has an episode of “elevated, expansive or irritable mood.” Elevated does not mean happy. There are lots of descriptions of these elevated moods and they vary from person to person but the key factor is that these episodes are not like other people and that there are times when this person is not like this. If this episode is really bad we may waive the 4-day rule.

B. Pick 3 or four symptoms from a list of seven.

Each of these symptoms can vary in intensity and it is a judgment call. The result is that diagnosis can vary from clinician to clinician and even from time to time for the same person and the same clinician.

Here are the 7 symptoms needed to make a manic episode.

1. Grandiosity and excessive self-esteem. They can make no mistakes and can’t understand why people question them.

2. Sleep changes. You don’t need to sleep. Someone with Bipolar I can stay up for days and is full of energy. They may only sleep three or four hours a night. And in the morning they are not tired.

This reduced need for sleep may be a little less than in mania but the result is the same. People who are going manic or hypomanic get accused of drug use but if tested they have no drugs in the system or at least no drugs that explain the excess energy.

This is a troubling part of the diagnosis. Research studies (Carver & Johnson 2008) say that a lack of sleep can “induce” mania. So the lack of sleep is both a cause and a symptom of Mania? This sleep mania question needs more research. If the definitive study of this connection has been done so far I have not found it.

Not sleeping and not feeling tired does not mean that the person is rested. The longer this below normal sleep episode goes on the more irritable and delusional the person is likely to get. They may even begin to hallucinate. Only they don’t know they are delusional. They are convinced they are right and other people are dumb to not see how smart they are. If the hallucinations or delusions are noticeable to others we call it mania, not hypomania.

3. They talk a lot.

In hypomania, you may be able to interrupt them but not for long. They have a lot to say. Sometimes they talk too loudly and too emphatically. This is not the same as the way we old people talk when wound up, but that might give you a picture.

4. They feel their thoughts are “racing.”

Too many things to think about. In kids, this looks a lot like ADHD.

5. Lack of focus and easily distracted.

They are in such a hurry they move from topic to topic, project to project and can’t figure out what to do next. Lots of things left half-finished and on to the next one.

6. Increased goal-directed activity.

In mania it is excessive, in hypomania, those around them notice an increase but can’t explain why.

This can be trying to do too much at work, socially, sexually or in most any area of life. This over goal-directed activity can lead to excessive physical motion like a person whose engine is always running.

7. Overdoing pleasurable activities.

Hard to believe that someone could have too much fun but what we are looking for here is not that they have a lot of fun but that they continue to do pleasurable things despite negative consequences. This could also be affected by the assessor’s values judgments.

Examples of excesses are overspending, reckless or dangerous activities, “sexual indiscretions” and so forth. This needs to be more than someone who just likes to do something, like collect something. There is an episodic nature to these activities and most everyone will agree that this person has binges of overdoing things despite them getting in trouble.

This characteristic is highly related to the continued use despite negative consequences we see in substance abuse. As a matter of fact, people with a Bipolar diagnosis are much more likely to also have addiction and alcoholism issues than the general population.

The result?

To be diagnosed with a hypomanic episode you need to have three of the seven symptoms. We want four if you are just irritable but not expansive or elevated in mood. But with hypomania, the symptoms can be milder, more of a judgment call and can be briefer in time duration.

If you or someone you know has symptoms of hypomania please see a professional. This article is not meant to be enough for you to do “do it yourself diagnosis.” There are many effective treatments for Mania, Bipolar Disorder, and related conditions.

BIG QUESTION: What about people who have these symptoms for less than four days? Or those that move in and out of Hypomania very quickly? Are we missing some other type of Bipolar Disorder? Or is that moodiness something else?

Stay tuned for more on Mania, Hypomania, Cyclothymia and Bipolar Disorder and Types of Bipolar Disorder and the things we know and don’t know about all these topics.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is Mania or a Manic Episode?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Manic Episodes.

Episodes, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) are not diagnoses, they are “building blocks” out of which diagnosis are created.

Mania and its milder cousin Hypomania are linked, closer than most marriages, to the Bipolar diagnoses. To get the Bipolar tag you must have had either a manic or a hypomanic episode and there is only a hand full of other things that might create a Manic or manic-like episode that is not Bipolar.

Some of these symptoms are a matter of judgment and intensity. There has been lots of research on the area of Mania and Bipolar disorders but the more we learn the more questions we have.

Currently, there are no laboratory tests, not even brain scans that are clearly diagnostic of mania. There are some differences in some tests but nothing that so far is clearly convincing enough to make the diagnosis.

The DSM-4-TR tells us that there may be differences in the functioning of some neurotransmitters. Then it lists five different transmitters that may vary. There are lots of ways any one transmitter may vary and any one person could have variations in from one to five transmitters. That whole approach so far is not very helpful to the clinicians or the people who have mania.

So in practice, we look for a whole list of symptoms, add them up with exclusions, inclusions, and severity, look for other explanations and when all else is ruled out what is left we call a manic episode.

If you have EVER had a Manic Episode for which we cannot find a medical cause you get the diagnosis of Bipolar I. First the symptoms, then the exclusions. This narrative parallels the DSM but is my less technical, more colorful explanation.

A. For over a week the person has an episode of “elevated, expansive or irritable mood.” Elevated does not mean happy. There are lots of descriptions of these elevated moods and they vary from person to person but the key factor is that these episodes are not like other people and that there are times when this person is not like this. If you get yourself locked up, usually this is in a psychiatric hospital; we wave the full week requirement.

B. Pick 3 or four symptoms from a list of seven.

Each of these symptoms can vary in intensity and it is a judgment call. The result is that diagnosis can vary from clinician to clinician and ever from time to time for the same person and the same clinician. For example, studies show that young children in the U.S. get diagnosed with Bipolar a lot. Show the same file to a psychiatrist in the U.K and the child is more likely to get OCD or ADHD (Dubicka et al. 2008.)

Here are the 7 symptoms needed to make a manic episode.

1. Big-shotism, to use a 12 step term. a sudden burst of confidence or thinking you are better, more intelligent or smarter than others. Plans to cure cancer, run for president and write a novel all in the same week. This can be fun for the person with Bipolar until others start disagreeing with you.

2. Sleep changes. You don’t need to sleep. Someone with Bipolar I can stay up for days and is full of energy. They may only sleep two, three or four hours a night. And in the morning they are not tired.

This looks a lot like a Meth user only they don’t need drugs to stay up and they get to sleep just a little each night.

The DSM says this is the big one of all the symptoms. To quote the DSM – “Almost invariably, there is a decreased need for sleep.”

This is a troubling part of the diagnosis. Research studies (Carver & Johnson 2008) say that a lack of sleep can “induce” mania. So a lack of sleep is both a cause and a symptom of Mania? This sleep mania question needs more research. If the definitive study of this connection has been done so far I have not found it.

Not sleeping and not feeling tired does not mean that the person is rested. The longer this below normal sleep episode goes on the more irritable and delusional the person is likely to get. They may even begin to hallucinate. Only they don’t know they are delusional. They are convinced they are right and other people are dumb to not see how smart they are.

3. They talk a lot.

Not used car salesman or late night infomercial type rapid talk. Professionals call this “pressured Speech.” The person has so much going on in their head they can’t talk fast enough to say it all. The can jump from subject to subject, include extra unrelated stuff and just generally talk so only they know what they are talking about. Sometimes even they can’t figure out what they were trying to say.

4. They feel their thoughts are “racing” or they keep jumping subjects like that old-school record with a scratch.

This also gets mentioned by clients diagnosed with anxiety based disorders. Are Bipolar and Anxiety related? We know that depression and anxiety co-occur commonly, why not Bipolar and anxiety?

5. Lack of focus and easily distracted.

They are in such a hurry they move from topic to topic, project to project and can’t figure out what to do next. Lots of things left half-finished and on to the next one.

This sort of lack of focus reminds me of sitting with a channel surfer who keeps changing the T.V. channel in mid-sentence. This is more a matter of being over-interested in too many things than of losing interest in any one thing.

This characteristic looks a lot like a symptom of ADHD and so given the same person and the same symptoms one clinician may see this as Bipolar and another will see ADHD.

6. Excessive goal-directed activity.

This can be trying to do too much at work, socially, sexually or in most any area of life. This over goal-directed activity can lead to excessive physical motion like a person whose engine is always running. This characteristic called “psychomotor agitation” also looks like the “hyperactivity” in ADHD further leading to the question are those two conditions related or do they just get confused?

7. Overdoing pleasurable activities

Hard to believe that someone could have too much fun but what we are looking for here is not that they have a lot of fun but that they continue to do pleasurable things despite negative consequences. This could also be affected by the assessor’s values judgments.

Examples of excesses are overspending, reckless or dangerous activities, “sexual indiscretions” and so forth. This needs to be more than someone who just likes to do something, like collect something. There is an episodic nature to these activities and most everyone will agree that this person has binges of overdoing things despite them getting in trouble.

This characteristic is highly related to the continued use despite negative consequences we see in substance abuse. As a matter of fact, people with a Bipolar diagnosis are much more likely to also have addiction and alcoholism issues than the general population.

The result

To be diagnosed with a manic episode you need to have three of the seven symptoms. We want four if you are just irritable but not expansive or elevated in mood.

But look at how many of these things are judgment calls. Was Steve Jobs grandiose? How about Bill Gates? How much can I work or write before it becomes “excessive goal-directed behavior.” Are all writers Bipolar? (I need to think about that one.)  How many books can I buy this week before it becomes excessive involvement with pleasurable activities?

Sorry, this post is running long. My short explanation of manic episodes leaves more questions unanswered than it answered. Like: How could you be manic and not have Bipolar disorder?  What is hypomania and how is it related to all this? Are their different types of mania? What is a mixed episode? What things cause mania? How will this all change when we get the DSM-5?

If you or someone you know has symptoms of mania please see a professional. This article is not meant to be enough for you to do “do it yourself diagnosis.” There are many effective treatments for Mania, Bipolar Disorder, and related conditions.

Stay tuned for more on Mania, Hypomania, Cyclothymia and Bipolar Disorder and the things we know and don’t know about all these topics.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Bipolar Disorder, Alcoholism and Addiction

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Bipolar.
Photo courtesy of Pixabay.com

HUGE connection between Bipolar Disorder and Substance Disorders.

There are so many connections between having Bipolar Disorder and having a Substance Use Disorder. In treatment facilities that screen for mental illness, it is not uncommon for Bipolar to be the single most common co-occurring mental illness. Anti-social disorders are common in court order referrals and sometimes you might see a lot of clients with PTSD but most often it is the combination of Bipolar Disorder and a Substance Use Disorder that really stands out.

Drugs and alcohol can mask psychiatric symptoms, can create them and both intoxication and withdrawal can look like mental illness, but the combination of Bipolar Disorder and a substance use disorder is so common it is an expectation.

Bipolar Disorder coexists with substance abuse more often than with all the Depressions put together. All mood disorders other than Bipolar Disorder are sometimes labeled unipolar depression to separate them from the bipolar condition.

The overlap between these two conditions is huge. The Epidemiological Catchment Area Study reported that more than 60% of people with Bipolar also had a substance use disorder.

Alcohol was the drug of choice for both people with Bipolar Disorder and unipolar depression.

Because many people with Bipolar Disorder report liking the mania or hypomania they most often go undetected and untreated for long periods of time. Most of the time they come in for treatment because of an episode of depression. Many also escape detection until they have legal consequences that send them to a treatment program.

Most people who finally do arrive at the diagnosis of Bipolar Disorder have seen five or more health care professionals and have spent ten or more years on the process before getting diagnosed with Bipolar Disorder.

The extreme fluctuations in mood in Bipolar Disorder interact with the drugs and alcohol. The reported rate of Bipolar Disorder is 1-2 % though it seems likely that many subclinical cases go undetected for prolonged periods of time.

Cyclothymia is another diagnosis related to Bipolar Disorder that has low highs and not so low lows. It is sometimes described as on the bipolar spectrum. For a full diagnosis of Cyclothymia, you need to have had the condition for at least two years.

This disorder is rarely diagnosed and treated as it does not cause the huge impairment or legal consequences of the more severe forms of Bipolar Disorder. People with Cyclothymia have periods of feeling better and stop treatment. They only come in when depressed and hide the hypomania well. In my own clinical experience, this condition is probably vastly underdiagnosed.

When we talk about having a substance use disorder most people will respond that they are not drug addicts or alcoholics. There are forms of the disease of addiction that stop short of physical addiction but result in ruined lives, broken relationships and periods of time incarcerated.

The hallmarks of a substance use disorder are:

Obsessions – you can’t stop thinking about it.

Cravings – repeated urges to use

Loss of control – using more and more often than planned.

Increased tolerance – Needing more to get the same high or getting less of a result from the same amount of drug.

Withdrawal effects when you run out of the drug.

Psychological addiction or dependence occurs long before physical addiction.

Bipolar Disorder may have existed before the substance abuse but did not get diagnosed because there had been no severe mania. Some people with Bipolar begin using to cover up the symptoms or to help themselves cope. We think of this as “self-medicating.

Drugs and alcohol may increase the risk of developing Bipolar Disorder.

People with Bipolar disorder and substance abuse issues are hospitalized more often and for longer. They are more likely to have rapid cycling Bipolar Disorder and to have developed the symptoms at a younger age. They are also much more likely to have mixed episodes of both mania and depression at the same time.

Co-occurring Bipolar Disorder and substance abuse are much more resistant to treatment and people with both conditions at the same time are far more likely to drop out of or fail to complete treatment.

Alcoholism is more often a result of having Bipolar Disorder rather than a risk factor and those with alcohol as their primary drug of choice do better in treatment than many other co-occurring disorders.

Further complicating this picture we should know that any alcoholic with or without a mental illness is likely to have severe mood swings. Alcohol withdrawal and alcohol intoxication can mimic many mental illnesses and it can take some period of sobriety before a baseline for diagnoses is clear.

Alcohol and illicit drug use will also interfere with getting the medication right resulting in many med changes that might otherwise not have been needed.

So there are some brief thoughts about connections between Bipolar disorder and substance abuse, especially alcohol abuse.

If you or someone you care about has a problem with Drugs, alcohol or may have a mental illness please encourage them to go for professional assessment and treatment.

Other articles about Bipolar Disorders and related conditions can be found at:

Bipolar or Major Depression?

Bipolar – misdiagnosed or missing diagnosis?

Am I Bipolar?

Bipolar doesn’t mean moody

Are you Hyperthymic?

New Bipolar Drug Trial

Bipolar Disorder Genetics research study – Come one come all

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.