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According to the National Institute of Mental Health, bipolar disorder (previously known as manic-depressive illness) is a “brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.”
Serious mood swings must last at least a week and symptoms must be persistent to be considered part of a bipolar disorder. This specific disorder is less common than major depression, and is often misidentified in patients after having used drugs or alcohol.
For example, if a patient with bipolar disorder is seen in an emergency room after having used cocaine or other stimulants, mania in “regard to grandiosity, hyperactivity, talkativeness, and paranoia will be attributed solely to the stimulant…. Substance intoxication is likely to exacerbate the disinhibition and poor judgment associated with mania and is associated with poor medication adherence which promotes relapse.” (Principles of Addiction Medicine)
The likelihood of substance abuse is four times greater with the presence of a bipolar disorder.
The longer untreated bipolar continues without treatment, the worse the chances of achieving abstinence and maintaining stability. Bipolar treatment can be successful only when drug and alcohol addiction and other co-occurring disorders are treated together within the context of an inpatient rehab. Close monitoring is required, as a bipolar-depressed person requires different treatment than the unipolar depressed patient.
| Symptoms of Mania | Symptoms of Depression |
Mood Changes Long period of feeling “high” or an overly happy or outgoing mood Extremely irritable mood, agitation, feeling jumpy |
Mood Changes Long period of feeling worried or empty |
Behavioral Changes Talking very fast, jumping from one idea to another, racing thoughts |
Behavioral Changes Feeling tired |
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