Bipolar_and_Substance_Abuse

Running head: The Correlation of Bipolar Disorder and Substance ABUSE The Correlation of Bipolar Disorder and Substance Abuse Abstract In many instances, a person can say that they have been exposed to someone who has been diagnosed of bipolar disorder, as well as a substance abuse disorder that is followed. In this paper, a well described correlation between the two is written according to information that can contribute to the research. The research is very interesting, but at the same time, it is not anything that has not been seen in mental health. The Correlation of Bipolar Disorder and Substance Abuse There is a growing body of literature exploring the interface between bipolar disorder and substance abuse disorders. Symptoms of mood instability are among the most common psychiatric symptoms seen in people who are addicted to drugs. Research of the co-occurrence of bipolar and substance abuse disorders are very important due to the negative impact on course, the treatment outcome, and the prognosis of both of these disorders (Davis, 2000). Upon my research of both of these disorders, this was very well documented. According to recent literature on substance abuse and bipolar disorder, these two diagnoses occur together so frequently among young people, that bipolar individuals need to be assessed for drug and alcohol problems. Unfortunately, people who experience mixed states or rapid cycling have the highest rate of danger from substance abuse. These people experience discomfort and will do anything to make their unstable mood better (Grohl, 2007). First, bipolar disorder must be defined. Bipolar disorder, which many people know it 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. Some of the symptoms of bipolar are severe. These symptoms are different from the normal ups and downs that most people go through on a day to day basis. Some people, who have a bipolar disorder do not realize that it can result in damaged relationships, poor job or school performance, and sometimes even suicidal thoughts or ideations. Unlike personality disorders, bipolar can be treated. People who have this disorder can lead very productive lives and can return back into the community and function rather well (Davis, 2000). This disorder usually develops in a person’s late teens or early adult years. At least half of all cases start before the age of 25. Actually some people who have been diagnosed ADHD, tend to be bipolar when they age (Newton, 2000). Bipolar disorder tends to run in families, so researchers are looking for genes that may increase a person’s chance of developing the illness. Genes are the “building blocks” of heredity. They help control how the body and brain work and grow (Davis 2000). Bipolar disorder is mostly known for erratic mood swings that can cause someone to experience bouts of mania one day and severe depression the next. It’s not entirely certain what causes bipolar disorder, but researchers believe it is genetic in nature. Bipolar disorder is sometimes difficult to diagnose at first. Some people suffer for many years before actually being diagnosed. Some people say that bipolar is a long term illness that must be managed in order to return back to society appropriately. As bipolar is considered a mood disorder, people tend to experience unusual emotional states that occur in what is called “mood episodes.” Sometimes a person can experience extremely joyful episodes and become overly excited. This is what is called “manic episodes”. When clients experience sad or extremely hopeless states, it is called a “depressive episode” (Goodwin, 2007). Sometimes a person can experience manic and depressive states at the same time, thus the old term of bipolar; manic depressive. When they experience this state in particular, it is called a mixed state. There are also instances where certain people with bipolar are extremely explosive, irritable, and hard to deal with. Bipolar disorder tends to worsen if it is not treated. Overtime, a person may suffer more frequent and more severe episodes than when the illness first appeared (Goodwin, 2007). When a person’s symptoms flair up, there will be a change in energy, activities of everyday living, sleep and behavior. These symptoms go along with a mood disorder. Sometimes, it is possible for someone with bipolar disorder to experience or suffer for long periods of time of instability. It is sometimes hard to hide these symptoms from others (Davis 2000). The following are symptoms of bipolar in the specific states: Symptoms of mania or manic episode · A long period of feeling “high” or an overly happy or outgoing mood · Extremely irritable mood, agitation, feeling “jumpy” or “wired” The following are examples of behavioral changes: · Talking very fast, flight of ideas, and racing thoughts · Being easily distracted · Increasing goal-directed activities, such as taking on new projects · Being unusually restless · Sleeping very little · Unrealistic beliefs in what that person can do · Being impulsive and doing pleasurable things such as spending sprees, impulsive sex, and spending money on useless things Symptoms of depression or a depressive episode include: Mood changes · A long period of feeling worried or empty · Loss of interest in things that was once enjoyed such as sex These behavioral changes are the following: · Being fatigued or extremely tired · Poor concentration, poor memory, and very indecisive · Restless and irritable · Change in eating, sleeping or usual habits · Suicidal ideations (Davis, 2000). Substance abuse often co-exists with bipolar disorder. Substance abuse is the use of mood-altering drugs that interferes with or has a negative effect on a person’s life. This can include a negative effect on a person’s physical, psychological, social, legal, emotional, occupational, and educational well-being. Sometimes people do not realize this until it happens immediately. Substance abuse describes a relationship between the drug and the drug user that creates what is called dysfunction and negative consequences. This basically interferes with a person’s life (Goodwin, 2007). Most drug-addicted people spend large amounts of time trying to obtain the drug; smoking, snorting, or injecting it in their system, and actual recovery from its effects. This can last anywhere from a few hours to almost an entire day. Some people would say that this is a characteristic of bipolar where they are very impulsive. So why is there a link between bipolar disorder and alcohol and drug abuse' There are various theories that have been put forward to explain this relationship. These theories generally fall into one of three categories: (1) The theory that the two disorders just happen to coexist in the same person without a causative relationship between them. This is generally based on the theory that there is a genetic link. The two disorders simply occur at the same time in the same individual due to genetics. (2) The theory that substance abuse is the result of underlying mental illness and that drugs and alcohol are an attempt to self-medicate. (3) The theory that the reverse is true and that substance abuse may actually cause the symptoms of mental illness (Newton, 2000). Recent epidemiology surveys show that more than 10 million American have co-existing substance related and mental health disorders (Davis, 2000). Several researchers pointed out that patients with co morbidity have less outcomes than those with single diagnoses, such as an increasing psychiatric symptoms, homelessness, higher risk for relapse, institutionalization, poorer compliance and managing their lives (Davis, 2000). Upon recognizing the existence of people with co-occurring psychiatric and substance abuse disorders, the treatment of these individuals can be very challenging. One challenge is the poor fit between the dually diagnosed and the regular treatment system. Most of the time, people are treated for one illness at a time. Once one disorder is under control, the other illness will be treated. Sometimes people can get lost in their own treatment. Nowadays, most facilities treat both illnesses. Antidepressants are most commonly prescribed for treating symptoms of bipolar disorder. Psychotherapy or “talk” therapy can be an effective treatment for bipolar disorder. It can provide support, education, and guidelines to people with bipolar disorder and their families (Newton, 2000). In order to better the outcomes of dually diagnosed patients, there must be an adequate assessment for them. The assessment needs to include severity of psychiatric symptoms as well as substance abuse symptoms. It must also include, but is not limited to, conditions associated with occurrence and maintenance of these disorders, psychosocial needs and problems, treatment motivation, and areas for treatment intervention. The link of dually diagnosed is unclear. People with bipolar disorder try to treat their symptoms with alcohol or drugs. Regardless, substance abuse may trigger or prolong bipolar symptoms, and the behavioral control problems associated with mania can result in a person drinking too much. When it comes to depression and substance abuse, some researchers want to know “which came first”. This is more than just the egg question. In the area of substance abuse, knowing whether the drug addiction came first or if the depression came first, just is not clear cut. Regardless of what some people say, whether it is depression or substance, it can lead to problems and may require specialized intervention and treatment (Durand, 2000). Research shows that depression is strongly linked to alcoholism and drug addiction. Fifty three percent of people who abuse drugs, and 37% of those who have an alcohol problem suffer of at least one psychiatric problem (Durand, 2000). From those struggling with a dual diagnosis, there are many challenges to diagnose and treat. Identifying both of the conditions presents problems. One study found that the people with substance problems were among the severely, mentally ill patients seen in an emergency room. Only a small percentage of 2% were detected (Grohl, 2007). Some drugs, including marijuana, downers, alcohol, and opiate seem to temporarily blunt the effects of mood swings. This will cause effects later. Some other drugs can actively exacerbate bipolar disorder. Speed and cocaine are two types of drugs that have sent many abusers into mania often followed quickly by depression and psychotic symptoms (Grohl, 2007). Hallucinogens, including LSD and PCP, can also set off psychotic symptoms. These effects on younger people with bipolar disorders can be even worse (Grohl, 2007). Studies show that around 60% of bipolar disorder patients are alcoholics. There are numerous effects of substance abuse on bipolar disorder. Some of them are as follows: · People with bipolar disorder seem to be extremely sensitive to the effect of drugs and alcohol. Moderate doses of alcohol or drugs can induce mood changes in bipolar disorder patients. · Substance abuse appears to worsen the health condition of the patient contributing to poor nutrition. · People who are bipolar are prone to substance abuse generally refuse treatment or do not follow medication. Recovery status is extremely poor. · Denial of treatment and the use of drugs and alcohol will pose burden to the family members which will result in poor and strained relationships. · Bipolar people who use substances are more prone to suicide attempts. · The quality of life for patients with bipolar disorder and substance abuse will be poorer than the people who are not addicted to substance abuse. · Drugs and alcohol have severe interactions with medications used to treat bipolar. Due to this reason, doctors usually treat the substance abuse problem first. (Davis, 2000). Finally, there is treatment for both of these disorders. For those using drugs and alcohol along with their bipolar disorder (dual diagnosis), admission into an inpatient drug rehab, alcohol rehab, addiction treatment program or dual diagnosis treatment program might be indicated. Most people suffering from drug or alcohol addiction might require detox from those substances before the bipolar disorder treatment can proceed. An effective dual diagnosis treatment program will utilize group and individual therapy, family therapy, educational and medication management classes to promote a greater understanding of the dual diagnosis process and bipolar disorder symptoms (Newton, 2000). During treatment, doctors usually give more priority to making the person free of substance abuse. Usually, hospitalization is needed for about one month. The earlier a user seeks treatment, the more likely he/she will be able to get completely free from substances without going into substance dependency. There also needs to be participation in some type of support group. Support groups are a good treatment for substance abuse. A couple of examples of support groups are Alcoholics Anonymous and Narcotics Anonymous. In both of these groups, people share their stories of their own personal addiction and also good coping skills (Davis, 2000).References Davis, S. F., & Palladino, J. J. (2000). Psychology (3rd ed.). Upper Saddle River, NJ: Prentice-Hall, Inc. Durand, V. M. & Barlow, D. H. (2000). Abnormal Psychology: An Introduction. Scarborough, Ontario: Wadsworth. Goodwin, Jamison. (2007). Manic-Depressive Illness: Bipolar Disorders and Recurrence Depression (2nd ed.). New York: Oxford University Press. Grohl, John M. Psy. D. (2007). Substance Abuse and Bipolar Disorder. Retrieved April 7, 2011 from http: psychocentral.com/lib/2007/substance-abuse-and-bipolar disorder/ Newton, David. (2000). Sick! Diseases and Disorders, Injuries and Infections. Vol. 1. San Francisco: Gale Group.