Types of Bipolar Disorder and Addiction

Updated on August 23,2019

There are several subtypes of bipolar disorder that consist of a wide range of symptoms and severity. Understanding the different types of bipolar disorders and their common links to addiction is critical for those living with bipolar disorder and their loved ones.

Although they are not necessarily suggestive of each other, a high percentage of people who have bipolar disorder also struggle with substance abuse. In fact, a co-occuring substance abuse disorder is so prevalent that many health providers perform regular addiction screenings for people who have been diagnosed with bipolar disorder.

The Bipolar Disorder Spectrum

Bipolar disorder is hallmarked by shifts in mood that can be quite dramatic. On the one hand, individuals may have a depressed mood in which they feel low, sad, and lethargic. On the other hand, individuals may experience a manic mood in which they feel happy, confident, powerful, and energetic.

People who suffer from bipolar disorder tend to encounter one or both of these moods without any particular external catalyst. Experts may diagnose people who have these striking mood shifts as bipolar, but there are many different ways that the disorder can present. Many experts posit that these different types of bipolar disorder exist on a spectrum in which a person might have one, some, or all of the potential symptoms associated with the disorder.

Types of Bipolar Disorder

Bipolar I

Bipolar I disorder exists on one end of this spectrum. Only about 1% of the population has this type of bipolar disorder, and symptoms present as what is generally known as classic bipolar disorder. People who experience this form of bipolar disorder alternate between the highest highs and the lowest lows on a routine basis. During a manic episode, they might behave in the following ways:

  • Speak so rapidly that they’re difficult to understand
  • Spend a considerable amount of money
  • Express delusional beliefs (sometimes delusions of grandeur)
  • Refuse to sleep
  • Have an increased interest in engaging in sexual activities

This same person might then encounter episodes of severe depression in which life doesn’t seem worth living. They might refuse to go to work or find it difficult to talk to others or make decisions. They can appear as though they’re in a pit of despair at the lowest point in their lives.

Substance abuse can play a significant role in the life of someone who has bipolar I disorder. In fact, this is a common occurrence among many mental health disorders. For people who have a mental illness, substances might seem to make the mental/emotional dysfunction a bit easier to endure.

Bipolar II

This type of bipolar disorder can also make life difficult, but people who experience it don’t usually encounter full mania. People with bipolar II are still cycling from one mood to another, but they are much less likely to experience the feelings of energy and joy that comes with mania.

Instead, they oscillate from moments of minor dysphoria, in which they feel just a little sad, to moments of intense despair. People with bipolar II face the highest risk of suicide among all people on the bipolar spectrum because their depression seems like it will never get much better.

Furthermore, they are also highly susceptible to illicit drug use. They may turn to euphoric drugs to feel some form of happiness or use stimulant drugs to increase their energy levels so they can get through the day while feeling depressed.


This type of bipolar disorder is on the other end of the spectrum from bipolar I, as it is characterized by the same kind of cycling between mania and depression, but the highs and lows are typically less intense. People with cyclothymia experience sudden changes in mood that they might find difficult to control, but they may not encounter extreme forms of either mood.

These patients may also try their hand at self-medication with drugs and alcohol in an attempt to iron out the mood swings they’re feeling. Unfortunately, cyclothymia tends to become worse over time if not appropriately treated, and those who are using drugs or alcohol might be less likely to get treatment. As a result, their substance abuse can contribute to a more severe form of bipolar disorder.

Not Otherwise Specified (NOS)

This form of bipolar disorder can be placed anywhere on the spectrum as it’s applied to people who have a group of symptoms that don’t fit nicely into diagnostic criteria. People with this type of bipolar disorder might encounter episodes of mania, but no depression or they may experience only a few symptoms of mania and/or depression, but their episodes do not manifest quickly enough to warrant a formal diagnosis.

It can be incredibly challenging to live with NOS bipolar disorder as many struggle to find the proper care. Because their symptoms don’t fit other categories, they may not receive the medication support or therapies needed for healing. Thus, it’s common for people with NOS to self-medicate with drugs and alcohol, which can cause an increase in symptoms and a more severe form of the disorder.

Alternating Moods and Rapid Cycling

While everyone who has bipolar disorder encounters mood shifts, people who have a rapid cycling form of the condition can go from one mood to another incredibly fast. They might wake up in the morning feeling depressed and experience mania by the afternoon.

People who must cope with shifts such as this can be profoundly disabled by their disorder, being completely unaware of what mood may soon follow and constantly feeling tense and on edge. Those with rapid cycling may be at an increased risk for substance abuse and addiction as they feel desperate to make the feelings stop.

Treatment for Addiction and Bipolar Disorder

While people often abuse drugs because they are attempting to manage their symptoms, substance abuse can make the dysfunction associated with bipolar much worse. However, specialized treatment for co-occurring disorders can make a huge difference, and usually begins with the following:

  • A thorough assessment of the symptoms the individual is currently encountering
  • A discussion about the person’s substance use patterns and habits
  • A timeline regarding symptom manifestation and the steps the person took to relieve the symptoms

Adjusting to Sobriety

Medical detox is usually next and is characterized by the process in which the body is cleared of toxic substances in a safe and controlled environment. Once detox is complete, doctors may use medications to stabilize mood and manage bipolar symptoms. However, because other drugs and alcohol can interfere with these medications, it’s essential for people to detox completely before they begin medication-assisted therapies.

Psychotherapy is another critical component of treatment. Here, the individual works with a therapist to understand their motives for using drugs along with potential triggers for bipolar shifts. Patients may work in a one-on-one setting, as well as in groups and learn from peers who also experience bipolar disorder.

At Harmony Ridge Recovery, we specialize in treatments for mental health disorders, particularly those that have been exacerbated by addiction. We believe that everyone who suffers from these disorders can recover and that an improved state of health can be achieved through medication management, psychotherapy, support groups, complementary therapies, and aftercare.

Call us today to find out how we can help you reclaim the fulfilling life you deserve!

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