DUAL DIAGNOSIS

Treatment For A Bipolar Dual Diagnosis

Bipolar disorder is a serious, chronic mental health condition that’s characterized by unusual changes in mood, energy, and activity levels. About 30% to more than 50% of people with bipolar disorder will develop substance use disorder, which complicates the diagnosis and treatment of their conditions.[1]

If you or a loved one is struggling with bipolar disorder and a substance use disorder – dual-diagnosis – treatment is available.

WRITTEN Review by:

Amanda Stevens, BS

On: Dec 12, 2023
Medical Review by:

Dr. Po Chang Hsu MD, MS

On: May 7, 2024
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    Common Symptoms of Bipolar Dual Diagnosis

    There are several types of bipolar disorder with different shifts in mania, hypomania, and depression periods:

    Bipolar I disorder: One manic episode that may be preceded or followed by hypomania or major depressive episodes.

    Bipolar II disorder: One major depressive episode and at least one hypomanic episode, but no manic episodes.

    Cyclothymic disorder: At least two years (one year in children and adolescents) of numerous periods with hypomanic symptoms and periods of depressive symptoms that do not meet the criteria for a major depressive episode.

    Other types: Other specified bipolar and related disorders can be induced by certain drugs or alcohol, or they may be due to another medical condition.[2]

    Manic and hypomanic episodes may include:
    Jumpiness
    Increased energy or agitation
    An exaggerated sense of well-being and self-confidence
    Decreased need for sleep
    Unusual talkativeness
    Racing thoughts
    Distractibility
    Poor decision making

    Major depressive episodes may include:
    Depressed mood
    Loss of interest in activities
    Significant weight loss
    Either insomnia or sleeping too much
    Either restlessness or slowed behavior
    Fatigue or loss of energy
    Feelings of worthlessness or inappropriate guilt
    Decreased ability to concentrate
    Suicidal thoughts or actions

    When bipolar disorder occurs with a substance use disorder, the symptoms can vary and may overlap with the symptoms of using the specific drug.

    Bipolar Dual Diagnosis Statistics

    Substance use disorders are extremely common among individuals with bipolar I and bipolar II disorders:

    Substance use disorders occur in about 38% of bipolar I patients

    Alcohol and cannabis are the most often abused, followed by cocaine and opioids, in people with bipolar
    In people with bipolar I disorder, approximately 61% have a lifetime prevalence of substance use disorder.

    In people with bipolar II disorder, approximately 48% have a lifetime prevalence of substance use disorder.[3]

    Treatment Centers for Bipolar Disorder Dual Diagnosis

    Treatment Centers for Bipolar Disorder Dual Diagnosis

    A formal dual-diagnosis treatment program can be effective for treating co-occurring substance use disorders and bipolar disorder. There are several levels of care to ensure that you have a tailored treatment plan that’s appropriate for your stage of the recovery process:

    Inpatient Treatment

    Bipolar inpatient or residential treatment provides 24/7 supervision and support. This is important for people who don’t have a stable home environment or who need intensive care and support, such as teens.

    Outpatient Treatment

    For those requiring more flexibility, outpatient treatment programs allow participants to continue meeting day-to-day responsibilities while attending scheduled therapy sessions. These programs vary in intensity and frequency of sessions. Instead of sleeping in the facility, you can go home at night to spend time with family and sleep in your bed.

    Although there is no permanent cure for bipolar disorder or substance use disorder, treatment programs provide a variety of therapeutic activities designed to help individuals manage their symptoms and prevent relapse.

    Cost of Dual Diagnosis Treatment for Bipolar Disorder

    The cost of dual diagnosis treatment for bipolar disorder can vary by the facility, the treatment plan, and other factors. Fortunately, dual diagnosis for bipolar disorder may be covered by some insurance policies, either fully or in part.

    Contact us today to see if your insurance provider is in the network and learn more about your treatment options.

    What Does Treatment For a Bipolar Dual Diagnosis Look Like?

    What Does Treatment For a Bipolar Dual Diagnosis Look Like?

    Treatment for bipolar disorder dual diagnosis requires treating both conditions simultaneously with an individualized care plan that considers the person’s symptoms, needs, preferences, and responses to treatment.

    Medications are often indicated for bipolar dual diagnosis, including:
    Mood stabilizers
    Atypical antipsychotics, such as quetiapine
    Antidepressants, such as fluoxetine

    Because some medications can be dangerous when mixed with substances, it’s crucial to be under the care of a mental health professional.

    Several types of therapy may be used to treat bipolar disorder and substance use disorder:

    Cognitive behavioral therapy (CBT): This therapy helps individuals with bipolar disorder recognize and change harmful or negative thought patterns and behaviors, aiming for a healthier mental state.

    Motivational interviewing: This therapy helps you determine your motivation for recovery.

    Contingency management: Indicated for substance use disorder, this therapy offers rewards for adherence to the treatment program and abstinence.

    Experiential therapy: This form of therapy utilizes activities such as role-playing, arts and crafts, music, and sometimes animals to promote emotional expression and exploration.

    Relapse prevention: This targeted approach helps individuals identify and cope with specific triggers to maintain abstinence and prevent relapse.

    Twelve-step facilitation: This therapy integrates 12-step mutual support groups to develop peer support and share with others.[4]

    Related Programs & Therapies

    Learn More About Other Co-Occurring Disorders

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    Frequently Asked Questions about Bipolar Disorder

    Can someone be diagnosed with both BPD and bipolar? Chevron Down
    Can you treat bipolar disorder without medication? Chevron Down
    What are the criteria for dual diagnosis? Chevron Down
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