Substance/Medication-Induced Bipolar And Related Disorders

While the symptoms of substance/medication-induced bipolar and related disorders may vary depending on the specific substance or medication involved, typical bipolar disorder is characterized by dramatic shifts in mood, energy, and activity levels that affect a person’s ability to carry out day-to-day tasks. These shifts may be referred to as manic, hypomanic, or depressive episodes. 

Some common signs of mania or hypomania may include: 

• An increase in activity, energy, or agitation
• A sense of euphoria, or an elevated sense of well-being or self-confidence
• A decreased need for sleep
• Excessive talking or speaking quicker than usual
• Racing thoughts and difficulty concentrating
• Impulsive decision making, such as risky spending or sexual behaviors

Common signs of a depressive episode may include the following: 

• A noticeably depressed mood
• Prolonged sadness, hopelessness, or excessive crying
• A loss of interest or pleasure in social, personal, or work-related activities
• Significant weight loss or weight gain
• Difficulty sleeping or sleeping too much
• Restlessness or slowed behavior
• Fatigue or general loss of energy
• Thoughts of worthlessness or excessive or inappropriate guilt
• Difficulty concentrating
• Suicidal thoughts or ideation

In some cases, mixed or cyclical symptoms may occur, such as:

• Sadness or hopelessness while also experiencing heightened energy levels
• Suicidal thoughts with impulsivity and restlessness
• Irritability or agitation accompanied by extreme sadness
• Rapid shifts between manic and depressive symptoms over a short period
• Abrupt changes in mood and behavior without apparent cause

Additionally, substance- and medication-specific symptoms may present in the form of: 

• Symptoms that emerge shortly after starting or stopping a particular substance or medication
• Increased severity of mood disturbances with higher doses or prolonged use
• Symptom improvement with substance cessation or medication adjustment

Substance/medication-induced bipolar and related disorders can be mistaken for other mood disorders, such as bipolar I disorder or bipolar II disorder, which do not have a direct link to substance or medication use. For this reason, seeking a comprehensive evaluation through a mental health or addiction specialist can be crucial in determining an appropriate and effective method of treatment.

The primary cause of substance/medication-induced bipolar and related disorders is the consumption of substances like alcohol, stimulants, hallucinogens, steroids, antidepressants, antipsychotics, and other mood-altering drugs. Other common causes for this condition include:

• Medication use: Some medications, when taken as prescribed or in higher doses, can lead to mood disturbances resembling bipolar and related disorders. These medications may include steroids, antidepressants, anticonvulsants, and others.
• Interactions: Mixing substances or combining them with medications can contribute to mood fluctuations and may cause manic or depressive episodes.

Additionally, risk factors for this condition include: 

• Personal or family history: Individuals with a history of bipolar disorder or related mood disorders may be more susceptible to substance/medication-induced bipolar and related disorders.
• Substance use history: A past or ongoing history of substance use disorder³ increases the risk of experiencing mood disturbances induced by substances or medications.
• Co-occurring disorders: Individuals with other mental health conditions, such as anxiety disorders or depression, may have an increased risk of developing substance-induced mood episodes.
• Stress and trauma: Traumatic events or chronic stress can exacerbate the risk of substance misuse, which may lead to mood disturbances.

Triggers related to trauma may include: 

• Stressful events: Significant life events, such as loss, interpersonal conflicts, or significant changes, can trigger mood swings.
• Reminders of trauma: Certain sights, sounds, or experiences that remind the individual of their traumatic past can evoke emotional distress and substance use as a coping mechanism.⁴
• Anniversaries: The anniversary of the traumatic event may evoke strong emotional reactions, leading to an increased likelihood of substance misuse and mood fluctuations.

Understanding these causes, risk factors, and triggers can be essential for medical and mental health professionals to develop appropriate prevention strategies and tailored treatment plans for individuals experiencing medication or substance-induced mood disorders.

Often, the primary goal of treating substance/medication-induced bipolar and related disorders is to stabilize mood and identify the underlying substance or medication challenge. A comprehensive approach using therapy, medication management, and self-care may promote recovery and prevent relapse.

Medication

The medication used in substance- and medication-induced bipolar and related disorders will depend on the individual, the substance used, and their co-occurring medical and mental health conditions. Below are several medications that may be used in treatment of substance-induced bipolar and related disorders: 

• Mood stabilizers: Certain medications, such as lithium or anticonvulsants, may control mood swings and prevent manic and depressive episodes.
• Antidepressants: In cases of co-occurring conditions, antidepressants may be prescribed to manage specific symptoms.
• Anti-anxiety medications: For individuals experiencing severe anxiety or agitation, short-term use of anti-anxiety medications may be considered.
• Antipsychotic medications: In some cases, antipsychotic medications are also used to treat symptoms of this disorder. 

Consult a medical doctor before starting, changing, or stopping medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.

Other treatment options

Other treatment options may include the following: 

• Detoxification: In cases of severe substance dependence, medically supervised detoxification may be required to manage withdrawal symptoms safely.
• Dual diagnosis treatment: Co-occurring disorders, such as anxiety or post-traumatic stress disorder (PTSD), can be addressed in conjunction with the substance/medication-induced mood disorder for comprehensive treatment.

Self-care

Self-care can mean taking care of your mental and physical health at home. This may help with substance-induced depression or anxiety. Below are strategies that may be recommended: 

• Establishing a routine: A daily schedule can provide stability and help individuals manage their time effectively.
• Physical activity: Regular exercise may improve mood, reduce stress, and promote overall health.
• Healthy diet: A balanced diet with fruits, vegetables, and whole grains can support physical and mental well-being.
• Mindfulness and meditation: Practicing mindfulness and meditation techniques can aid in managing stress and regulating emotions.
• Social support: Engaging with a support network of family, friends, and specialized support groups can provide encouragement and understanding during challenging times.

Effectively treating substance/medication-induced bipolar and related disorders often requires regular communication with medical and mental health professionals. By identifying the root cause of mood disturbances, individuals can work toward managing their symptoms, reducing substance use, and achieving stability and well-being in their lives.

In cases of substance/medication-induced bipolar and related disorders, therapy can play a crucial role in helping individuals understand the connections between substance use and mood disturbances. Several online therapy platforms, such as BetterHelp, offer comfortable therapy options, allowing participants to receive specialized treatment from the comfort of their homes.

Additional resources include the following: 

• Substance Abuse and Mental Health Services Administration (SAMHSA)
• American Addiction Centers (AAC)
• Mental Health America (MHA)
• National Alliance on Mental Illness (NAMI)

For those with thoughts of suicide, contact 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Research has shown that mood disorders, particularly depression and bipolar disorder, are commonly seen alongside substance use disorders. While recent advancements have identified specific therapeutic options for individuals with both substance use disorders and mood disorders, a study of the national addiction treatment infrastructure found several challenges in delivering care due to challenges in the mental health and addiction treatment systems.

These challenges include high staff turnover, limited availability of healthcare professionals, and a lack of resources. To overcome these systemic issues, it can be crucial to enhance communication and collaboration between different agencies and healthcare providers to ensure the best possible care for individuals with substance/medication-induced bipolar and related disorders.

Below are several key statistics on substance/medication-induced bipolar and related disorders:

• Substance/medication-induced mood disorder is estimated to affect approximately 4% to 13% of individuals with substance use disorders. 
• Alcohol and stimulant substances are among the most common causes of substance-induced mood disturbances. 
• More than one in four adults living with a mental health condition such as depression or anxiety also has a substance use challenge. 
• According to research, most symptoms of substance/medication-induced mood disorders resolve naturally up to one month after an individual stops taking, misusing, or being exposed to the substance causing the disorder.

Bipolar I Disorder