Substance Addiction

This is luckily not a subject that affects me (the only things I'm 'addicted' to are sugar and Facebook) but a high percentage of people with bipolar disorder are addicted to substances, whether they be cigarettes, alcohol, cannabis, cocaine, or other drugs, and unfortunately these addictions up the risks of both depressive and manic episodes and/or prevent medication from working so effectively.

Cigarettes

People with bipolar disorder are two to three times more likely to start smoking than people without psychiatric disorders and may be less able to quit. People with bipolar disorder die an average of twenty years before their counterparts from the general population, and while some of these deaths are due to suicide or accidents, the

most frequent causes of death are due to cancer, cardiovascular, cerebrovascular, and respiratory diseases, which are all conditions for which tobacco use is a known cause of early mortality. Cigarettes also make some medications such as lithium less effective, and a higher dose is needed in order to reach the desired effect, which in turn increases risks of side effects like kidney damage.

Alcohol

Many people drink but it is considered excessive if a woman drinks more than three drinks on any day or more than seven per week or if a man drinks more than four drinks on any day or more than fourteen per week. Excessive doesn't equal addiction though. Drinking is considered an addiction if the person feels unable to function normally without alcohol. Studies have shown that people with bipolar disorder have a 60% chance of developing a drinking problem at some point in their lives, which is a frightening statistic! Alcohol is dangerous for people with bipolar disorder, as it reacts badly with medication, and can fuel both mania and depression.

Cannabis 

Almost 70% of people with bipolar disorder use marijuana during their lifetime and 30% are dependent on it.  This is problematic because the risk of psychotic disorders increases with cannabis use and its use is linked to a younger onset of bipolar disorder. It can worsen both manic and depressive symptoms and suicide attempt rates in people with bipolar disorder are higher in those who use marijuana than in those who abstain.

Cocaine 

A large amount of people with bipolar disorder also use cocaine and 5% to 30% of cocaine users have bipolar disorder compared to 1% in the general population. However, it is difficult to prove causality- do people use because they have bipolar or do they have bipolar because they use? Either way it's bad news because cocaine causes big boosts in mood, often accompanied by hallucinations and fears, and then a crash accompanied by depression and a feeling of loss. These shifts in mood are similar to those experienced by people with bipolar disorder, and one on top of the other is a recipe for disaster. There is a high suicide risk for people with bipolar, and about 20% of people who commit suicide have some form of cocaine in their bodies, which makes taking cocaine a double risk for people with bipolar.

Bipolar disorder is complicated enough without adding drugs as these promote relapse and make the disorder harder to treat. Help is fortunately at hand, whether it be from your GP, Alcoholics Anonymous, Nicotine Anonymous, Narcotics Anonymous, or a hotline. Help is also available to those with addictive behavioural problems, such as gambling. For those in France the association SOS Addictions can be contacted for any type of addiction problem.