Bipolar Disorder and Opiates: Understanding this Co-Occurring Condition

opiates and bipolar disorder

Mental health is something many people fail to truly focus on despite its indisputable importance. However, the more emphasis professionals place on this matter, the better. Not only will this help to inform more people of the truth about mental health disorders, but it will also help individuals to make healthy decisions about treatment for these disorders. Additionally, those who suffer from mental health disorders may also find themselves dealing with addiction in their lives. These co-occurring disorders can make life complicated and lead to negative results. One example of a harmful combination that can lead to these negative results is bipolar disorder and opiates.

Often, those who suffer from a dual diagnosis of addiction and mental illness are unsure about the effects of these disorders in their lives. Some may be aware of the truth of their struggle but they may not know how or where to get help in dealing with their challenges. This is where treatment facilities like ours here at Sana Lake Recovery Center can help.

What Is Bipolar Disorder?

Bipolar disorder is a mental disorder that affects a person’s behavior, cognitive functions, and overall mood. Individuals who have bipolar disorder often experience unusual or abnormal changes in their energy levels and emotions. Once known as manic-depressive illness, bipolar disorder is characterized by mania and depression.

During manic periods, individuals who suffer from bipolar disorder may appear to be “up”. This might involve symptoms such as elation or an increase of energy. Some may experience periods of hypomania, which is a less intense state of mania. The depressive periods cause people to appear “down”. These periods may be characterized by irritability, low energy, loss of motivation, and more.

Unfortunately, as is the case with many other mental health disorders, the media hasn’t always painted the most accurate picture of bipolar disorder. Although there is currently more opportunity to discuss mental health in today’s culture, it’s still very clear that there’s much more to learn.

Some may refer to a person who seems to show signs of unstable emotions as “bipolar”: an angry boss who sometimes appears to be nice, a friend who easily becomes irritated, etc. But these individuals may not have bipolar disorder. So, without meaning to do so, those who use this term so loosely actually make light of this mental health disorder.

An Overview of the Symptoms of Mania and Depression

When a person who has bipolar disorder is experiencing manic or hypomanic episodes, the following symptoms may occur:

  • Euphoria
  • Agitation
  • Impulsivity
  • Grandiosity
  • Restlessness
  • Loss of appetite
  • Increased energy
  • Increased activity
  • Racing thoughts
  • Impaired judgment
  • Lack of tiredness
  • Lack or decrease in sleep
  • Difficulty making decisions
  • Abnormal sense of excitement
  • Abnormal sense of self-confidence or self-esteem
  • “Jumpiness” or the appearance of being “wired”

Talkativeness is another symptom of mania. Individuals may begin to speak faster than usual and talk about many different topics quickly. 

In some cases, mania can produce symptoms of psychosis. Individuals may lose touch with reality and may even experience hallucinations or delusions. Manic episodes often interfere with people’s ability to concentrate in school or at work. It can also cause issues in relationships as some individuals may be met with misunderstanding. Social settings and events may also be difficult for those who are experiencing the symptoms of bipolar disorder-related manic periods.

During depressive episodes, a person who has bipolar disorder may encounter the following symptoms:

  • Anxiety
  • Emptiness
  • Forgetfulness
  • Extreme worry
  • Indecisiveness
  • Lack of energy
  • Slow speech
  • Intense sadness
  • Feelings of fear
  • Feelings of guilt
  • Sense of worthlessness
  • Feelings of hopelessness
  • Lack of pleasure or enjoyment
  • Crying that can’t be controlled
  • Inability to focus or concentrate 
  • Suicidal ideation or thoughts of death in general
  • Changes in sleep patterns (either too much sleep or insomnia)

In many instances, those who experience the depressive episodes that occur with bipolar disorder may even show physical signs such as weight gain or weight loss. 

Types of Bipolar Disorder

There are multiple types of bipolar disorder. Although periods of mania and depression tend to affect everyone who suffers from bipolar disorder, the severity of these symptoms depends on the type of bipolar disorder a person has. The main 3 kinds of bipolar disorder include cyclothymia (also known as cyclothymic disorder), bipolar I disorder, and bipolar II disorder.

Bipolar I Disorder: Individuals who have this form of bipolar disorder experience one or more periods of mania as well as depression, which may last two weeks. The individual’s period of mania must last for at least 7 days before he or she can receive a diagnosis for bipolar I disorder. However, depression is not a requirement for this diagnosis. In some cases, a person who has this type of bipolar disorder may even be hospitalized as a result of a manic period. Also, symptoms of psychosis may occur as a symptom of this disorder. Sometimes, those who have bipolar I disorder also have mixed symptoms during depressive episodes. This means that they may experience symptoms of mania and symptoms of depression at the same time. 

Bipolar II Disorder: If a person has experienced one or more periods of hypomania and depression but never a manic episode, he or she may have bipolar II disorder. 

Cyclothymic Disorder: This type of bipolar disorder is identified as a mood state that is chronically unstable. Individuals who suffer from cyclothymia tend to have periods of normal or stable mood (usually less than 8 weeks). But, they experience symptoms of mild depression and hypomania regularly for at least 2 years. 

“Other Specified”, “Unspecified”: In some cases, people may experience bipolar disorder symptoms that do not exactly fall into a defined diagnosis. In other words, an individual may have symptoms that do not specifically indicate the presence of bipolar I disorder, bipolar II disorder, or cyclothymic disorder. This may cause a diagnosis of an “unspecified” or “other specified” disorder.

Risk Factors and Causes of Bipolar Disorder

The causes for the development of bipolar disorder may vary. But, some people suffer from this disorder due to genetics. If a person’s sibling or other family member suffers from bipolar disorder, he or she may also experience the disorder. However, having a loved one who suffers from bipolar disorder does not guarantee that a person will also develop the disorder. Still, it is possible for genetics to influence an individual’s likelihood of having bipolar disorder. But

Another possible cause of bipolar disorder is a person’s neural structure. The way an individual’s brain functions and is structured may have something to do with the occurrence of bipolar disorder. Some studies have found that there are differences in the brain structures of individuals who have bipolar disorder and individuals who do not. 

Alcohol or drug use can also be a cause of bipolar disorder. This can cause dangerous combinations to occur, such as bipolar disorder and opiates. Let’s discuss what opiates are and how it affects those who are living with mental health disorders.

What Exactly Are Opiates?

Opiates are drugs that are derived from the opium poppy plant. Sometimes, opiate drugs are referred to as opioid painkillers. They have a calming effect on those who use them and can provide pain relief. There are two main categories of opiates. These include agonists and antagonists. 

Types of opiates and opioids include the following substances:

  • Fentanyl
  • Codeine
  • Morphine
  • Oxycodone
  • Methadone
  • Hydrocodone

Generally, opiates are prescribed for pain. Unfortunately, however, many people suffer from opiate dependence. When a person uses opiates regularly, he or she may develop a tolerance for the drugs. As a result of this tolerance, individuals may begin to use higher doses of opiate drugs. This leads to opiate dependence and addiction. 

The Harmful Combination of Bipolar Disorder and Opiates 

As we mentioned earlier, one of the possible risk factors for bipolar disorder is addiction.  Sometimes, substance dependence can actually lead to the development of mental illness. In other cases, however, mental illness can occur before an addiction develops. 

Regardless of how co-occurring disorders develop or the order in which they do so, it’s important to understand the seriousness of having a dual diagnosis. It can be very difficult for individuals to overcome addiction when they also suffer from mental health disorders. It can also be challenging to manage the symptoms of mental illness when substance dependence is present. 

When bipolar disorder and opiates combine, the consequences can be very serious. Many individuals use opiate drugs as a form of self-medication. Some who have bipolar disorder may use these drugs in order to get relief from the symptoms of depression. Opiates can also cause euphoria, which can cause feelings of happiness or a sense of well-being. 

Opiate misuse can have harmful effects on the lives of those who suffer from bipolar disorder. Individuals may find that the effects of opiates bring about “good” feelings or a “high”. But, when those effects wear off, symptoms of depression can set in, perhaps even intensifying the effects of bipolar disorder depressive episodes.

The Importance of a Dual Diagnosis Program

Dual diagnoses can certainly be challenging to treat. But, it is absolutely evident that those who suffer from co-occurring disorders must receive treatment that focuses on each of their disorders. Simply put, individuals should seek help from a dual diagnosis treatment program. There are multiple reasons for this. But, the main reason is effectiveness.

When a person is suffering from substance dependence as well as a mental health disorder, those disorders tend to interact with one another. In other words, a person’s substance use may intensify the symptoms of his or her mental illness and vice versa. Some may even use alcohol or drugs in an effort to cope minimize the effects of the symptoms of their mental illness. But this could actually worsen the disorder over time. 

Since co-occurring disorders affect each other, it’s important to treat them simultaneously. Treating only substance dependence will leave the effects of a person’s mental health disorder in place. As a result, the symptoms of his or her disorder may lead to relapse. On the other hand, helping a person manage symptoms of mental illness is helpful but it will not rid the individual of substance dependence.

A program that addresses both mental health and addiction can be a tremendous help for those who have co-occurring disorders. So, if you’ve been suffering from the dangerous mixture of bipolar disorder and opiates, you can find hope through our dual diagnosis program here at Sana Lake Recovery Center!

Contact Our Facility Today

Here at our facility, we offer our members a safe and healing environment where they can focus on improving their health. Not only can we help individuals to end their physical addictions, but we also focus on emotional and mental health. Our goal in treatment is to give struggling individuals the resources and support they need in order to begin the road to recovery. So, if you are ready to take a step toward freedom, just reach out to us. Let our team of licensed professionals and certified substance use counselors help you today!

References:

https://www.nami.org/learn-more/mental-health-conditions/bipolar-disorder

https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.