Bipolar disorder is a major risk factor for developing a substance use disorder. One study found that among people with bipolar disorder, 56 percent developed a substance use disorder at some point in their lives. By comparison, just over eight percent of American adults have a drug or alcohol use disorder. Bipolar disorder massively increases your risk of developing a substance use disorder and it is also one of the most commonly misdiagnosed mental health issues. One survey found that nearly 70 percent of people with bipolar disorder were initially misdiagnosed and more than one-third of those people remained misdiagnosed for at least 10 years. Other studies have found similarly discouraging results. Getting the wrong treatment for bipolar disorder may actually make symptoms worse and increase your risk for developing a substance use disorder. Here are the most significant characteristics of bipolar disorder.

Depressive episodes

The most conspicuous aspect of bipolar disorder is typically major depression. Symptoms of a depressive episode include depressed mood, fatigue, inability to feel pleasure, poor concentration, slow movements, irritability, sleep disturbance, weight changes, physical aches, and thoughts of suicide or death. To be diagnosed with depression, you must have five symptoms, including depressed mood and inability to feel pleasure, or anhedonia, for at least two weeks.

Depressive episodes that are part of bipolar disorder are the same as those of unipolar major depression, which is the main reason bipolar is so frequently misdiagnosed. People tend to go to the doctor when they feel awful, not when they feel great. If your doctor or therapist doesn’t know about your manic episodes, there’s no reason to suspect the less common bipolar disorder.

Manic or hypomanic episodes

Manic episodes are what distinguish bipolar disorder from unipolar major depression. Symptoms of a severe manic episode may include delusions of grandeur or persecution, racing thoughts, high energy, little need for sleep, starting ambitious projects that don’t go anywhere or engaging in reckless behavior such as unsafe sex or drug use. A severe episode may result in a psychotic break or hospitalization.

However, most people with bipolar don’t experience manic episodes of that intensity. They may instead experience milder, hypomanic episodes, which are typically characterized by little need for sleep, lots of energy, hyper-productivity, and a good mood that may occasionally tip into anxiety. Some people actually enjoy these hypomanic episodes or at least enjoy the increased productivity that comes with them.

Contrary to popular belief, people with bipolar don’t typically swing from one extreme to the other in a matter of hours or days. An episode of depression may last weeks or months then go away. Then later, a manic or hypomanic episode might begin. Often these episodes are triggered by seasonal patterns or changes in routine, like daylight savings time or jet travel.


At Fort Behavioral Health, we offer a safe, nurturing, and healing space for men and women to find recovery from the multifaceted disease of addiction. Our team believes in inspiring each client to face their challenges, discover the root of their problems, and reclaim their lives. If you or a loved one are struggling with addiction, call us today at 844.332.1807 or contact us through our admissions page.


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