Adolescents, Bipolar Disorder and Drugs

September 30, 2022 0 Comments

Wherever you go, if there are teenagers, there can be drug abuse, whether in high schools or on college campuses. Marijuana is the most common, but there are many others. Adolescents with bipolar disorder are particularly vulnerable to the misuse of these dangerous substances, as a form of self-medication. While drug abuse is common among teens, consider the fact that some of our kids may have pre-existing mood disorders that can make things worse.

Bipolar disorder is characterized by drastic changes in mood over hours, days, or weeks. Patients can feel depressed and tired and then go into an expansive, grandiose mood out of the blue. It is what the psychological literature calls a manic or hypomanic episode. On both sides of the spectrum, children are at risk of using drugs or alcohol.

When they are depressed, marijuana can help them take their mind off their pain. Cocaine can give them a jolt. Alcohol can count them to life. When high, marijuana can slow everything down, cocaine can make a person more charged, and alcohol is a great social lubricant. When a teenager is manic, he has no real judgment. The moment, right now, is all that counts. The drug in front of him is the drug he will usually use. I have seen bipolar teens abuse just about everything: LSD, ecstasy, heroin, mushrooms, PCP, marijuana, cocaine, methamphetamine, Oxycontin, and others. On college campuses, children often crush and snort the ADD drug, Adderall.

This combination of bipolar disorder and drug use is one of the toughest treatment cases that we psychiatrists have to deal with. You can’t treat a bipolar case when they’re using drugs, period. The patient must become abstinent. This is because the drugs exacerbate the disorder or cover it up. I have had tremendous success in treating these cases where the patient has agreed to stop the abuse. The process then turns into giving them the standard treatment for bipolar disorder: medication to stabilize their mood and psychotherapy to help them understand and prevent future problems.

The hard part about treating a drug-abusing bipolar teen is staying with them long enough for them to accept real treatment, one that involves getting off drugs and drinking. For some, they hit rock bottom early and get help. For others, they do themselves and others great harm before they are mature enough to benefit from good treatment. It is like riding a wild horse, which requires skill and endurance. These young people often get better, but try to help them minimize the damage they can do to themselves along the way.

I am writing this article because many parents will recognize their child here. My general recommendation is to treat the chemical dependency, get it under control, and everything can go smoothly from there. In most major hospitals you will find dual diagnosis units. Find one that has a solid twelve-step model as well as a program for treating bipolar disorder.

Success is attainable. Do not despair.

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