The strong relationship between bipolar and substance‐use disorder

Abstract

Bipolar disorder and substance‐use disorders commonly occur in the same individual. In fact, bipolar disorder has a higher prevalence of substance‐use disorders than any other psychiatric illness. Individuals with both disorders have a more severe course of bipolar disorder, including earlier onset, more frequent episodes, and more complications, including anxiety‐ and stress‐related disorders, aggressive behavior, legal problems, and suicide. Bipolar and substance‐use disorders share common mechanisms, including impulsivity, poor modulation of motivation and responses to rewarding stimuli, and susceptibility to behavioral sensitization. Studies of potential treatments for bipolar substance‐use disorder have paid scant attention to the combined disorders. The most promising treatment strategies are those that address their shared mechanisms.