Substance/Medication-Induced Bipolar or Related Disorder
Management and Resources
At home
Some basic suggestions which may help improve substance-induced bipolar disorder over time:
An individual should inform their provider of the use of all substances, including alcohol. They are there to offer guidance regarding safely withdrawing from substances. In some cases, inpatient detox is recommended to ensure a medically safe withdrawal process. Many receive rehabilitative treatment and also consider joining a twelve-step group, such as Alcohol Anonymous or Marijuana Anonymous.
If an individual's symptoms seem to be escalating and if they are feeling at risk of harming oneself or others, they are encouraged to reach out to their provider or go to the nearest emergency department, if needed.
Dealing with weight gain
A common complaint about antipsychotics is that they cause many people to gain weight. The mechanism by which this happens is unclear: For some individuals, antipsychotics cause increased appetite or cravings for carbohydrates. For others, the medication changes their metabolism. Regardless of its cause, there a couple ways to combat medication-related weight gain:
Improving one’s diet and increasing daily exercise is particularly difficult while depressed. However, it is one of the best ways to manage weight gain related to medications. Remember to start small, and give oneself grace if this is too difficult to do during an episode of depression.
Some individuals feel that side effects, including weight gain are intolerable. This is when direct communication between client and prescriber is essential.
At work
Substance-induced bipolar disorder tends to affect all parts of one’s life, including life at work. It can lead to tardiness, absenteeism, missing details, and lower productivity. In some cases, work scenarios and related stress can contribute to one’s depression. Unsupportive work cultures, or demanding environments can contribute to burnout, and amplify the symptoms of depression.
Getting treatment can make work and life, in general, feel more manageable. In the meantime, there are a few steps one can try in order to move forward:
Check in with the human resources team to learn about the services available, including an employee assistance program or additional mental health services. This is a benefit many organizations have begun to offer.
Find out the mental health and substance abuse insurance benefits that are available.
Self compassion and giving oneself grace is encouraged as is taking self care measures, utilizing healthy stress management strategies and obtaining social support.
If needed, discuss taking time off for attending rehab, appointments, and self care.
No one needs to tell anyone at work about their mental health challenges, nor do they need to keep it a secret. The amount they share is their choice, though some people find it useful to share that they are having a rough patch with a colleague or supervisor. Well trained managers understand that individuals experiencing a mental health problem might need a modification in their work responsibilities for a period of time.
Finding support
Having a friend, preferably at work, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share one's stories in a confidential and dignified way.
Some people who work in an unsupportive and high pressure job environment consider a job change: As a general guideline, it can be helpful to think about postponing making life-changing decisions about work and relationships while in the midst of a mental health crisis, and that big decisions such as a job change are best made when intense symptoms have subsided, for at least several weeks.
Some individuals report that it has benefited them to discuss work modifications with their employer while getting treatment. Others may feel strongly that sharing with employers is not an option
At school
Mania and depression tend to affect all parts of a person’s life, including academics. This can lead to tardiness, missing details, problems with focus, and absences. When depressed, it is important to remember that getting treatment might make one's school scenario feel more manageable. In the meantime, there are a couple points to consider when attempting to move forward:
School administrations may offer student counseling services. Given the abundance of stress related to exams, and school performance, it is common for students to feel overwhelmed, depressed, and in need of support. Reach out to a dean or student services for information.
Adopt an attitude of self compassion and a sense of personal grace, self acceptance and forgiveness. For some in a depressed state, simply keeping in mind that they might need to take a break every so often is helpful. Or, reminding oneself that everyone makes mistakes, and goes through rough patches at some point or another. Remember that one's productivity requires feeling energized, and these breaks and moments of self-forgiveness are important.
Find support: Having a friend, preferably at school, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share memories and stories in a confidential and dignified way.
No one needs to tell anyone at school about their bipolar disorder, nor does a person need to keep it a secret. Whether and how much to share is up to the individual. Teachers and administrators often understand that individuals experiencing depression might need a modification in their coursework for a period of time.
In relationships
Substance-induced bipolar disorder can have an impact on relationships in many ways. Partners or friends who do not have this disorder can find mental health challenges difficult to understand. They may expect others to be able to “snap out of it,” which can add to one's feelings of loneliness or sadness. Manic states may also be difficult for others to understand or cope with. Even so, communication, when possible, can help bridge the gap in understanding. Sometimes, being open during these struggles can fortify relationships.
Mental health symptoms outside of the core condition may also bring challenges to a relationship. If an individual is depressed, they may be less likely to want to plan activities together or socialize with others: they may want to sleep more and eat less. Conversely, if they are manic, they may think they can accomplish amazing feats in record time, even when these accomplishments seem impossible to everyone else (and are impossible). It is critical that both parties in the relationship focus on treatment, and to remember that this lack of interest is temporary. In most cases, the right combination of therapy and medication restores a person.
Couples counseling can be a fantastic tool for improving relationship quality when one or more partners struggles with depression. It can help both parties empathize with the other, and to find ways to best support one another. For some people, medications sometimes can impact their sex lives. If an individual is experiencing low libido, erectile dysfunction, etc... There is hope: The first step to addressing this issue is to acknowledge it, but we know that sharing this type of sensitive information with one’s partner or provider is not always easy. Also keep in mind that people in a manic state of bipolar disorder or even a hypomanic state may want a lot more sex than they normally choose to engage in.
A couple steps individuals might try include:
- Try a new routine with one's partner such as exercising before sex, or incorporating new types of stimulation into one's routine.
- It is possible that when one's depression improves, their libido will also improve: Research has shown that depression can cause these effects with or without taking an antidepressant.
- One's provider may adjust their dose of medication to find a level which balances effectiveness with libido.
- Some commonly known medications for erectile dysfunction (Viagra, Cialis, etc..) can be helpful to antidepressant induced sexual dysfunction in men.
If these recommendations don’t work, a different type of medication that has fewer sexual side effects might be the next step.
Within the family
Mania and depression have a genetic component, and it can look different within the family. In children, for example, depression can manifest as anxiety or fear, and develop into depression after hitting puberty. Mania may present as euphoria. Parents who have struggled with their own depression or mania can be vigilant of their children. In addition, the children of substance abusers are themselves at risk for developing a substance use disorder. Getting early treatment for one's own children if needed could eliminate years of potential suffering.
Organizations & resources
American Psychological Association