Teenagers, Bipolar Disorder, and Drugs

Teenagers, Bipolar Disorder, and Drugs

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

Bipolar disorder is characterized by dramatic changes in moods over hours, days, or weeks. Patients can feel depressed and weary and then swing to an expansive and grandiose mood out of nowhere. It’s what the psychological literature calls a manic or hypomanic episode. On both sides of the spectrum kids are at risk to use drugs or alcohol.

When they are depressed, marijuana can help them not think about their pain. Cocaine can give them a jolt. Alcohol can numb them to life. When they are high, marijuana can slow everything down, cocaine can just make the person more charged, and alcohol is a great social lubricant. When a teen is manic, he has no real judgment. The moment, right now, is all that counts. The drug that is in front of him is the drug he’ll generally use. I have seen bipolar teenagers abuse just about everything: LSD, ecstasy, heroine, mushrooms, PCP, marijuana, cocaine, meth, Oxycontin and others. On college campuses, kids often crush and snort the ADD medication, Adderall.

This combination of bipolar disorder and drug use is one of the toughest treatment cases that we psychiatrists have to deal with. You cannot 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’ve had tremendous success in treating these cases when the patient has agreed to drop their abuse. Then the process becomes giving them the standard treatment for bipolar disorder – medication to stabilize their moods and psychotherapy to help them understand and help prevent future issues.

The hard part of treating the bipolar, drug abusing teen is staying with them long enough to get them to buy into a real treatment, one that involves giving up drugs and drinking. For some, they hit bottom early and get help. For others, they cause themselves and others great damage before they mature enough to benefit from good treatment. It is like riding a wild horse, requiring skill and stamina. These young people often get better, but you have to try to help them to minimize the damage that they can do to themselves along the way.

I’m writing this article because many parents will recognize their child here. My recommendation in general is to treat the chemical dependency, get them under control, and everything can flow well from there. In most major hospitals you’ll find dual diagnosis units. Find one that has a strong twelve-step model as well as a program to treat the bipolar disorder.

Success is accessible. Don’t despair.