Substance Abuse and Bipolar Disease - Research Paper Example

? Bipolar Disease and Substance Abuse Substance abuse and bipolar disease are some of the major mental disorders which create problems to the individual, family and the community in which he/she stays. Bipolar diseases and substance use disorder co-occur at higher rates than one would normally expect. However, it is not necessary that all the people with substance abuse behaviour may have bipolar diseases. Same way it is not necessary that all the people with bipolar diseases may have substance use disorders (SUD). At the same time it is an accepted fact that majority of the people with bipolar disease have the habit of substance abuse which forced medical science to study these two mental disorders together. The exact reasons for the close association of bipolar disease and substance abuse are still unknown to medical science. This paper analyses bipolar disorders, substance abuse or substance use disorder and the relationship between the two. Bipolar Disease and Substance Abuse “Bipolar disorder is a chronic enduring mental illness characterised by periods of elation and depression in mood. A lifetime history of alcohol misuse is one of the more common co-morbidities occurring in about 46% of people with bipolar I disorder” (Saunders and Goodwin 2010). Bipolar disorders were earlier referred as manic depression. Constant and continuous mood swings are one of the major symptoms of bipolar disorder. Within a short period of time, a person with bipolar disorder may show extremities of mood; He can demonstrate the feeling of sadness, hopelessness and helplessness at a particular moment and in the very next moment he can feel like on top of the world. One of the major characteristics noticed by the psychologists about Bipolar disorders is the fact that majority of these patients show substance use disorders (SUD) also. For example, alcoholism and drug abuses are seen common among people with bipolar disorders. Even though many studies and researches are still going on, the exact reason for bipolar disorders and substance abuse are still unknown. Heredity and environment play an important role behind all psychological diseases and many people are of the view that these parameters contribute heavily to bipolar diseases and SUD’s. Bipolar diseases Based on the severity of disease, bipolar diseases are often classified into two; bipolar 1 and bipolar 2. Bipolar 1 is more severe than bipolar 2. People with bipolar 1 disease need hospitalization whereas bipolar 2 do not need hospitalization. “Mania is seen in bipolar 1 and hypomania is seen in bipolar 2” (Fast &Julie A Fast (Author) › Visit Amazon's Julie A Fast Page Find all the books, read about the author, and more. See search results for this author Are you an author? Learn about Author Central Preston, 2006, p.20). People with bipolar 2 may not show many changes in their normal behaviors whereas people with bipolar 1 diseases will show many changes in their normal behavior patterns and they may experience hallucinations, delusions, paranoia etc. It is possible that a person with bipolar disease may induce self harm. In many cases, these patients may attack others also. Aggression is one of the major characteristics of bipolar 1 disease. The reasons for bipolar disorders are still unknown. However, as in the cases of other psychological disorders, heredity and environment play an important role in causing bipolar disorders to a person. Long (2005) has pointed out the role of heredity in causing bipolar disorders; About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder. If one parent has Bipolar I Disorder, the child will have a 25% chance of developing a mood disorder. If both parents have Bipolar I Disorder, the child has a 50%-75% chance of developing a mood disorder. (Long, 2005) The above results clearly show that bipolar disorders have strong association with heredity. No studies succeeded yet in singling out a particular gene which causes bipolar diseases. Moreover, it is not necessary that all the children born to mentally disordered parents may become mentally disordered. However, the chances of occurrence of psychological disorders among such children are more than that among the normal children which is evident from the above statistics. It is difficult to point out a single most prominent reason for bipolar diseases. In many cases, bipolar diseases were caused by more than one reason. Even though the studies. It is assumed that introvert personalities are more vulnerable to bipolar disorders compared to extrovert personalities. “Researches pinpointed that individuals who are surrounded by an environment high in criticism and hostility are more likely to relapse shortly after they are discharge from the hospital or from a treatment program” (What is Bi polar disorder?, 2007). The above finding clearly shows the involvement of environmental factors in causing bipolar disorders. People always like to lead a happy life. But the environment does not provide the parameters needed to lead a happy life always. In many cases, the environment provides disappointing parameters which will generate frustration and stress among the people. Those who have more mental or will power may survive the environmental pressure whereas those who with less mental power may become mentally disordered. Cataldo et al (2010) have pointed out that Mitochondria from patients with BD exhibited size and distributional abnormalities compared to that of the normal people (Cataldo et al 2010). Andreazza et al (2010) have also concluded that “mitochondrial dysfunction may be potential therapeutic targets for bipolar disorder’ after a comprehensive research (Andreazza et al 2010). Mitochondria help the cells to convert energy and nutrients into useful forms. It is the power generators in cells. In other words people with bipolar disorders may have some abnormalities in their physiology. In short, biological or physiological reasons can also cause bipolar disorder. Substance abuse or substance use disorder Substance abuse refers to a habit in which people make use of substances such as alcohol, drugs etc for changing their moods temporarily. Even tobacco use is also grouped in the category of substance abuse. However, tobacco use may not make many changes in the moods of a person just like alcohol or narcotic drugs. So when we talk about substance abuse we usually refer to the abuse of substances like alcohol and narcotic drugs which can change the moods immediately. The regular uses of these substances will make them substance dependent. For example, a person who consumes alcohol may become alcohol dependent, if he continues his drinking habit. Narcotic drugs can also change the moods of a person. The regular use of narcotic drugs may make the person drug dependent. We are living in a highly tensed world in which people struggle to fulfil their commitments. The responsibilities of the current generation are more than that of the older generation. Current people have lot of personal, professional, social and family commitments. It is difficult for him to show justice to all these commitments. The failure in showing justice to these commitments will result in the development of stress or negative moods. In order to get rid of these negative moods or thoughts, people often take shelter in alcohol and narcotic drugs. As in the case, of bipolar disorders, heredity and environment play an important role in the making substance abusive characteristics in the minds of a person. People brought up in an unhealthy environment are more vulnerable to substance abuse than the people brought up in a healthy environment. Same way the probabilities of children becoming substance abusive is more in the case of children of parents with substance abuse behaviour. In short, most of the reasons cited for bipolar diseases and substance abusive behaviour are similar in nature. Relation between Substance abuse and bipolar disease “It has been suggested that alcohol may help alleviate early symptoms of mania. Individuals with bipolar disorder are also more likely to drink when in a depressed state than individuals with unipolar depression”(Saunders and Goodwin, 2010). Moreover, Last (2009) has also pointed out that substance abuse especially alcohol abuse is prevalent among people who have bipolar disease” (Last, 2009, p.188). In short, many of the researchers and scholars who researched about substance abuse and bipolar disease came to a conclusion that both bipolar disorders and substance abusive behavior may have some close connections. However, they failed to pinpoint a specific reason for that. Verduin et al (2005) have also pointed out that “substance abuse is associated with more mixed depressive-manic episodes, increased frequency of mood swings, and more hospitalizations in bipolar patients currently abusing substances than in bipolar patients without SUDs” (Verduin et al 2005). Bipolar diseases always cause mental agitations to a patient. It is difficult for a person with bipolar disease to stay long in the same agitated mental state. In order to escape from such agitated mental state he will deliberately look for options to changes his moods. Naturally, alcohol and narcotic drugs will appear in front of him as an option and he will accept it. Although the literature establishes a strong association between bipolar disorder and substance abuse, the direction of causality is uncertain. An association is also seen with anxiety disorders, attention-deficit/hyperactivity disorder, and eating disorders, as well as cyclothymia and other axis II personality disorders (Krishnan, 2005) The association of substance abuse with many of the other psychological disorders made it difficult to pinpoint substance abuse as the single most visible symptom of bipolar disorders. Last (2009) has pointed out that it is not necessary that substance abuse will automatically cease once the bipolar disease is under control (Last, 2009, p.49). In fact bipolar disease is one among the several other reasons for substance abuse. For example, it is quite possible that person abuse substance just for enjoyment. Many of the youths who are addicted to alcohol and narcotic drugs are not mental patients. In fact they are misusing the substances for enjoyment. At the same time, it is obvious that prolonged or regular use or misuse of alcohol and narcotic drugs like substances may result in the development of bipolar diseases. Integrated group therapy is one of the major treatment options available for bipolar patients with bipolar diseases and substance abusive behavior. Integrated group therapy consists of 20 weekly hour-long meetings; it employs a cognitive behavioural relapse prevention model that integrates treatment by focusing on similarities between recovery and relapse processes in bipolar disorder and substance use disorder. A foundation of integrated group therapy is that the same types of thoughts and behaviours that facilitate recovery from one disorder will enhance the likelihood of recovery from the other disorder. Conversely, similar types of thoughts and behaviours can impede recovery from both disorders (Weiss et al, 2007) Bipolar diseases and substance use disorders cannot be treated with the help of medicines alone. In fact the services of a psychologist are as important as the services of a psychiatrist in treating bipolar diseases and substance abuse. Instead of treating the disease, it is necessary to treat the causes of the diseases in order to get better result. If we treat only the disease, and leave the causes of the diseases unattended, the reoccurrence rate of the disease may increase. In order to avoid that it is necessary to treat both the disease and the causes of disease simultaneously. In integrated group therapy, the procedure is aimed to achieve the above objectives. Since integrated group therapy aims the settlement of both the disease and the cause of disease, it will take more time than usual treatment procedures. Conclusions Bipolar disease and substance abuse behaviour are seen commonly among some of the mentally disorders peoples. Both these mental disorders are caused by same factors which is the reason why these two diseases occur simultaneously to a person. Along with heredity and environmental factors, biological factors can also contribute to these disorders. Substance abuse is one of the major symptoms of many of the other psychological disorders and it is difficult to conclude that all the people with substance abuse behaviours may have bipolar diseases. At the same time, the chances of occurrence of bipolar disease among people with substance abuse behaviour are more than that among other people. Integrated group therapy is often advised as the major treatment option available for the people with bipolar disease and substance use disorder. References 1. Andreazza A.C; Pharm D, PhD; Shao L, PhD; Wang J, PhD and Young L.T, MD, PhD Mitochondrial Complex I Activity and Oxidative Damage to Mitochondrial Proteins in the Prefrontal Cortex of Patients With Bipolar Disorder. Journal of American Medical Association Vol. 67 No. 4, April 2010 Retrieved from http://archpsyc.ama-assn.org/cgi/content/abstract/67/4/360 2. Cataldo A.M. McPhie D.L, Lange N.T., Punzell S., Elmiligy S., Ye N.Z., Froimowitz M.P., Hassinger L.C., Menesale E.B., Sargent L.W., Logan D.J., Carpenter A.E., and Cohen B.M (2010). Abnormalities in Mitochondrial Structure in Cells from Patients with Bipolar Disorder. American Journal of Pathology. Retrieved from http://ajp.amjpathol.org/cgi/content/abstract/177/2/575 3. Fast J.A &Julie A Fast (Author) 1. › Visit Amazon's Julie A Fast Page 2. Find all the books, read about the author, and more. 3. See search results for this author 4. Are you an author? Learn about Author Central 5. Preston J. (2006). Take Charge of Bipolar Disorder: A 4-Step Plan for You and Your Loved Ones to Manage the Illness and Create Lasting Stability. Publisher: Warner Wellness; 1 edition (September 26, 2006) 4. Krishnan, R.R., MB, ChB (2005). Psychiatric and Medical Comorbidities of Bipolar Disorder. Psychosomatic Medicine 67:1-8 (2005) American Psychosomatic Society . Retrieved from http://www.psychosomaticmedicine.org/content/67/1/1.abstract 5. Last C.G. (2009). When Someone You Love Is Bipolar: Help and Support for You and Your Partner Publisher: The Guilford Press; 1 edition (April 16, 2009) 6. Long, P.W. MD. (2005). Bipolar Disorder. Retrieved from http://www.mentalhealth.com/dis/p20-md02.html 7. Saunders K. E. A. and Goodwin G.M. ( 2010). The course of bipolar disorder. Advances in Psychiatric Treatment. 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