Can Cocaine Cause Bipolar Disorder?

Cocaine alters dopamine, which is an essential neurotransmitter for communication between the brain and the rest of the body. Dopamine is a critical part of the functionality of the brain, it is responsible for the processes controlling pleasure and reward, as well as movement.

In many instances, cocaine can also affect the parts of the brain that control memory, new information and emotions. Most mental conditions, including bipolar disorder, involve imbalances in the dopamine system of the brain. When someone uses cocaine, especially for an extended period, symptoms of mental disorders can either start to emerge or become worse.

When someone has bipolar disorder and they start using a substance like crack cocaine, the combination can put their lives in danger. Combining crack cocaine and a bipolar disorder may start varying episodes of mania and depression that can develop into a drug-induced psychosis.

There can be adverse effects when someone uses cocaine, one outcome may be the development or onset of bipolar disorder. These side effects can lead to aggression, hospitalization and a reduced tendency to take medicine as prescribed. The combination of cocaine use and a bipolar disorder can compromise many functions of the brain to be compromised. Some of the most common side effects of cocaine use combined with bipolar disorder include:

• Difficulty with decision-making
• Impulsive behavior
• Attention problems
• Problems with planning for the future
• Cognition issues

Because stimulants are highly addictive, people who have bipolar disorder and start using cocaine usually develop an addiction. Patients have reported that after using cocaine for an extended period, their symptoms worsen instead of improving. For example, instead of feeling pleasure or euphoria after using cocaine, patients reported feeling paranoid or irritated. Some patients even reported that they had suicidal ideations during withdrawal from the stimulant.

Cocaine isn’t necessarily the cause of a bipolar disorder, but it can lead to the development of a stimulant-induced psychosis. Drugs like cocaine and hallucinogens can lead to psychotic symptoms that are similar to bipolar disorder and schizophrenia.

Symptoms of drug-induced psychosis can include visual hallucinations and delusions that make someone see reality differently than how it is. Some of the symptoms of drug-induced psychosis, which are similar to bipolar disorder, include changes in emotion, lethargy, lack of motivation and withdrawing from social interactions. People with a bipolar and cocaine use disorder can also experience erratic behavior or disorganized thoughts and speech.

The symptoms of being high and then crashing can seem similar to those associated with bipolar disorder. For example, when someone takes cocaine they typically experience a euphoric high that leads to a rush of energy and feelings of self-confidence. As they come down from a cocaine high, they’ll likely feel withdrawn, anxious and depressed, and these symptoms can feel a lot like the symptoms of a bipolar disorder, which is why cocaine addiction and bipolar disorder are often so closely associated.

• Increased energy and mental alertness
• Optimistic
• Self-confident
• Irritable
• Aggressive
• Sleeplessness
• Disorganized thoughts
• Increased sex drive
• Increased recklessness

Physicians suggest that even though the symptoms of both disorders are similar, one difference to look for is that these symptoms will be even more pronounced in someone who is using cocaine.

The first step of treatment for co-occurring disorders is a detox. If someone has been using cocaine for an extended period, they’ll need to go through detoxification from the substance so their body no longer craves the drug. It’s important to detox in a treatment facility because of the dangers associated with cocaine withdrawal. After completing detox, the patient can enter therapy for both their cocaine use and bipolar disorder. The type of therapy used will be determined by the patient’s:

• Mental health diagnosis
• Overall health
• Social needs (relationships, health status)
• Goals for recovery 
• Potential threats to maintain sobriety (underlying behavioral disorders, learning disabilities, chronic disorders)
  In addition to therapy for their cocaine addiction, the treatment for their bipolar disorder may consist of therapy and medication. The types of therapy that a treatment provider may use includes:
• Psychotherapy
• Cognitive Behavioral Therapy
• Inpatient treatment
• Group or family therapy
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  The treatment provider will choose the best type of therapy to suit the patient’s treatment plan. They may also choose to combine therapy with medication. Some medications commonly used for bipolar disorder treatment include:

• Mood stabilizers (lithium)
• Anticonvulsants
• Antipsychotics
• Antidepressants
• Anti-anxiety
•  

  Clinicians typically try to avoid prescribing anti-anxiety medications because a large class of drugs in that category are benzodiazepines. This class of anti-anxiety medications has addictive tendencies and isn’t the best option for someone with a substance use and co-occurring mental health disorder because of the risk of addiction.