Combining cocaine with bipolar disorder may amplify the symptoms of the disorder, make decision-making difficult and result in increasingly reckless behavior.
Article at a Glance
People living with bipolar disorder may start using cocaine to cope with their symptoms.
Using cocaine and other stimulants to counteract the depressive period of bipolar disorder can worsen symptoms instead of improving them.
Cocaine use disorder and bipolar disorder sometimes have similar symptoms, which can make it difficult to differentiate between the two disorders.
Using cocaine for an extended period can also cause cocaine-induced psychosis, which causes hallucinations and paranoia.
Bipolar disorder is a group of mental health disorders that can often be managed with psychotherapy, medication or both. Symptoms of bipolar disorder are typically related to extreme mood swings and changes in behavior and energy levels. Bipolar disorder was previously referred to as “manic depression” due to the hallmark symptoms of mania or hypomania that distinguish it from other mood disorders.
Cocaine is an addictive stimulant drug that can result in a euphoric high, a rush of energy and feelings of confidence. It can also cause symptoms of anxiety, mania or psychosis. One of the many reasons cocaine can be dangerous is its unpredictable effect on a person’s brain and body.
How Cocaine Affects Bipolar Disorder
Cocaine use is more highly prevalent among people with bipolar disorder compared to the general population. Combining cocaine use with bipolar disorder may amplify the symptoms of the mental condition, make judgment and decision-making difficult and result in reckless behavior.
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 brain’s functionality and is linked to 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. It is thought that most mental conditions, including bipolar disorder, involve imbalances in the dopamine system of the brain. When someone uses cocaine, especially for an extended period of time, symptoms of mental disorders can worsen.
Bipolar Disorder and Cocaine Use
Someone living with bipolar disorder may find it difficult to manage their symptoms and look for ways to cope, even if they’re unhealthy. The symptoms of bipolar disorder can be incredibly challenging and leave a person feeling exhausted. During a low period, a person with bipolar disorder may use stimulants like cocaine to experience increased energy, focus and sociability.
Because stimulants are highly addictive, people who use cocaine as a coping strategy for bipolar disorder symptoms may go on to 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 thinking during withdrawal from the stimulant.
Bipolar Disorder and Cocaine Side Effects
There can be adverse effects when someone uses cocaine, including 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 bipolar disorder can compromise many functions of the brain. 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
A Note on Crack Cocaine
Crack cocaine is a mixture of cocaine, water and ammonia or baking soda. It is typically smoked in pieces referred to as “rocks” and instantly affects the brain. While the law treats crack possession more harshly than cocaine possession, they are chemically almost identical, so their interactions with bipolar disorder may be very similar.
Does Cocaine Cause Bipolar Disorder?
Bipolar disorder is a complex brain disorder that is caused by multiple factors. While cocaine doesn’t necessarily cause bipolar disorder, chronic use can lead to similar symptoms, including grandiosity, paranoia, loss of appetite and euphoria. Withdrawal can also mirror or worsen a depressive episode.
The symptoms of being high and then crashing may appear similar to those associated with bipolar disorder. For example, when someone takes cocaine, they typically get a rush of energy and may feel overly self-confident. As they come down from a cocaine high, they may feel withdrawn, anxious and depressed. This overlap in symptoms is one reason why cocaine addiction and bipolar disorder have a challenging association.
Some people who use cocaine can also develop drug-induced psychosis, which may involve visual hallucinations and delusions that cause them to see reality differently than how it is. Symptoms of drug-induced psychosis can mimic symptoms of schizophrenia. In addition, people with co-occurring bipolar and cocaine use disorder can develop erratic behavior or disorganized thoughts and speech.
Similarities Between Cocaine Use and Bipolar Disorder
The symptoms of cocaine and bipolar disorder can appear similar to one another, so people may incorrectly believe they developed bipolar disorder from using cocaine. However, it is possible that the person may indeed have bipolar disorder and require treatment for both disorders at the same time. Cocaine and bipolar disorder share some of the same symptoms, so it can be difficult to identify the differences between each disorder. Some of the shared symptoms of cocaine use and bipolar disorder may include:
- Increased energy and mental alertness
- Unusual talkativeness
- Disorganized thoughts
- Racing thoughts
- Increased sex drive
- Increased recklessness
Bipolar and Cocaine Addiction Treatment
If someone thinks they have cocaine use or bipolar disorder, it’s important they speak with a professional to receive a proper assessment and diagnosis. Co-occurring disorders can be treated in a professional facility that understands how to treat both addiction and an underlying mental health condition.
The first step of treatment for co-occurring disorders may be detox. If someone has been using cocaine for an extended period, they’ll need to go through some sort of detoxification from the substance, so their body adjusts to not having the drug. It’s helpful to detox under the supervision of a professional because of the symptoms associated with cocaine withdrawal.
In addition to detox, the person may start treatment for their cocaine use as well as their bipolar disorder. The type of treatment used will likely be determined by a variety of factors, including the person’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)
Some typical treatment pathways include:
Therapy may also be combined with medication. Some medications commonly used for bipolar disorder treatment include:
- Mood stabilizers (lithium)
- Antidepressants (though this class of medications is controversial in the treatment of bipolar disorder)
It’s most effective if a person diagnosed with a co-occurring disorder, including bipolar and cocaine use disorder, gets treatment for both disorders at the same time.
If you or someone you know is struggling with substance use or a co-occurring disorder like bipolar disorder, help is available. At The Recovery Village, a team of professionals can design an individualized treatment plan to suit your needs. Call and speak with a representative to learn more about which treatment program could work for you.
Ashok, Abhishekh; Marques, Tiago; Jauhar, Sameer; Nour, Matthew; et al. “The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment“>The dopa[…]for treatment.” Molecular Psychiatry, March 14, 2017. Accessed August 28, 2021.
Drug Policy Alliance. “What is the difference between cocaine and crack?“>What is […]ne and crack?” AAccessed August 28, 2021.
Hunt, Glenn; Malhi, Gin; Cleary Michelle; Lai Harry; et al. “Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990-2015: Systematic review and meta-analysis.” Journal of Affective Disorders, July 9, 2016. AAccessed August 28, 2021.
National Institute on Drug Abuse. “Cocaine DrugFacts“>Cocaine DrugFacts.” April 2021. Accessed August 28, 2021.
National Institute of Mental Health. “Bipolar Disorder“>Bipolar Disorder.” January 2020. Accessed August 28, 2021.
Sabe, Michel; Nan Zhao; Kaiser, S. “A systematic review and meta-analysis of the prevalence of cocaine-induced psychosis in cocaine users.” Progress in Neuro-Psychopharmacology and Biological Psychiatry, January 29, 2021. Accessed August 28, 2021.
Substance Abuse and Mental Health Services Administration. “Co-occurring disorders“>Co-occur[…]ing disorders.”
August 9, 2021. AAccessed August 28, 2021.
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