Bipolar disorder is a mental illness that can be managed and treated with medication. Symptoms of bipolar disorder are typically related to extreme mood swings and changes in behavior and energy levels. Bipolar disorder is also referred to as manic depression, because of the alternation between highs and lows. These changes can last anywhere from hours to months.

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 why drugs like cocaine are dangerous is because of their unpredictable effects on the brain and body.

a baggie of cocaine emptied out
Combining cocaine use with a 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 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.

Crack cocaine is a mixture of cocaine, water and ammonia or baking soda. Crack is typically smoked in pieces referred to as “rocks”. Crack cocaine and bipolar disorder can be a particularly dangerous combination, and it can often lead to severe emotional changes that can contribute to suicidal ideations or self-harm.

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
Someone living with a bipolar disorder may find it difficult to manage their symptoms and look for ways to cope, even if they’re unhealthy. The symptoms of a bipolar disorder can leave someone feeling exhausted so, during a low period of their condition, someone with bipolar disorder may use stimulants like cocaine to experience increased energy, focus and sociability.

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.

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 a bipolar disorder and treatment is necessary for both the disorders at the same time. Cocaine and bipolar disorder share some of the same symptoms, so it can difficult to identify the differences of each disorder. Some of the shared symptoms of cocaine use and bipolar disorder may include:

  • 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.

If someone thinks they have a cocaine use or bipolar disorder it’s important they speak with a professional to receive a proper 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 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:

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.

Some relevant facts to remember about cocaine and bipolar disorder may include:

  • People living with bipolar disorder may start using cocaine to manage or numb their symptoms.
  • Using cocaine and other stimulants to counteract the depressive period of bipolar disorder can worsen symptoms instead of improving them.
  • Cocaine use and bipolar disorders 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.
  • A person diagnosed with a co-occurring disorder, including a bipolar and cocaine use disorder, should get treatment for both disorders at the same time.

If you or someone you know struggles with a substance use or 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.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Share on Social Media: