Mania And Addiction: Co-Occurring Disorders

Medically Reviewed by Johnelle Smith, M.D on April 19, 2021

Mania is a symptom of bipolar I disorder that commonly occurs with substance abuse, particularly alcohol abuse. The best way to treat mental health disorders and substance use disorders is through dual diagnosis treatment, which considers both conditions.

Dual Diagnosis Mania And Addiction

Mania, or manic periods, is a mental health condition that occurs in individuals with bipolar disorder.

It is common for individuals with mania to also abuse substances and become addicted, as this mental health disorder increases impulsive behaviors.

In many cases, the best way to treat mania and addiction is through a dual diagnosis bipolar treatment program. These programs offer an integrated approach that treats mania and substance abuse.

What Is Mania?

Mania is a period of extremely high energy or energetic mood associated with bipolar disorder. These periods typically last a week or longer.

In general, everyone’s mood and energy levels fluctuate throughout the day. But with mania, individuals experience a severe change from the way they usually act and think.

Often, mania is referred to as a manic episode. Manic episodes tend to last at least a week, up to a month at a time. Mania is different from heightened energy, though.

People with bipolar disorder experience dramatic “highs,” otherwise known as manic episodes, and “lows,” also referred to as depressive episodes.

Different Types Of Mania

People with bipolar disorder may experience two common types of mania:


It is essential to note that mania can include psychotic symptoms or a kind of psychosis.

This can look like the following:

  • experiencing hallucinations (seeing and hearing things others can’t)
  • speaking in a bizarre way that seems disorganized to others
  • becoming paranoid of friends, family, strangers, or organizations
  • feeling as though someone is watching you


Hypomania is a less intense type of mania, also known as bipolar II or cyclothymia. While the symptoms are similar to standard mania, the impact on daily life is less significant.

Mania can be considered different from hypomania because it does not cause a significant deficit in social or occupational functioning and typically lasts four days instead of a week or more.

Hypomania doesn’t involve psychotic symptoms and, because it is so much less severe than regular mania, often goes unreported.

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Signs And Symptoms Of Mania

When someone with bipolar disorder experiences a manic episode, they are likely to feel invincible.

Feelings of invincibility can lead to increased drug abuse and more risky behaviors like unprotected sex or spending unnecessary amounts of money.

Some potential symptoms someone experiencing mania may have include:

  • talkativeness
  • rapid speech
  • racing thoughts
  • reckless behavior
  • distractedness
  • jumpiness
  • increase in goal-oriented activity
  • increased energy
  • hyperactivity
  • irritability
  • restlessness
  • decreased need to sleep

In some cases, a manic episode can even lead to hospitalization.

Signs Of Substance Abuse

Some substances can increase the chance of a manic episode or mania occurring when they are misused—substances like cocaine or prescription stimulants such as Adderall.

Possible signs someone is misusing alcohol and drugs include:

  • abnormal mood swings
  • avoiding loved ones and responsibilities
  • lying about their whereabouts
  • increased and unexplainable spending
  • taking medications that are not theirs

Signs of substance abuse can vary from person to person, too. It is important not to confuse the symptoms of mania with the symptoms of substance abuse.

Why Do People With Mania Abuse Drugs And Alcohol?

In some cases, having bipolar disorder can increase the likelihood that someone will abuse drugs and alcohol. At the same time, abusing substances may trigger a manic episode.

Because people experiencing a manic episode are more likely to engage in risky behaviors, those with bipolar disorder are more likely to abuse substances while on a manic high.

Shared risk factors of mania and addiction can include:

  • genetics and family history of mania and addiction
  • physical brain structure
  • inability to regulate emotions
  • past traumatic experiences

Typically, bipolar disorder is diagnosed between teenage years and young adulthood. On occasion, bipolar symptoms can appear in children, too.

How Likely Is It For Someone To Have Mania And An Addiction?

Individuals who have both mania and a substance use disorder (SUD) have a dual diagnosis.

Mood disorders, like bipolar disorder, are the most common psychiatric conditions that occur with substance use disorders.

Researchers are not sure why individuals with bipolar disorder are more likely to have a co-occurring alcohol use disorder than a substance use disorder.

Consider the following statistics from the National Center of Biotechnical Information:

  • Three to five percent of the population in the United States is diagnosed with bipolar disorder each year.
  • Fifty-eight percent of individuals with bipolar I (mania) experience an alcohol use disorder at some point in their lifetime.
  • Thirty-eight percent of those with bipolar I (mania) experience a drug use disorder in their life.
  • A little more than 60 percent of people with bipolar I (mania) experience a drug or alcohol use disorder in their lifetime.

According to researchers, further investigation is required as to why these two disorders are highly likely to occur together.

Most Effective Treatment For Co-Occurring Disorders

Effective treatment plans for substance abuse and mania typically consist of a form of talk therapy as well as a combination of medications.

Dual diagnosis treatment is different from standard addiction treatment as it considers the symptoms of the co-occurring mental health disorder.

Formal dual diagnosis treatment can help many people deal with the severe forms of bipolar disorder, such as mania. Both mania/bipolar disorder and addiction require lifelong treatment.

Finding Dual Diagnosis Treatment For Mania And Addiction

Generally, many rehab centers across the United States offer dual diagnosis treatment programs.

These programs commonly start with inpatient treatment and transition into outpatient treatment as recovering persons learn to manage their substance abuse symptoms more thoroughly.

If you are looking for a dual diagnosis treatment program for yourself or a loved one, contact our addiction treatment helpline today.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D on April 19, 2021
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