Two Problems, One Innovative Solution
by Dr. Richard Frances and Nancy Helle

Bipolar disorders affect more than 5 million Americans and about 60 percent of the patients with these psychiatric problems or mood disorders also have alcohol or drug problems. Silver Hill continually studies how these disorders interact.

The outlook for treatment of these problems is encouraging. Educational programs are gradually creating public awareness that mental disorders and substance abuse are not signs of character weakness, but of diseases that can be treated. As a result, more people are seeking treatment. Also, new psychopharmaceutical drugs, such as depakote, are effective mood stabilizers for treating the bipolar disorders most likely to occur with substance abuse problems. At the same time, they are good agents to treat alcohol withdrawal symptoms.

Seventy percent of the time, people develop alcohol problems before they are diagnosed with bipolar disorder. The substance abuse may bring about the disorder, or it may be that bipolar people tend to self-medicate with alcohol or drugs. It’s the combination of both disorders that often leads them to need hospitalization.

Early diagnosis and treatment of either disorder might prevent complications of the other problem. When both are present, alcohol problems must be treated first or “in synch” with the other disorder, because if the person is drinking, he or she will fail to respond to the treatment.

Patients who have bipolar disorders should consider that they may also have an alcohol problem when they find themselves drinking to relieve depression, drinking during a manic episode, encountering medical, work or legal problems related to drinking, or if there is a family history of alcoholism. Alcoholics in recovery might suspect a bipolar disorder if they find themselves skipping their 12 step meetings, having frequent mood swings or suicidal thoughts or if there is a family history of bipolar disorder.

Both of these problems are brain diseases and we need to get away from any moral stigmas. We should have compassion and understanding for these people who have two illnesses and need treatment. #

Dr. Frances is President and Medical Director of Silver Hill Hospital in New Canaan, CT, one of the top programs for treating substance abuse and bipolar disorder. For more information, call 1-800-899-4455 x2222.

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