Bipolar Disorder and Substance Abuse

The assessment, diagnosis and treatment of these disorders when they are co-occurring is extremely challenging. They require a clinician who is aware differential diagnosis and the complexity of treatment for this population.

Treatment considerations
BD, alcoholism, and SUD are chronic relapsing disorders that require a longterm treatment approach to ensure continuity of treatment between episodes. It is important to emphasize preventive and recovery issues. Self-help activities, including participation in dual-diagnosis self-help groups and consumer advocacy groups, such as the Depression and Bipolar Support Alliance (www.dbsalliance.org), should be considered.

Psychotherapy has a crucial role in the overall treatment of patients who present with multiple psychosocial needs and dysfunctions. Psychotherapy also has an essential role in cementing the therapeutic alliance, enhancing treatment and medication adherence, and addressing relapse prevention and recovery issues.

Michigan is moving towards a more intergrated treatment for mental illness and substance use disorders. The benefits of treating these disorders in an intergrated system has been documented to improve relapse rates and recovery.

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