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Highlights of a Lecture by Roger Weiss, M.D.,
Director, Alcohol and Drug Abuse Treatment Center, McLean Hospital
April 28, 1999

General Information About Mood Disorders & Substance Abuse:

  • People with bipolar disorder are 11 times more likely to abuse substances (alcohol or drugs) than the general population.
  • Substance abuse is the single most common predictor of bad outcomes for people with mood disorders.
  • Cocaine and amphetaimines are the leading substances that precipitate manic episodes. Hallucinogens are second, followed by marijuana (in some people).
  • Alcohol is the leading precipitator of depressive episodes.
  • Some people with bipolar illness self-medicate to reduce symptoms such as hypomania, while others self-medicate to enhance their symptoms
  • Some people with bipolar disorder and substance abuse issues will choose between substances and medication because they don't want to mix the two. This can lead to major problems when the medication is foregone in favor of the substance.
  • Early substance abuse problems often result in errors of omission, like you just forget to do something. Later problems are more typified by doing the wrong thing outright.
Why Substance Abuse Problems Are So Common For People With Mood Disorders:
  • When people with mood disorders get depressed they may try to drink or drug their mood away, even if they are aware of their substance abuse problem.
  • Substance abusers and people with mood disorders often have similar thought patterns: they are often pathologically optimistic.
  • The opposite of the above is also true: healthy thought patterns that help you get out of substance abuse can also help with mood disorders.
How To Tell If You Have A Substance Abuse Problem:
It is important to note that substance abuse problems come in all shapes and sizes, regardless of whether the person has bipolar disorder/manic-depression. The situation is also not black or white - substance abuse problems are not necessarily something you have or something you don't.

The following are some key indicators that a substance abuse problem may be present:

  1. Having more than you intended at a given time, and this happens unpredictably. For example, if you intended to have only 3 drinks and end up having 6 or 8 or more.
  2. Repeated unsuccessful attempts to cut back or stop.
  3. Preoccupation with alcohol or drugs or they play an increasing role in your life.
  4. Substances interfere with your functioning or with your psychiatric treatment. Family problems are often the first to emerge when there is a drinking problem, while money & legal problems often emerge first if there is a drug problem. Treatment problems can include not taking medications, missing appointments, etc.
To order an audio tape of this lecture please call 617-855-2795.

For more information on treatment for mood disorders & substance abuse contact McLean Hospital or see our resource directory .

Email or Contact us at 617-855-2795
Our Office Hours: Tues-Wed-Thurs, 11:00 am - 4:00 pm
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PO Box 102. 115 Mill Street. Belmont, MA 02478. Fax: 617-855-3666
Last Update: November 27, 2005

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