The prognosis for successfully managing the mood swings of bipolar disorder is poor if the individual also has an untreated and active substance abuse problem, according to WebMD. Individuals with bipolar disorder and an addiction have a dual diagnosis and a greater risk for violence and suicide, reports Mayo Clinic.
Episodes of mania and depression can become more frequent or severe in an individual who is also abusing drugs or alcohol, explains WebMD. The medications prescribed to manage bipolar disorder are often rendered ineffective when combined with mind-altering substances. Substance abuse can cause symptoms that mimic phases of bipolar episodes, such as the manic state often created by cocaine use or the extreme depression some individuals experience in the period of cocaine withdrawal. Individuals may be perceived as addicts or alcoholics but can be acting out of a manic state of impulsivity and recklessness that fuels their substance abuse at that time.
Because up to 60 percent of individuals with bipolar disorder abuse drugs or alcohol, making an accurate bipolar diagnosis is challenging, states WebMD. Up to 20 percent of individuals who seek treatment for depression really suffer from bipolar disorder. Since depression is the dominant state, the manic periods may be too mild or infrequent to be noticed. Due to delays or mistakes in accurate diagnoses, an average of 10 years passes from the time bipolar symptoms begin until individuals seek treatment.