Depression & Mental Health Blog
July 22, 2016
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Dual Diagnosis: Mania and Substance Abuse

Mania is a mood disorder in which someone chronically exhibits manic symptoms. It's a disorder that's sometimes difficult to differentiate from bipolar disorder, which includes both manic and depressive episodes.

When a person also has substance abuse problems, it's called a dual diagnosis. Identifying and treating all disorders is crucial, as all issues must be treated at the same time to prevent relapse.

Mania: Signs and Symptoms

The Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria defines bipolar I disorder as when a person has experienced at least one manic episode. In the United States, it’s estimated that 1 percent of the population meets the criteria for bipolar I disorder. Although some forms of bipolar disorder are defined in part by experiences of depression, here we are focused on the experience of mania.

Mania is defined by a period of elation or irritability with a decreased need for sleep, increased activity, racing thoughts, extreme self-confidence, lots of talking, distractibility, and pursuit of rewarding activities without regard to the risk involved. To be termed manic, symptoms must interfere with daily functioning, and either last one week or require hospitalization.

Dual Diagnosis Treatment Involving Mania

When a person has a dual diagnosis, the first step is to undergo a medical detoxification. Medications are used by healthcare professionals to cleanse and wean the body from drugs or alcohol. Attempting a detox without medical help can result in painful, severe and sometimes life-threatening withdrawal symptoms.

Once a person has been stabilized and illicit substances eliminated from their system, an integrated treatment plan begins. The main components of the plan must treat mania and substance abuse issues at the same time.

Inpatient treatment is recommended for an immersive experience where the client is in a controlled setting, free from temptations.

Psychotherapy is therapy provided to address underlying mental and emotional causes of mania and substance abuse. Family and alternative therapies also fall into this category.

Behavioral therapy includes behavioral modification conducted to discover thoughts and feelings related to addiction and mental illness, then modifying behaviors from harmful to positive.

vPsychopharmacology is medications administered to treat symptoms of mania, control long-term withdrawal symptoms and eliminate cravings for drugs or alcohol. Initially, the mania is treated with an antipsychotic drug, benzodiazepine, and/or lithium to quickly control hyperactivity, insomnia, hostility and irritability. A mood stabilizer is also typically prescribed. Medications to treat addiction are also usually given, depending on the substances abused.

Aftercare services help ease the transition from inpatient to daily living. Programs like sober living houses, day programs, outpatient medication clinics, group meetings, individual counseling sessions and 12-step meetings can all help a person shift from 24/7 supervision back into regular daily life.

It's important to stress that any mania episode that's serious requires immediate professional help. The unpredictable behavior while in a manic state can be risky and harmful. Abusing drugs or alcohol also becomes an increased risk. If you or a loved one find yourself in any of these circumstances, it's important to seek help right away.