Bipolar Disorder & Addiction Treatment in Tennessee
Bipolar disorder can affect mood, sleep, energy, judgment, relationships, work, and almost every part of daily life. When alcohol or drug use occurs alongside bipolar disorder, those challenges can become even more difficult to separate and manage because intoxication, withdrawal, cravings, sleep loss, and mood episodes can influence one another.
Brooks Healing Center provides integrated treatment for adults experiencing bipolar disorder alongside substance use concerns. Our treatment campus is located between Nashville and Chattanooga in Normandy, Tennessee, where clinically appropriate patients can receive substance-use stabilization, residential treatment, behavioral therapy, psychiatric and medication support when appropriate, and continued care through PHP and supportive recovery housing.
Treatment begins with understanding the whole picture: whether symptoms are consistent with Bipolar I or Bipolar II disorder, what substances are involved, whether intoxication or withdrawal may be contributing to mood symptoms, current medications, sleep patterns, previous episodes, safety concerns, and what has or has not worked in previous treatment.
John Ingham
Updated on: October 5, 2026 by John Ingham
Table of Contents
Key Points About Bipolar Disorder and Addiction
- Bipolar disorder involves distinct episodes of significant changes in mood, energy, activity, and functioning. It is more than ordinary emotional highs and lows.
- Bipolar I and Bipolar II are different diagnoses. Bipolar I requires at least one manic episode. Bipolar II requires at least one hypomanic episode and at least one major depressive episode, with no history of a full manic episode.
- Bipolar II is not simply “mild bipolar disorder.” Hypomania is less severe than mania, but depressive episodes can create substantial impairment and may dominate the course of Bipolar II.
- Substance use disorders are especially common among people with bipolar disorder. A 2025 American Psychiatric Association review reported lifetime SUD estimates of approximately 55% in research cohorts of people with bipolar disorder. Alcohol and cannabis use disorders are particularly common.
- Alcohol and drugs can worsen or imitate bipolar symptoms. Stimulants, cannabis, hallucinogens, sedatives, alcohol, withdrawal, and prolonged sleep deprivation can complicate diagnosis.
- Medication is often a central component of bipolar treatment. Mood stabilizers and atypical antipsychotics are commonly used, while antidepressants require particular caution and are generally not used alone for bipolar depression because they can precipitate mania or rapid cycling in some patients.
- Psychotherapy, sleep consistency, recovery structure, medication adherence, and identifying early warning signs all matter.
- How Brooks helps: Brooks addresses bipolar symptoms and substance use together through integrated dual-diagnosis care, residential structure, individualized therapy, medication support when appropriate, relapse prevention, PHP, supportive housing, and continued recovery planning.
Bipolar Disorder & Dual Diagnosis Treatment at a Glance
| Treatment Component | What It Addresses | When It May Be Important |
|---|---|---|
| Substance-Use Stabilization / Detox | Withdrawal, intoxication, sleep disruption, medical concerns, and determining how substances may be affecting mood symptoms. | When alcohol or drug dependence requires structured withdrawal support before the clinical picture can be evaluated more clearly. |
| Residential Dual-Diagnosis Treatment | Bipolar symptoms and substance-use patterns within a structured 24-hour recovery environment. | When mood instability, relapse risk, substance use, or the recovery environment makes outpatient treatment difficult to maintain. |
| Medication Evaluation & Management | Mood stabilization, depressive symptoms, psychosis when present, sleep, and other psychiatric concerns. | When medication is part of the individualized bipolar treatment plan. |
| Behavioral Therapy | Mood awareness, coping, triggers, substance use, relationships, emotional regulation, and relapse prevention. | Throughout treatment and continuing recovery. |
| Partial Hospitalization Program (PHP) | Intensive daytime treatment with increasing independence outside treatment hours. | As an appropriate step down after residential treatment or for patients needing substantial structure without 24-hour residential care. |
| Supportive Housing / Sober Living | Routine, accountability, substance-free living, and continued recovery structure. | For eligible patients transitioning toward greater independence. |
What Is Bipolar Disorder?
Bipolar disorder is a mood disorder characterized by episodes of significant changes in mood, energy, activity, thinking, sleep, and behavior. The condition was historically called manic depression or manic-depressive illness, but bipolar disorder is the current clinical terminology.
Everyone experiences changes in mood. Bipolar disorder is different because mood episodes represent a meaningful departure from the person’s normal functioning and can persist for days or longer.
The National Institute of Mental Health describes bipolar disorder as a chronic or episodic condition involving manic, hypomanic, depressive, or mixed symptoms that can substantially affect work, relationships, judgment, and everyday functioning. National Institute of Mental Health
Bipolar disorder often begins during late adolescence or early adulthood, although it can emerge at other ages. It generally requires long-term management, but appropriate treatment can help reduce episode severity, improve functioning, and support a better quality of life. National Institute of Mental Health
Bipolar I vs. Bipolar II: What Is the Difference?
| Feature | Bipolar I Disorder | Bipolar II Disorder |
|---|---|---|
| Defining Episode | At least one manic episode | At least one hypomanic episode and at least one major depressive episode |
| Mania | Yes | No. A full manic episode changes the diagnosis to Bipolar I |
| Hypomania | May occur but is not required | Required |
| Major Depression | Common but not required for diagnosis | Required |
| Typical Duration of Elevated Episode | Mania lasts at least 7 days, unless symptoms are severe enough to require hospitalization sooner | Hypomania lasts at least 4 consecutive days |
| Functional Impairment | Mania causes marked impairment, may require hospitalization, or may involve psychosis | Hypomania represents a clear change in functioning but does not cause the degree of impairment required for mania |
| Psychosis During Elevated Episode | Can occur | Psychotic features mean the episode is manic rather than hypomanic |
| Substance Use Can Complicate Diagnosis | Yes | Yes |
The current DSM-5-TR framework requires one lifetime manic episode for Bipolar I disorder. A major depressive episode is common but is not required for the diagnosis. Bipolar II requires both a hypomanic episode and a major depressive episode. PubMed Central (PMC)
What Is Mania?
A manic episode involves a distinct period of abnormally elevated, expansive, or irritable mood and increased activity or energy.
Symptoms can include:
- Dramatically decreased need for sleep
- Racing thoughts
- Rapid or pressured speech
- Increased goal-directed activity
- Unusual confidence or grandiosity
- Distractibility
- Increased social or sexual activity
- Excessive spending
- Impulsive business or financial decisions
- Risk-taking
- Agitation
- Poor judgment
A manic episode generally lasts at least seven days, unless symptoms become severe enough that hospitalization is required sooner. Mania also involves marked impairment in functioning, hospitalization, or psychotic symptoms. PubMed Central (PMC)
Someone experiencing mania may not recognize how dramatically their judgment or functioning has changed. Family members, friends, coworkers, or clinicians may notice the change before the person experiencing the episode views it as a problem.
What Is Hypomania?
Hypomania involves many of the same types of symptoms as mania, including increased energy, decreased need for sleep, rapid speech, racing thoughts, greater confidence, and increased activity.
The difference is severity and impairment, not simply the number of symptoms.
A hypomanic episode lasts at least four consecutive days and represents a noticeable change from the person’s usual functioning, but it does not cause the marked impairment or need for hospitalization associated with mania. If psychotic symptoms occur during an elevated mood episode, the episode is considered manic rather than hypomanic. PubMed Central (PMC)
Hypomania can sometimes feel productive or enjoyable, which is one reason Bipolar II may initially go unrecognized. Someone may seek help during depression while never mentioning periods of reduced sleep, increased energy, impulsivity, or unusual confidence because those periods did not feel like an illness. National Institute of Mental Health
Why Bipolar II Is Not Simply a Milder Version of Bipolar I
The elevated episodes in Bipolar II are less severe than full mania, but the disorder itself should not be dismissed as “mild.”
Major depressive episodes are required for Bipolar II and can create serious impairment. NIMH notes that people with Bipolar II may spend extended periods experiencing depressive symptoms even though their elevated episodes never reach the severity of full mania. National Institute of Mental Health
Bipolar Depression
Depression is a major part of bipolar disorder and can sometimes be the reason someone first seeks treatment.
Symptoms of a major depressive episode can include:
- Persistent sadness or emptiness
- Loss of interest or pleasure
- Fatigue
- Significant sleep changes
- Appetite or weight changes
- Difficulty concentrating
- Slowed movement or restlessness
- Feelings of worthlessness or excessive guilt
- Hopelessness
- Thoughts of death or suicide
The depressive phase of bipolar disorder can resemble major depressive disorder, which makes a detailed lifetime history important when diagnosing the condition.
Someone may initially appear to have depression until a clinician identifies a previous period of mania or hypomania. This distinction matters because treatment for bipolar depression differs from treatment for unipolar depression.
Mixed Features and Rapid Cycling
Bipolar episodes do not always fit neatly into “up” or “down.”
What Does “With Mixed Features” Mean?
The DSM-5-TR uses a “with mixed features” specifier when symptoms associated with the opposite mood pole occur during a manic, hypomanic, or depressive episode.
For example, someone experiencing mania may simultaneously have significant depressive symptoms, while someone experiencing bipolar depression may also have increased energy, racing thoughts, agitation, or other symptoms associated with an elevated state.
The modern diagnostic framework uses mixed features rather than a standalone mixed-episode diagnosis. NCBI
Mixed symptoms deserve careful clinical assessment because they can be associated with substantial distress, impulsivity, and safety concerns.
What Is Rapid-Cycling Bipolar Disorder?
Rapid cycling means experiencing four or more episodes of mania, hypomania, or depression within a 12-month period.
It is a course specifier rather than a separate type of bipolar disorder. People can move into or out of a rapid-cycling pattern over time. National Institute of Mental Health
Sleep disruption, medication changes, substance use, and other factors can complicate mood stability, which makes tracking episodes and patterns useful during treatment.
What Is Cyclothymic Disorder?
Bipolar I and Bipolar II are not the only conditions within the bipolar spectrum.
Cyclothymic disorder, or cyclothymia, involves repeated periods of hypomanic and depressive symptoms that do not meet the full criteria for hypomanic or major depressive episodes.
For adults, this pattern generally continues for at least two years. Cyclothymia can still interfere with relationships, functioning, and emotional stability even though individual episodes do not reach the threshold required for Bipolar I or Bipolar II. National Institute of Mental Health
How Common Is Bipolar Disorder?
The National Institute of Mental Health estimates that approximately 2.8% of U.S. adults experience bipolar disorder in a given year, while about 4.4% experience bipolar disorder at some point during their lifetime. National Institute of Mental Health
These figures come from the National Comorbidity Survey Replication, which was conducted in the early 2000s using DSM-IV diagnostic criteria. They remain the prevalence estimates currently published by NIMH, but the age and methodology of the underlying dataset should be understood when interpreting them. National Institute of Mental Health
The condition can create substantial impairment. In that same NIMH dataset, 82.9% of adults identified with past-year bipolar disorder were categorized as experiencing serious impairment. National Institute of Mental Health
Bipolar Disorder and Substance Use
A 2025 review published by the American Psychiatric Association reported that historical epidemiological data found a lifetime substance use disorder prevalence of approximately 56% among people with bipolar disorder, while a more recent combined cohort of nearly 4,000 people with bipolar disorder produced a similar estimate of 54.9%. Alcohol and cannabis use disorders were particularly common. PubMed Central (PMC)
That does not mean substance use is inevitable for someone with bipolar disorder. It does show why treatment programs working with addiction need to evaluate bipolar symptoms carefully.
Why Bipolar Disorder and Substance Use Can Become Intertwined
Different people arrive at the combination in different ways.
Someone may use alcohol or drugs in an attempt to:
- Slow racing thoughts
- Sleep during an elevated episode
- Increase energy during depression
- Escape emotional pain
- Reduce anxiety
- Increase confidence
- Prolong euphoria
- Manage medication side effects
- Cope with trauma or stress
Substance use can then introduce additional instability.
A recent review found that co-occurring bipolar and substance use disorders are associated with more frequent and severe mood symptoms, poorer functioning, greater impulsivity, and increased suicide-related risk compared with bipolar disorder without a co-occurring SUD. PubMed Central (PMC)
Alcohol and Bipolar Disorder
Alcohol is one of the most common substances involved alongside bipolar disorder.
Alcohol may initially feel calming during periods of anxiety or agitation, but intoxication, disrupted sleep, withdrawal, medication interactions, and the consequences of repeated drinking can complicate mood stability.
A 2024 study highlighted in a recent APA review found that even relatively small increases in alcohol consumption among people with Bipolar I or Bipolar II were associated with increased manic and depressive symptoms during the following six months. PubMed Central (PMC)
Cannabis and Bipolar Disorder
Cannabis use disorder is also disproportionately common among people with bipolar disorder.
Cannabis can affect sleep, motivation, anxiety, perception, and cognition. Higher-THC products may also contribute to paranoia or psychotic symptoms in susceptible individuals.
For someone with both bipolar disorder and problematic marijuana use, treatment needs to distinguish mood symptoms from intoxication, withdrawal, and other cannabis-related effects.
Stimulants and Bipolar Symptoms
Methamphetamine, cocaine, Adderall misuse, and other stimulants can produce symptoms that resemble mania, including:
- Decreased sleep
- Increased energy
- Rapid speech
- Agitation
- Grandiosity
- Increased goal-directed behavior
- Paranoia
- Impulsivity
- Psychosis
That overlap can make diagnosis especially difficult during active stimulant use.
A manic-looking episode caused entirely by a substance is not automatically evidence of Bipolar I disorder. Clinicians need to consider timing, previous episodes, family history, periods of abstinence, medication exposure, and whether symptoms persist outside the physiological effects of the substance. PubMed Central (PMC)
Substance-Induced Mood Symptoms vs. Bipolar Disorder
Alcohol, stimulants, cannabis, hallucinogens, prescription medications, withdrawal states, and other substances can produce, trigger, intensify, or imitate mood symptoms. There is also a separate diagnostic category for substance/medication-induced mood conditions.
Determining whether someone has a primary bipolar disorder requires looking beyond what is happening during intoxication or withdrawal.
Clinicians may consider:
- Whether manic or depressive episodes existed before heavy substance use
- Whether symptoms occur during periods without substances
- How long symptoms persist after intoxication or withdrawal resolves
- Family history
- Previous psychiatric diagnoses
- Medication history
- Sleep patterns
- Prior episodes
- Age at onset
- Whether symptoms meet full manic or hypomanic criteria
NIMH specifically notes that substance use, medications, and some medical conditions can mimic or worsen bipolar symptoms, making longitudinal assessment important. National Institute of Mental Health
How Is Bipolar Disorder Diagnosed?
There is no blood test, brain scan, or single questionnaire that can definitively diagnose bipolar disorder.
Diagnosis is based on a detailed psychiatric history and the pattern of symptoms across time.
An assessment may consider:
- Previous manic symptoms
- Previous hypomanic periods
- Major depressive episodes
- Sleep patterns
- Changes in energy
- Impulsivity
- Psychotic symptoms
- Family psychiatric history
- Current medications
- Antidepressant response
- Alcohol and substance use
- Medical conditions
- Previous hospitalizations
- Suicidal thoughts or behavior
A healthcare provider may also perform a physical examination or order laboratory testing to rule out medical conditions that can cause similar symptoms, such as thyroid disorders. National Institute of Mental Health
Why Bipolar II Can Be Misdiagnosed as Depression
Bipolar II can be especially difficult to recognize because patients frequently seek care during a depressive episode.
Hypomania may be remembered as a period when someone was simply:
- More productive
- More social
- Sleeping less
- More confident
- More creative
- More energetic
If those periods are not identified, the depressive episodes may appear to represent major depressive disorder.
This distinction matters because NIMH warns that antidepressants used alone in bipolar disorder can precipitate mania or rapid cycling in some patients. National Institute of Mental Health
Bipolar Disorder With Psychotic Features
Some people experience psychotic symptoms during severe bipolar episodes.
These can include:
- Hallucinations
- Delusions
- Extreme paranoia
- Grandiose beliefs
- Disorganized thinking
- Loss of contact with reality
Psychotic symptoms often reflect the mood state. For example, someone experiencing mania may develop extreme beliefs about their importance, power, wealth, or special abilities.
NIMH notes that psychosis can occur during severe manic or depressive episodes. National Institute of Mental Health
Psychosis also requires careful differential diagnosis because schizophrenia-spectrum disorders, substance-induced psychosis, stimulant intoxication, cannabis, and other drugs can produce similar symptoms.
Brooks also provides information about drug-induced psychosis and substance use.
Treatment for Bipolar Disorder and Addiction in Tennessee
When bipolar disorder and a substance use disorder occur together, treating only one condition can leave the other untreated.
Integrated care considers both disorders within the same treatment plan.
For example, stopping alcohol or stimulant use can reduce one source of mood instability, but abstinence alone does not treat an underlying Bipolar I or Bipolar II disorder. Likewise, stabilizing mood without addressing an active substance use disorder may leave a major trigger for future destabilization in place.
Brooks’ broader approach to dual-diagnosis treatment in Tennessee addresses substance use and appropriate co-occurring mental health conditions together.
Medical Detox and Stabilization
If physical dependence on alcohol, benzodiazepines, opioids, or another substance is present, treatment may begin with medical detox and stabilization.
Detox does not treat bipolar disorder by itself.
It can, however, provide an important period of medical stabilization during which clinicians can monitor sleep, mood, behavior, withdrawal symptoms, medications, and whether psychiatric symptoms change as substances leave the body.
Residential Dual-Diagnosis Treatment
After stabilization, clinically appropriate patients may continue into residential addiction treatment at Brooks.
A structured environment can be especially useful when substance use and mood instability have disrupted:
- Sleep
- Medication consistency
- Daily routines
- Relationships
- Nutrition
- Work
- Judgment
- Recovery support
- Ability to remain abstinent
Residential treatment also provides more opportunity to observe patterns over time than a single outpatient appointment or brief period of intoxication.
Medication Treatment for Bipolar Disorder
Medication is often an important part of bipolar-disorder management.
The exact medication depends on whether someone is experiencing mania, bipolar depression, mixed symptoms, psychosis, or long-term maintenance needs.
NIMH identifies mood stabilizers and atypical antipsychotics as commonly used bipolar medications. National Institute of Mental Health
Mood Stabilizers
Mood stabilizers can help reduce or prevent manic and depressive episodes.
Examples include lithium and certain anticonvulsant medications such as valproate. Medication selection depends on symptoms, medical history, other medications, pregnancy considerations, side effects, laboratory monitoring, and individual response.
NIMH notes that lithium may also reduce suicide risk during long-term treatment for some people. National Institute of Mental Health
Atypical Antipsychotics
Atypical antipsychotics are commonly used in bipolar treatment and may be prescribed for mania, bipolar depression, psychotic symptoms, or long-term mood stabilization depending on the specific medication.
These medications can require monitoring for side effects such as changes in weight, blood sugar, and lipids. National Institute of Mental Health
Antidepressants Require Special Consideration
Antidepressants are sometimes used for bipolar depression, but they generally should not be used alone in someone with bipolar disorder.
NIMH notes that antidepressant monotherapy can trigger a manic episode or rapid cycling in some patients. When an antidepressant is used, it is generally combined with an appropriate mood-stabilizing treatment. National Institute of Mental Health
Patients should not stop or change psychiatric medication without discussing it with the appropriate prescriber.
Therapy for Bipolar Disorder and Addiction
Medication can address important biological aspects of bipolar disorder, but psychotherapy can help patients understand mood patterns, improve coping, address substance use, strengthen relationships, and recognize early warning signs.
NIMH notes that effective bipolar psychotherapy can include interpersonal and social rhythm therapy, family-focused therapy, and CBT, typically alongside appropriate medication treatment. National Institute of Mental Health
Brooks uses the therapies available within our program as part of an individualized dual-diagnosis treatment plan.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) can help patients identify relationships among thoughts, mood, behavior, triggers, and substance use.
CBT may help someone:
- Recognize early signs of mood changes
- Identify substance-use triggers
- Challenge patterns that contribute to relapse
- Develop coping strategies for depression
- Improve problem-solving
- Strengthen medication and treatment adherence
Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) focuses on emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness.
Those skills can be useful when someone experiences intense emotions, impulsive behavior, interpersonal conflict, or difficulty tolerating distress without returning to alcohol or drug use.
Trauma-Informed Therapy
Trauma and bipolar disorder are not the same condition, and treatment should not assume trauma explains someone’s mood disorder.
However, trauma can coexist with bipolar disorder and substance use. When relevant, Trauma-Informed Therapy can help treatment account for those experiences without reducing the entire clinical picture to trauma.
Experiential Therapy
Experiential Therapy can provide structured opportunities to work on emotional awareness, communication, relationships, coping, and self-understanding outside traditional talk therapy.
Brainspotting
Brainspotting Therapy may be incorporated when clinically appropriate as part of an individualized treatment plan, particularly when trauma or difficult emotional experiences are relevant.
Sleep, Routine, and Bipolar Stability
Changes in sleep can be both a symptom and a warning sign of a bipolar mood episode.
Someone moving toward mania may sleep dramatically less while still feeling energized. Depression can involve insomnia, early waking, or excessive sleep.
NIMH recommends maintaining consistent routines for sleep, eating, activity, medication, and appointments as part of long-term bipolar management. Interpersonal and social rhythm therapy is also specifically designed around the relationship between mood and biological/social rhythms. National Institute of Mental Health
For someone recovering from substance use at the same time, rebuilding routine can be especially important because alcohol, stimulants, cannabis, benzodiazepines, and other substances can all disrupt sleep.
Recognizing Early Warning Signs of a Mood Episode
Long-term bipolar management often includes learning a person’s individual warning signs.
Possible signs that mania or hypomania may be developing include:
- Sleeping less without feeling tired
- Rapid increase in energy
- Racing thoughts
- Talking much more or faster
- Increasing impulsivity
- Unusual spending
- Sudden increase in projects or plans
- Greater irritability
- Increased substance use
- Feeling unusually powerful or important
Possible signs of an emerging depressive episode include:
- Increasing isolation
- Loss of interest
- Changes in sleep
- Low energy
- Reduced self-care
- Missing appointments
- Hopelessness
- Increased alcohol or drug use
- Thoughts of death or suicide
Tracking mood, sleep, medications, substance use, and major stressors can help patients and treatment teams identify recurring patterns. NIMH specifically recommends mood journaling or life-charting as one strategy for recognizing mood changes over time. National Institute of Mental Health
When Bipolar Symptoms Require Emergency Help
Some bipolar episodes can become psychiatric emergencies.
Immediate evaluation may be necessary when someone:
- Has suicidal thoughts with intent or a plan
- Is unable to care for basic needs
- Has severe psychosis
- Has not slept for several days and is becoming increasingly disorganized
- Is engaging in dangerous impulsive behavior
- Becomes violent or severely agitated
- Is unable to distinguish reality
- Is experiencing dangerous substance intoxication or withdrawal
For a life-threatening emergency, call 911. For suicidal thoughts or a mental health crisis in the United States, call or text 988. NIMH recommends immediate crisis support when someone is experiencing suicidal thoughts or urges to harm themselves. National Institute of Mental Health
Continuing Care After Residential Treatment
Bipolar disorder generally requires long-term management, so recovery planning should extend beyond a residential stay.
For someone with co-occurring substance use, continued treatment may include:
- Psychiatric medication follow-up
- Individual therapy
- Mood monitoring
- Relapse-prevention planning
- Peer recovery support
- Substance-free housing
- Consistent sleep and routine
- Family support
- Coordination with community providers
Partial Hospitalization Program
Brooks’ Partial Hospitalization Program (PHP) provides intensive daytime clinical treatment for medically stable patients who continue to need substantial structure after residential care.
PHP can provide continued therapy, recovery support, medication follow-up when appropriate, relapse-prevention planning, and increased independence while patients transition out of 24-hour residential treatment.
Eligible patients who need a structured living environment while participating in PHP may use supportive housing in Tullahoma.
Sober Living
For eligible individuals who no longer require intensive clinical treatment but continue to benefit from accountability and a substance-free environment, Brooks provides sober living in Tullahoma.
This can be especially useful when substance use has historically destabilized mood, disrupted medication adherence, or interfered with sleep and daily structure.
Why Choose Brooks for Bipolar Disorder and Addiction Treatment in Tennessee?
Brooks Healing Center provides integrated substance use and co-occurring mental health treatment between Nashville and Chattanooga in Normandy, Tennessee.
Rather than treating substance use as completely separate from bipolar symptoms, Brooks’ dual-diagnosis approach considers how the two conditions interact.
That can include evaluating:
- Bipolar I versus Bipolar II history
- Current manic, hypomanic, or depressive symptoms
- Alcohol and drug use
- Withdrawal or intoxication effects
- Medication adherence
- Sleep disruption
- Previous psychiatric treatment
- Psychotic symptoms
- Suicide and safety risk
- Trauma when relevant
- Recovery environment
- Relapse history
Brooks is accredited by The Joint Commission and licensed by the Tennessee Department of Mental Health and Substance Abuse Services. Its licensed Normandy services include residential detoxification, residential rehabilitation, and non-residential rehabilitation. Brooks Healing Center
Depending on clinical need, the Brooks continuum can include:
- Substance-use detox and stabilization
- Residential dual-diagnosis treatment
- Psychiatric and medication support when appropriate
- Individual and group therapy
- Cognitive Behavioral Therapy
- Dialectical Behavior Therapy
- Trauma-Informed Therapy
- Experiential Therapy
- Brainspotting
- Relapse-prevention planning
- Partial Hospitalization Program
- Supportive PHP housing
- Sober living
- Continuing recovery planning
Does Insurance Cover Bipolar Disorder and Dual-Diagnosis Treatment?
Many commercial health insurance plans include behavioral-health and substance-use benefits, but exact coverage depends on the individual policy, diagnoses, medical necessity, recommended level of care, network status, deductible, coinsurance, and authorization requirements.
Brooks’ admissions team can verify your insurance benefits before admission and explain the information provided by your insurance carrier.
Insurance verification does not guarantee payment, but it can help patients and families understand which benefits may be available.
Get Help for Bipolar Disorder and Addiction in Tennessee
Bipolar disorder and substance use can reinforce one another in ways that make both conditions more difficult to manage. Alcohol or drugs may disrupt sleep and mood stability, while depression, impulsivity, agitation, or mania can increase vulnerability to substance use.
Effective dual-diagnosis treatment looks at those relationships together rather than asking someone to solve one disorder before addressing the other.
Brooks Healing Center provides integrated treatment for adults with co-occurring bipolar disorder and substance use through stabilization when appropriate, residential treatment, individualized therapy, psychiatric and medication support when clinically appropriate, PHP, supportive housing, sober living, and continued recovery planning.
Frequently Asked Questions About Bipolar Disorder and Addiction
What Is the Main Difference Between Bipolar I and Bipolar II?
The defining difference is mania versus hypomania.
Bipolar I requires at least one full manic episode. Bipolar II requires at least one hypomanic episode and at least one major depressive episode, with no history of full mania.
If someone with a previous Bipolar II diagnosis later experiences a true manic episode, the clinical picture is consistent with Bipolar I. PubMed Central (PMC)
Is Bipolar II Less Serious Than Bipolar I?
Not necessarily.
Hypomania is less severe than mania, but Bipolar II can involve substantial and recurrent depression. The absence of full mania does not mean the overall disorder causes little impairment. National Institute of Mental Health
Can Bipolar I Occur Without Depression?
Yes.
A major depressive episode is not required for a Bipolar I diagnosis. One qualifying manic episode is sufficient, although many people with Bipolar I also experience major depressive episodes. NCBI
Can Bipolar Disorder Be Managed Without Medication?
Psychotherapy, sleep regulation, stress management, and lifestyle structure are important, but medication is often a major part of bipolar treatment.
Mood stabilizers and atypical antipsychotics are commonly used to treat or prevent mood episodes. Medication decisions should be individualized, and someone should not stop a prescribed psychiatric medication without discussing it with the appropriate healthcare provider. National Institute of Mental Health
What Is the Difference Between Bipolar Disorder and Depression?
Major depressive disorder involves depressive episodes without a history of mania or hypomania.
Bipolar disorder involves depression alongside mania or hypomania depending on the subtype. Because patients often seek treatment during depression, identifying previous elevated episodes is an important part of diagnosis.
Can Drugs Cause Symptoms That Look Like Bipolar Disorder?
Yes.
Stimulants, steroids, certain medications, alcohol or sedative withdrawal, cannabis, and other substances can produce mood or behavioral changes that resemble mania, depression, or psychosis.
That does not automatically mean the person has primary Bipolar I or Bipolar II disorder. Diagnosis requires careful attention to timing, substance exposure, previous episodes, and symptoms during periods without intoxication or withdrawal. National Institute of Mental Health
Can Someone Have Bipolar Disorder and Addiction at the Same Time?
Yes, and the combination is common.
A recent APA review found lifetime substance use disorder rates around 55% in large samples of people with bipolar disorder. Alcohol and cannabis use disorders were especially common. PubMed Central (PMC)
Does Alcohol Make Bipolar Disorder Worse?
It can.
Alcohol can interfere with sleep, judgment, medication adherence, and mood stability. Co-occurring alcohol use disorder is associated with a more difficult bipolar course, and recent research has linked increases in alcohol use with increases in both manic and depressive symptoms. PubMed Central (PMC)
Can Marijuana Affect Bipolar Disorder?
Cannabis may affect sleep, mood, anxiety, motivation, cognition, and psychotic symptoms.
Cannabis use disorder is also disproportionately common among people with bipolar disorder, which makes marijuana use important to evaluate during dual-diagnosis treatment. PubMed Central (PMC)
Can Bipolar Disorder Cause Psychosis?
Yes.
Severe manic or depressive episodes can include hallucinations or delusions. Psychosis during an elevated episode means the episode is manic rather than hypomanic. National Institute of Mental Health
What Is Rapid-Cycling Bipolar Disorder?
Rapid cycling refers to four or more mood episodes within 12 months.
Those episodes may be manic, hypomanic, or depressive. Rapid cycling is a description of the disorder’s course rather than a separate bipolar diagnosis. National Institute of Mental Health
Why Is Sleep So Important With Bipolar Disorder?
Changes in sleep are closely connected with bipolar mood episodes.
Reduced need for sleep can be an early sign of mania or hypomania, while depression may cause insomnia or excessive sleep. Maintaining a consistent sleep and activity routine is one component of long-term bipolar management. National Institute of Mental Health
Can Brooks Treat Bipolar Disorder and Substance Use Together?
Yes. Brooks provides integrated dual-diagnosis treatment for clinically appropriate adults experiencing substance use alongside bipolar disorder.
Treatment can address withdrawal or stabilization needs, mood symptoms, substance-use patterns, medication support, therapy, relapse prevention, sleep and routine, and continuing-care planning within one coordinated treatment approach.
Does Brooks Provide Residential Treatment for Bipolar Disorder and Addiction?
For clinically appropriate adults with co-occurring substance use and bipolar disorder, Brooks provides residential dual-diagnosis care between Nashville and Chattanooga in Normandy, Tennessee.
The recommended level of care depends on substance use, mood symptoms, psychiatric stability, safety concerns, medical needs, treatment history, and the recovery environment.
How Can Family Members Help Someone With Bipolar Disorder and Addiction?
Family members can learn the warning signs of both mood episodes and substance relapse, encourage treatment adherence, avoid enabling harmful behavior, support healthy routines, and participate appropriately in recovery planning.
It is also useful for family members to know the person’s individual warning signs for mania, depression, intoxication, withdrawal, and crisis so they can respond earlier when symptoms begin changing.
Sources
- National Institute of Mental Health. (2025). Bipolar disorder. https://www.nimh.nih.gov/health/publications/bipolar-disorder
- National Institute of Mental Health. (n.d.). Bipolar disorder. Retrieved October 5, 2026, from https://www.nimh.nih.gov/health/statistics/bipolar-disorder
- National Institute of Mental Health. (2023, December). Mental health medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
- Sperry, S. H., & Lippard, E. T. C. (2025). Co-occurring bipolar and substance use disorders: A review of impacts, biopsychosocial mechanisms, assessment, and treatment. Focus, 23(2), 173–182. https://pmc.ncbi.nlm.nih.gov/articles/PMC11995909/
- Singh, B., Swartz, H. A., Cuellar-Barboza, A. B., Schaffer, A., Kato, T., Dols, A., Sperry, S. H., Vassilev, A. B., Burdick, K. E., & Frye, M. A. (2025). Bipolar disorder. The Lancet, 406(10506), 963–978. https://pmc.ncbi.nlm.nih.gov/articles/PMC12340982/
- Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment for people with co-occurring disorders (Treatment Improvement Protocol Series No. 42; Publication No. PEP20-02-01-004). https://www.ncbi.nlm.nih.gov/books/NBK571020/
- National Institute of Mental Health. (2025, March). Finding help for co-occurring substance use and mental disorders. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
- Brooks Healing Center. (n.d.). Licensure. https://brookshealingcenter.com/licensure/