Q: My son has recently been diagnosed as bipolar. He has just finished high school and is going to start university in the fall. We initially thought his erratic behaviour was due to his drug and alcohol use. He is now on medication that seems to be controlling the behaviour but he still wants to party. I am worried about what will happen when he goes off to university.
A: Bipolar disorder has been diagnosed more frequently in the last few years. We now are aware that while some stormy adolescent behaviour may be normal, when extremely erratic behaviours are noted, this may be due to depression or bipolar disorder, previously referred to as manic-depression.
When people use mind-altering substances such as recreational drugs or alcohol, the intent is to alter mood and to achieve the “high”. Medications prescribed for depression or for bipolar disorder are intended to stabilize mood. Clearly, recreational substances used to alter mood are working against medication that is intended to stabilize mood. Hence your son, when using recreational substances will, at least, be receiving no benefit from his meds. At worst, he is further destabilizing his mood and will experience greater mood swings and discomfort. This is problem number one.
Problem number two is “disinhibition”. Alcohol lowers inhibitions. It gives the shy, or insecure person the opportunity to be more outgoing and confident. This is fine if the young person is able to apply good judgment and adequate impulse control, however, these attributes are often in short supply for teens off to their first living experience away from home. This is even more true for the person with bipolar disorder. Individuals with bipolar disorder try to reign in their mood. Substances elevate mood. It is like trying to put out a fire with gasoline.
If your son can control and limit his drinking or drug use to a bare minimum then it might not be an issue, but that is a very big if for a teen, especially away from home for the first time. The bottom line is that bipolar disorder and mind-altering substances do not happily coexist. Hopefully your son can learn to respect the limits that his bipolar disorder puts on him and learn to value his well-being.