Cannabis is the most commonly abused drug among people with bipolar disorder. In fact, with anecdotal evidence that medical marijuana might help with the symptoms of bipolar disorder, many people may wonder if the plant could have a role in treating it. Unfortunately, marijuana and bipolar disorder don’t mix, according to most clinical studies. This guide reviews the characteristic effects of bipolar disorder and delves into the research regarding how marijuana affects this condition.
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Bipolar Disorder Symptoms
The National Alliance on Mental Health estimates that nearly 3% of Americans have a bipolar diagnosis, which is around 10 million people. This complex, chronic mental illness is characterized by dramatic changes in mood, from manic states to deep depressive episodes. Mood instability is typically unpredictable and usually “cycles” from one mood to the other.
People with bipolar disorder may also develop psychosis, with symptoms such as delusions and hallucinations. The mood instability and other symptoms of bipolar disorder present unique treatment challenges, which may be partly why many people turn to the cannabis plant for relief.
Manic Symptoms
Some of the most common bipolar symptoms during the manic phase of the disease include:
- Inability to keep up with school and work responsibilities
- Feeling overly energized or wired
- Difficulty making sensible decisions
- Constant feelings of boredom, distraction or restlessness
- Lack of fatigue despite lack of sleep
- Feeling invincible and powerful
- Extreme sociability
- Fast, excessive talking
- Elevated self-esteem and self-confidence
- Euphoria
- Increased sexual interest
- Risky behavior such as substance use and uncontrollable spending
- Racing thoughts and ideas
- Inability to recognize issues with behavior
Depressive Episodes
During episodes of depression, bipolar symptoms often include:
- Unexplained physical pain
- Difficulty sleeping or sleeping too much
- Deep feelings of sadness, hopelessness and despair
- Chronic anxiety or guilt about minor events
- Appetite changes, often resulting in weight gain or loss
- Loss of interest in favorite activities
- Fatigue and exhaustion
- Problems with cognitive function, including thinking, remembering and focus
- Irritable mood
- Problems in work and school
- Suicidal thoughts and actions
While some people with bipolar disorder may use cannabis to help with their symptoms, it’s not an approved condition for medical marijuana treatment. In fact, scientific evidence shows that THC can worsen symptoms or even bring on mental health problems associated with bipolar disorder, even though the drug may have short-term positive effects. While some psychiatric disorders and psychotic disorders respond to cannabis use, patients with bipolar disorder often experience worse outcomes and negative effects when they try medical marijuana.
One research brief published by the Alcohol and Drug Abuse Institute at the University of Washington associated cannabis abuse by people who have bipolar disorder with higher rates of disability, poor function, limited long-term remission and attempted suicide. Cannabis users who have bipolar disorder are also more likely to experience rapid symptom cycling and worse psychotic symptoms than those who abstain from THC.
Psychiatric Times cited a 2006 systematic review published in the Journal of Affective Disorders. The study interviewed and reviewed the medical records of 4,915 participants diagnosed with bipolar disorder. At a three-year follow-up assessment, people with bipolar disorder who used cannabis had a higher risk of manic symptoms than participants who didn’t use marijuana during the same period. Researchers also found that the participants who had cannabis exposure:
- Were less likely to take medication and follow treatments prescribed by their health care providers
- Had more challenges with work, school and relationships
- Had worse bipolar disorder symptoms overall
- Experienced more rapid cycling of bipolar disorder symptoms with more frequent relapse
The Journal of Affective Disorders published a 2015 follow-up study that looked specifically at the impact of marijuana abuse on mania for people with bipolar disorder. They looked at nearly 3,000 individuals and found that cannabis abuse made mania worse. In addition, they found use of cannabis increased the risk for new manic episodes by an estimated 300%.
In 2009, the journal Psychiatry published a case study on cannabis-induced bipolar disorder. The authors posited that chronic marijuana use by the college student profiled in the study resulted in psychotic symptoms. The person was eventually diagnosed with bipolar disorder with psychotic features. Researchers suggest that people who develop psychosis after abusing cannabis over a long period have a genetic predisposition to cannabis-induced bipolar disorder.
Psychiatric Times also cited newer research published in the Journal of Clinical Psychiatry in 2018. This study reviewed two years of treatment outcomes for more than 1,900 people with bipolar disorder. Some participants were cannabis abusers who stopped their marijuana use after an acute mental illness episode prior to the study. Others had never used cannabis.
A third group continued to use cannabis even after an acute bipolar episode prior to the study. Authors found that, compared to those who stopped or had never started marijuana use, participants who continued to use:
- Were less likely to live with a partner
- Were more likely to have work issues
- Had lower rates of recovery from bipolar disorder
Research published in 2015 in a special edition of the journal Neuroplasticity found that people with bipolar disorder who use cannabis had three times as many suicide attempts as people with bipolar disorder who didn’t use marijuana. The study also found that individuals who used cannabis and eventually received a bipolar disorder diagnosis had an earlier onset of manic episodes than non-cannabis users by about six years.
Not all the news is negative, however. Medical News Today reported on two smaller studies looking at the efficacy of medical marijuana to treat bipolar disorder. Research published in a 2010 edition of the journal Psychological Medicine found marijuana use improved memory, attention and the ability to reason quickly among people with bipolar disorder. In 2016, a study published in the journal PLOS ONE reported that marijuana use helped bipolar patients by reducing depressive symptoms, boosting energy levels and alleviating tension and anger.
Help for Marijuana and Bipolar Disorder
If you’re struggling with bipolar disorder and marijuana abuse, you can get help for this dual diagnosis. People who use marijuana often experience mental health problems at an earlier age. Treating bipolar disorder alone or with cannabis use disorder requires an intensive approach that combines prescription medication with cognitive therapy and group support.
Summit Detox addresses both substance abuse and mental illness so you can begin the path to recovery. Call (888) 995-5265 to talk to one of our experienced, professional counselors and learn more about how we treat bipolar disorder and other mental health conditions.
