Alcohol or drug abuse
About 50% of people with bipolar disorder also have a substance abuse problem, particularly alcohol use, Dr. Bearden says.
Many people will drink when they are in a manic phase to slow themselves down, and use alcohol to improve their mood when they are depressed.
When they are in a manic phase, people with bipolar disorder can have an inflated self-esteem.
“They feel grandiose and don’t consider consequences; everything sounds good to them,” Dr. Malone says.
Two of the most common types of behavior that can result from this are spending sprees and unusual sexual behavior. “I have had a number of patients who have had affairs who never would have done that if they weren’t in a manic episode…during this episode they exhibited behavior that is not consistent with what they would do normally,” he says.