How Does Substance Abuse Affect Bipolar Youth?

The Journal of the American Academy of Child and Adolescent Psychiatry published a study in November 2013 which stated that approximately 1 in 3 teenagers with bipolar disorder developed substance abuse problems. There was an approximate time frame of 4 years between diagnosis of bipolar disorder and the first reported indication of substance abuse.

Studies on Bipolar Youth and Substance Abuse

University of Toronto and the University of Pittsburgh let by Dr. Benjamin Goldstein examined 167 youth who suffered from bipolar disorder. These youth were between the ages of 12 and 17 and were studied to document the frequency of first time onset of substance abuse as well as any possible predictors that lead to it.  The participants were interviewed an average of seven times over the next four years to examine symptoms and to observe the functioning, stressors and treatment.

The results showed that 32% of the youths developed a dependence on drugs and alcohol. The time to onset of dependence was 2.7 years. The single strongest predictor of future substance abuse and dependence issues was the repeated experimentation with alcohol. Experimentation with cannabis was also a strong indicator.

Predictors of Substance Abuse

Apart from experimentation with alcohol and cannabis, there are some factors that have been noted as being strong predictors of future substance abuse among bipolar youth. These are:

  • Oppositional defiant disorder
  • Panic disorder
  • History of substance abuse in the family
  • Lack of cohesiveness in the family
  • Absence of antidepressants in treatment

If bipolar youth have three or more of the above mentioned factors, then it was noted that just over half of them i.e. 54.7% were likely to develop substance abuse issues. If the bipolar youth had two risk factors or less then the risk of substance abuse was only 14.1%.


The presence of bipolar disorder and substance abuse is referred to as co-morbidity, where the presence of one often leads to the presence of other. Research has shown that boys with bipolar disorder are more likely to develop substance abuse issues than girls are. It was also found that an attempt at suicide formed the strongest factor in predicting which youth would engage in substance abuse, even more powerfully than other common factors.

Fortunately there is good news here. Research has also indicated that when the bipolar disorder is treated, the risk for co-morbid substance abuse diminishes too. This emphasizes the importance of recognizing bipolar disorder as soon as possible, so that patients with bipolar disorder can be warned by healthcare providers about the potential risk of substance abuse. Conversely, when teens are undergoing treatment for substance abuse, it would be wise to also screen them for bipolar disorder.

If you have a teen struggling with bipolar disorder and substance abuse, there is help available. Call The Villa to find out about treatment options.