Self-medication describes the process in which people with bipolar disorder and other conditions use alcohol and drugs in an attempt to reduce their symptoms. Because bipolar disorder is a mood disorder, it makes intuitive sense that people will turn to mood-altering drugs to try and make themselves feel better.
Common strategies that people with bipolar disorder try include the use of alcohol and sedatives to get to sleep at night, especially when in a hypomanic, manic, or mixed state. Stimulants and cocaine are often sought to try and break a crushing depression. Unfortunately, these strategies that might give some momentary relief tend to worsen things over time. While alcohol might cause someone who is manic to eventually pass out, the sleep will be broken and not restful. (Alcohol diminishes deep sleep and dream (REM) sleep and once awake the person may have even more difficulty falling back to sleep.) The person who uses cocaine or amphetamines to achieve some temporary relief from depression will eventually crash, having depleted important neurotransmitters in the brain, and become even more depressed and possibly paranoid, psychotic, and suicidal.
Other substances frequently used by people with bipolar disorder include marijuana and opiates, such as prescription painkillers, methadone, and heroin. Opiates appear to be especially prevalent in people with bipolar disorder who have histories of significant traumas (physical, sexual, or emotional). The notion of self-medication with these individuals is often described as, “wanting to deaden the pain.”