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Substance Abuse Signals Suicide Risk in Bipolar Teens

Wednesday, September 5, 2012
Many adolescents with bipolar disorder use drugs and alcohol to dull the disorder’s painful symptoms, such as agitation, depression and anxiousness.
Although teens with bipolar disorder may initially turn to drugs and alcohol to get high, they often continue their substance abuse to feel normal, says Segundo Ibarra, MD, a psychiatrist with The Menninger Clinic’s Adolescent Treatment Program. These attempts to self-medicate are one of the signs of imminent suicide risk, according to a University of Pittsburgh study reported recently in the Archives of General Psychiatry.
Ibarra says many of the teens he treats for bipolar disorder also struggle with substance abuse.
“They just want to feel better,” he says, adding that substance abuse increases risk for suicide because it increases impulsiveness and reduces inhibitions. When the drugs wear off, agitation and hopelessness return in force. Today’s drugs, including marijuana and synthetic marijuana, are stronger than in the past, and may trigger psychosis in some patients, Ibarra says. “When you mix changes in mood with substance abuse, it takes the risk for suicide to another level.”
An estimated three percent of American youth have bipolar disorder, which typically emerges in mid to late adolescence. The disorder is difficult to diagnose, Ibarra says, because teen patients don’t have the classic cycles of mania and depression common in adults with the disorder. More often, teens experience bouts of increased irritability, anxiousness and occasional euphoria.

Ibarra says reducing the risk for suicide in teens with bipolar disorder requires treating all three problems: the bipolar disorder itself, substance abuse and suicidality.