This post recaps an educational presentation hosted by The Dorm, in collaboration with Psychiatrist Abigail Cohen, MD and Ariel Tabachnik, MD of Galynker Family Center for Bipolar Disorder.
For many clinicians, the legalization and increasing potency of cannabis has raised new questions about their clients with bipolar disorder, which affects up to 4.4% of adults and 2.9% of adolescents in the United States today. Among these roughly twelve million young people, many of whom use cannabis. While it may offer individuals temporary relief, it is also associated with worsened episodes and psychotic symptoms.
Now more than ever it’s important to understand the effect cannabis use can have on individuals with bipolar disorder, and we were grateful to welcome Dr. Abigail Cohen, MD and Dr. Ariel Tabachnik, MD of the Galynker Family Center for Bipolar Disorder, to share their knowledge and expertise in working with young adults with bipolar disorder and cannabis use. The following article will summarize key points of their educational presentation for mental health care providers.
Why are clients with bipolar disorder drawn to cannabis?
Individuals with bipolar disorder may turn to cannabis for various reasons:
Self-medication
One common reason is to self-medicate, and numb the more uncomfortable symptoms associated with the disorder. Being high can allow someone to put aside their negative feelings for a moment, which can be a large motivator for why someone with bipolar disorder, which features many confusing emotional states, may feel especially attracted to the substance.
Sleep
Another common motivator for cannabis use is for its association with better perceived sleep. This is especially so in populations with bipolar disorder, for Dr. Tabachnik explains that in bipolar disorder, “one of the earliest signs, that is both a sign and predisposing factor, is poor sleep.” Those who experience bipolar disorders most likely also experience the common symptom of disruptive sleep patterns, which may be another reason why they turn to cannabis.
Social factors
Many young individuals with bipolar disorder also may feel drawn to cannabis due to its prevalence in young people’s social settings. Dr. Cohen described one of her clients who had worked to achieve and maintain a relatively stable state, but felt motivated to go out and buy cannabis again because he wanted to feel like a “normal kid.” The desire to be able to do the same things as your peers may also be a factor in young people’s use of cannabis.
Why has cannabis become more of a problem for people with bipolar disorder?
As Dr. Cohen says, “Today’s weed is not your father’s weed. Over the past 30, 40 years, the potency of cannabis has been growing enormously.”
She goes on to explain how the ratio of the two most well-known elements of cannabis, THC and CBD, has been consistently leaning toward a higher concentration of THC and a lower concentration of CBD, which has been shown to potentially activate more intense symptoms of bipolar disorder, as well as even induce psychosis. This is particularly concerning for those dealing with weed and bipolar, as the higher potency can lead to more severe episodes. Additionally, it is common to find cannabis that is laced with harder, more dangerous substances when bought from an unknown, unverified source.
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In short, the potency of cannabis is becoming stronger, which makes it increasingly risky for clients with bipolar disorder or psychosis.
How long do cannabis related symptoms stay active in the body?
The duration of cannabis-related symptoms varies, depending on which symptom; however, its presence in the body can last for weeks or even months. This is because cannabis is lipid-soluble – stored in body fat and easily distributed to other parts of the body over time.
Dr. Cohen notes that cutting back on cannabis may allow an individual to also cut back on their prescription medicine, such as antipsychotics. This means that antipsychotics are able to counteract the negative effects of cannabis use, including higher likelihood of induced psychosis or increased intensity in bipolar symptoms.
How can we address cannabis legalization for clients with bipolar disorder?
For some, the recent decriminalization of cannabis use may signal that it’s a substance without risk. However, legalization does not correlate with safety.
Dr. Tabachnik compares this with an allergy: “if someone is allergic to shellfish, it doesn’t matter if they eat 100 oysters or one oyster. They want to avoid those oysters because they are likely to cause a bad reaction.” Likewise, it is crucial to remember that not every person has the same reaction toward cannabis, and what is “safe” for some may be extremely harmful to others.
Additionally, there is strong research suggesting that cannabis use changes the developing brain, with varying degrees of cognitive impairment. This, in addition to the potential for triggering a bipolar episode, makes young adults with bipolar disorder extremely vulnerable to the negative effects of cannabis use.
In Conclusion
We’re grateful to Dr. Cohen and Dr. Tabachnik for sharing their insights into cannabis and bipolar disorder in young adults. To learn more, and view a dynamic Q+A with the audience, tap above to view or listen to their entire presentation on YouTube.
About Our Approach Substance Use Treatment
At The Dorm we offer holistic, wrap-around care for young adults experiencing symptoms of bipolar disorder and co-occurring substance use disorders (up to 93% of our clients present with more than one diagnosis upon intake).
Our treatment for cannabis use disorder focuses on two critical areas: building the skills necessary to maintain sobriety and establishing a support network of peers in recovery. By helping clients successfully navigate situational triggers with new tools including life skills and the emotional support of The Dorm, our goal is to see clients live their lives fully in a manner that reflects ‘normality’ without compromising their sobriety. Learn more about our services here.
