Bipolar disorder is a complex mental health condition characterized by significant shifts in mood, energy, activity levels, and concentration. These shifts involve distinct periods of elevated mood, known as manic or hypomanic episodes, and periods of low mood, referred to as depressive episodes. This article explores how cannabis might affect individuals living with this condition.
Cannabis and Mood Stability
Cannabis use can significantly impact the mood episodes characteristic of bipolar disorder. While some individuals might perceive a temporary calming effect, consistent use can disrupt the delicate balance of mood regulation. This disruption may lead to more frequent, severe, or rapid mood cycling.
During manic or hypomanic episodes, cannabis can intensify symptoms such as increased energy, impulsivity, racing thoughts, and a decreased need for sleep. The psychoactive component in cannabis, THC, can further increase dopamine levels, potentially escalating these manic symptoms. Conversely, cannabis use can also worsen depressive episodes, leading to increased lethargy, anhedonia (loss of pleasure), and feelings of despair.
Cannabis is not a mood stabilizer and can undermine efforts to achieve mood stability in bipolar disorder. Research indicates that cannabis use is associated with a worsening course of bipolar disorder over time, including an earlier age of onset for the condition, greater overall illness severity, and poorer life functioning.
Cannabis and Psychosis Risk
A notable concern for individuals with bipolar disorder is the link between cannabis use and the risk of psychotic symptoms. Evidence suggests that cannabis, particularly high-potency strains, can increase the likelihood of developing psychotic features. These features may include hallucinations, delusions, or disorganized thinking.
Early or heavy cannabis use can also potentially precipitate an earlier onset of psychosis in vulnerable individuals. For those already experiencing psychotic symptoms as part of their bipolar disorder, cannabis use can exacerbate these existing symptoms or trigger new ones during mood episodes. Studies have shown that among individuals who experience cannabis-induced psychosis, a notable percentage may later develop schizophrenia or bipolar disorder.
Cannabis impacts brain chemicals and functions, including dopamine, which play a role in psychotic symptoms. Introducing THC can further disrupt neural pathways in individuals with bipolar disorder, increasing the risk of psychotic episodes.
Cannabis, Medications, and Dependence
Cannabis use can interfere with the effectiveness of prescribed psychiatric medications commonly used to treat bipolar disorder. These medications include mood stabilizers, antipsychotics, and antidepressants. Cannabis may alter how the body processes these medications, potentially reducing their effectiveness or increasing side effects.
This interference can compromise treatment outcomes, making it more challenging to manage bipolar disorder symptoms effectively. For instance, the active compounds in marijuana, THC and CBD, can interact with liver enzymes responsible for processing medications like lithium, potentially leading to unpredictable levels in the bloodstream.
Individuals with mental health conditions, including bipolar disorder, have a higher risk of developing substance use disorders. Approximately 22% to 59% of people with bipolar disorder may develop a cannabis use disorder (CUD) in their lifetime. CUD can complicate the management of bipolar disorder, making it more difficult for individuals to adhere to their treatment plans and achieve long-term stability.
Consulting a Healthcare Professional
Open communication with a healthcare provider is important for anyone with bipolar disorder who is considering or currently using cannabis. This advice should be individualized due to the complex interplay of symptoms, medications, and personal circumstances.
Discussing all substance use with a care team helps ensure that treatment strategies are safe and effective. A healthcare professional can provide guidance tailored to a person’s specific condition and medication regimen, helping them make informed decisions about their health. This collaborative approach can support better management of bipolar disorder and overall well-being.