How to Manage Post-Acute Withdrawal Syndrome and Bipolar Disorder During Recovery

Some individuals with substance use disorder (SUD) experience post-acute withdrawal syndrome (PAWS). The extended symptoms related to withdrawal from drugs or alcohol negatively impact a person's mental health and quality of life. Meanwhile, individuals in recovery diagnosed with bipolar disorder (BD) may have a more challenging time navigating recovery without professional addiction treatment if they experience PAWS. West Coast Recovery Centers offers tailored treatment programs to help clients address co-occurring disorders and manage persistent symptoms related to SUD. 

What Is Post-Acute Withdrawal Syndrome?

Post-acute withdrawal syndrome, also called protracted withdrawal syndrome, is a condition affecting some individuals recovering from substance abuse. Individuals with alcohol use disorder (AUD) and a history of relapse have a higher risk of developing PAWS. According to the Journal of Studies on Alcohol and Drugs, "Although acute [alcohol withdrawal syndrome] symptoms usually last for only a few days up to a week, some symptoms can persist, including anxiety, depression, irritability, cognitive dysfunction, cravings for alcohol, sleep disturbance, fatigue, and autonomic irregularities." 

The symptoms of PAWS may last for weeks or months depending on multiple factors, including: 

• A client's ability to manage symptoms
• Type and severity of symptoms
• A client's general health 
• Type and intensity of substance abuse
• Family history of substance abuse or mental health disorders 

Substances like alcohol and benzodiazepines have a higher likelihood of causing long-term withdrawal symptoms due to the accumulative side effects caused by chronic abuse. The clinical team at West Coast Recovery Centers uses comprehensive assessments and screening tools to determine if clients have an increased risk of experiencing PAWS. 

Comorbid Bipolar Disorder

Bipolar disorder is one of the most common co-occurring disorders diagnosed alongside substance abuse. According to Substance Abuse Treatment, Prevention, and Policy, "[R]esearch has consistently shown that substance use disorders (SUDs) are extremely common in bipolar I and II disorders." In fact, "The lifetime prevalence of SUDs is at least 40% in bipolar I patients." The symptoms of bipolar disorder may make it challenging for some people to maintain routines and attend treatment sessions if they experience PAWS. Prescription medication and psychotherapy often provide the greatest support for clients with co-occurring PAWS and BD. 

Potential Side Effects of Untreated Bipolar Disorder During Treatment for Post-Acute Withdrawal Syndrome

Some people seeking treatment for SUD  may have undiagnosed bipolar disorder. During the early stages of treatment, it can be difficult for clinicians to differentiate between symptoms of BD and withdrawal. The care team conducts additional assessments and screenings after detox and withdrawal to determine if clients have any undiagnosed co-occurring disorders. PAWS may complicate diagnoses by introducing additional factors. Meanwhile, undiagnosed BD must eventually be addressed in later stages of treatment. 

Diagnosed and untreated bipolar disorder may also cause potential side effects during treatment for PAWS, including: 

• Increasing the frequency or severity of symptoms 
• Increasing overall stress levels 
• Reducing the effectiveness of treatment 
• Increasing the risk of developing additional mental health issues 

Leaving bipolar disorder untreated has the potential to impact the quality of life for individuals with PAWS. Misdiagnosis is one of the most common causes of untreated BD. According to Scientific Reports, "Multiple episodes of major depression frequently occur prior to the first episode of hypomania or mania . . . Therefore BD is frequently misdiagnosed for major depressive disorder" (MDD). The most common co-occurring condition alongside SUD is MDD. An accurate diagnosis ensures people with BD receive effective and appropriate treatment for their dual diagnosis. 

How Does West Coast Recovery Centers Treat Co-Occurring Post-Acute Withdrawal Syndrome?

Mood disorders, including bipolar disorder, may impact PAWS and recovery from SUD. According to Addiction Science and Clinical Practice, "Patients with underlying preexisting mood disorders may experience symptoms of varying type and intensity at any time during withdrawal or treatment." West Coast Recovery Centers addresses mood disorders and co-occurring PAWS using evidence-based and alternative holistic therapies and other methodologies. 

The type and severity of symptoms determine what treatment approach will provide the best outcomes. Some of the treatment options and services include: 

• Individual psychotherapy
• Group therapy 
• Family therapy
• Alternative therapies
• Prescription medication 

The symptoms of bipolar disorder and PAWS exist along a spectrum, making each case unique. Clinicians collaborate closely with clients and their loved ones to create a comprehensive, tailored care plan to address active and underlying issues that impact treatment and recovery. Clients may require multiple forms of therapy and continued treatment for PAWS or DB during continuing care. 

Long-Term Recovery and Dual Diagnosis

Bipolar disorder is a condition people must manage throughout their lives. For many people, this involves taking prescription medications to reduce symptoms and side effects. PAWS may also cause long-lasting symptoms. Symptoms often overlap between PAWS and BD. The combination could make it more difficult for clients to transition smoothly from structured treatment programs to continuing care. West Coast Recovery Centers offers alumni services and other forms of support to help clients successfully achieve and maintain sobriety while managing co-occurring conditions. 

Some people with post-acute withdrawal syndrome have co-occurring bipolar disorder. The combination may make it difficult for individuals to cope with everyday stressors in treatment and early recovery. Routine, structure, and therapeutic support help clients manage their condition and heal from substance abuse. The effects of PAWS and BD often last for significant periods, making it essential for people to build a solid support system and practice self-care. West Coast Recovery Centers helps clients and their families prepare for long-term sobriety by educating them and ensuring clients have the tools to manage their co-occurring conditions. To learn more about our programs and support services, call us today at (760) 492-6509.