Alcohol and Marijuana Use to Self-Medicate Bipolar Disorder Symptoms in Later Life: A Case Study Approach

The use of substances to self-medicate, that is to alleviate or treat various negative states, has been acknowledged as a common coping mechanism for various psychiatric conditions. Self-medication with substances is associated with various negative outcomes, including the development of substance use disorders. Extant literature shows that 60% of community samples with bipolar disorder (BD) have reported abusing one or more substances at some point in their lives. Aside from sharing a common cause of psychopathology, self-medication may be one contributing factor to the high co-occurrence of BD and substance use. Understanding people's interpretations and reasons for use could help inform interventions and assess readiness to change. Given the high prevalence of co-occurring BD and substance use and the complex unique trajectories of each person, we used a case study approach to highlight individual experiences during these types of co-occurrence in later life. The lens of a life course framework with a focus on personal theories on self medication allowed us to uncover how and when the use of different substances fit into the participant's lives over time and across mood states.