Personal theories of substance use among middle-aged and older adults with bipolar disorder

Sarah L. Canham, Atiya Mahmood, Marissa N. Stalman, David King, Norm O'Rourke

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objectives: Most persons with bipolar disorder (BD) misuse alcohol and/or illicit drugs at some point, yet research specific to older adults with BD is nascent. The current study sought an in-depth understanding of the experiences and meanings of substance use in a sample of adults who self-reported substance misuse. Methods: Semi-structured interviews were conducted and thematically analyzed to understand the personal theories of substance use by 12 adults (9 women and 3 men; M = 49 years old) who self-reported diagnoses of BD and regular alcohol or illicit drug use. Results: Findings provide an in-depth picture of the theories middle-aged and older adults with BD have developed to explain their substance use. Participants’ theories suggest multiple reasons for substance use, including self-medication; increased confidence with substance use; rejection of prescribed medications; easy access to alcohol; early social exposure/use as facilitator; and living in a culture of substance use. Conclusion: Findings suggest multiple theories for the comorbid link between BD and substance use, primarily that persons with BD use drugs and/or alcohol to relieve stress or manage symptoms. It is clinically relevant to incorporate personal reasons for actively and regularly using substances as part of personalized substance treatment and BD symptom management.

Original languageEnglish
Pages (from-to)813-818
Number of pages6
JournalAging and Mental Health
Issue number6
StatePublished - 3 Jun 2018


  • Bipolar disorder
  • comorbidity
  • drug and alcohol misuse
  • self-medication

ASJC Scopus subject areas

  • Psychiatric Mental Health
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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