Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Bipolar Disorder

Bipolar Disorder

Bipolar disorder is characterized by two phases, a manic phase and a depressive phase.  The person experiences these mood shifts either a few times a year or several times a day, shifting from mania (elevated mood) then through a depressed episode. A manic or depressive episode can last for a few days or persist for months until the next phase becomes active. Men and women are equally as likely to have bipolar disorder1 and the disorder typically begins between ages 15 and 25.2 Patients who experience bipolar disorder experience these manic and depressive episodes in either a rapid cycle or it could take years. A mild form of bipolar disorder is cyclothymia in which people experience hypomania, less manic behavior, and a mild depression. Patients may abuse alcohol or other substances, which can worsen symptoms and increase suicide risk.2

Diagnosed with Bipolar DisorderPercentage
U.S. Population1.6
Current Smokers68.8
Lifetime Smokers82.5

Bipolar Disorder and Smoking

The prevalence of Bipolar Disorder among the United States population is 1.6%.  In the population of those with bipolar disorder, 68.8% make up the amount of current smokers. That is an incredibly large amount of people who make up a small percentage of those currently smoking in the United States population.  In addition to being likely to smoke if they are diagnosed with bipolar disorder, they are more likely to be heavy smokers- >30 cigarettes a day.3 Research suggests that the individual with Bipolar Disorder smokes in an attempt to moderate the changes from becoming very upset (agitated or irritated) to feeling low in mood.  In particular, the shifts in moods can make it difficult for the individual with bipolar disorder to feel balanced in emotions and energy level.  There is also some evidence to suggest it feels like a tool to help with concentration and remembering when the individual is having difficulty with staying focused.  From this research, it seems to be understandable that an individual with bipolar disorder may become a heavy smoker to help alleviate some of the distress associated with certain symptoms. Ultimately, because they are at higher risk for smoking, they are also at higher risk for the health consequences associated with the use of tobacco.  For treatment suggestions, please click here.

References: 

1 American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author

2 A.D.A.M. Medical Encyclopedia. (2011, March 29). Bipolar Disorder. PubMed. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001924/

3Diaz, F. J., James, D., Botts, S., Maw, L., Susce, M. T., & Leon de, J. (2009). Tobacco smoking behaviors in bipolar disorder: A comparison of the general population, schizophrenia, and major depression. Bipolar Disorders, 11(2), 154-165.

4Morris, C D., Giese, A.A., Turnbull, J.J., Dickinson, M., Johnson-Nagel, N. (2006). Predictors of tobacco use among persons with mental illnesses in a statewide population. Psychiatric Services, 57(7), 1035.