Although some sources recommend treating the substance abuse first, mostly because drugs and alcohol can have severe interactions with the medication used to treat manic depression, both really need to be addressed at once. Obviously, a person who is not sober is unable to adhere to the lifestyle changes, medication regime, and therapy appointments needed to hold back mood swings. At the same time, most bipolar substance abusers drink or use drugs partly to self-medicate their symptoms, and they may misuse their prescription medications as well.

Drug treatment programs, including inpatient detox centers, are beginning to be more knowledgeable about working with bipolar patients. If your child will be going to a drug treatment program, make sure that its clinical staff is fully aware of the implications of his illness, and that appropriate medication management and psychiatric expertise will be available.

Most detox centers say that about a month is needed to break a true addiction’s physical grasp, and it takes a year of sobriety before an addict can honestly feel mentally comfortable without his substance of abuse. Relapses are common until several years of sobriety have been achieved, and can present severe dangers, including suicide. The earlier a drug or alcohol user seeks effective treatment, however, the more likely he is to achieve complete freedom from substance abuse without progressing to substance dependency.

Many addicts use self-help resources like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or Rational Recovery to get and stay sober. In these programs, people attend regular meetings to talk about their addiction problems and offer each other support. Former substance abusers who have gotten clean act as mentors to newcomers. Generally speaking, these 12-step programs are an excellent resource for drug and alcohol users in recovery. There are special groups for teens, although many experts recommend teens attend mixed-age groups. Participants in 12-step programs are paired with sponsors who can help them deal with temptation, social pressure, old behavior patterns, and the stress of meeting new expectations.

There are also adjunct groups for the families of addicts. Family support groups can really help you make it through this difficult period. You’ll learn many strategies for helping your child on the road to recovery. Families Anonymous is one with many local chapters.

The only down side of 12-step programs is that a few former addicts are against using prescription medications for brain disorders, seeing them as simply a legal substitute for street drugs or alcohol. This is not an official policy of AA or NA, by the way. To make sure a particular 12-step group doesn’t have this orientation, talk to one of the group’s long-term members or to its institutional sponsor, if any.