Ecstasy doesn’t cause bipolar disorder or similar conditions. It can, however, exacerbate symptoms for those who have the disorder.
Drug abuse also makes it tougher to treat bipolar disorder. Substances of abuse can interact poorly with prescription medications used to control symptoms.
Ecstasy is one of the many names for 3,4–methylenedioxymethamphetamine, or MDMA. This is a notorious club drug that causes an intense, euphoric high by forcing the brain to release a surge of dopamine.
The substance leads to feelings of intense happiness and physical energy, but it may also cause hallucinations, elevated body temperature, dehydration, and disorientation. Additionally, the comedown effects that occur when the drug has been metabolized out of the body can be uncomfortable.
While ecstasy is now a Schedule I drug per the U.S. Drug Enforcement Administration (DEA) — it is not considered to have any medical benefits, and it is only a dangerous, addictive substance of abuse — MDMA was used in the 1970s as a prescription substance to help with psychotherapy. Due to high rates of diversion, misuse, illicit manufacture, and addiction, ecstasy was made completely illegal in the United States in 1988.
The substance has risen and fallen in popularity since then, with a surge in the 1990s and then a decline. It has had a more recent resurgence with “purer” forms of MDMA like Molly.
This chemical has an intense, long-lasting impact on the brain. Effects begin between 20 and 40 minutes after consumption, depending on how the drug was taken, and the high can last for about 6 hours.
Peak effects hit for about 60 to 90 minutes, but hypertension, hyperthermia, and intense physical energy, including anxiety, can last for hours after that. This experience can lead to acute bodily harm, dehydration, and exhaustion.
Even the average adult, who does not have a mental illness, will experience psychological and physical side effects from taking MDMA or ecstasy. Mental illnesses, especially those involving mood swings from serotonin and dopamine changes like bipolar disorders, can make the condition worse.
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Bipolar disorder was once called manic-depressive disorder, but the name changed as the medical community learned more about this group of conditions.
In general, bipolar disorder involves alternating periods of mania, or high emotional and physical energy, and depression, or low mood and energy. The intensity of mania and how often these two extreme cycles depends on what type of bipolar disorder a person struggles.
People who struggle with any mental health condition, especially intense mood disorders like bipolar disorders, may self-medicate with drugs or alcohol. This is especially likely before the person receives a diagnosis of their condition and begins a treatment plan.
While MDMA and ecstasy are not common substances of abuse for people with bipolar disorder, the drug causes such an imbalance in brain chemistry that it could mimic a manic episode. This could lead to a more intense depressive period than the person is used to experiencing.
Bipolar disorder and substance abuse are reportedly so intertwined that medical recommendations for counselors, doctors, and addiction specialists are to screen anyone — particularly adolescents — with a diagnosis of bipolar for co-occurring substance abuse. Those who have forms of bipolar disorder that involve rapid cycling are the most likely to self-medicate with drugs and alcohol due to emotional intensity and psychological pain.
These drugs cause a sense of relaxation and sleepiness, which can blunt the effects of mania and mood swings. However, they can produce uncomfortable side effects later, as they are abused more often.
Stimulants like amphetamines, crystal meth, and cocaine may be taken during periods of severe depression, but they are likely to trigger manic episodes due to the intense surge of dopamine from the stimulant. This is often followed by a deeper depression, which is more likely to feature psychotic symptoms than depression not induced by chemicals.
Hallucinogens, most often LSD, psilocybin, and PCP can cause psychotic symptoms in either depressive or manic states. Since ecstasy is both a stimulant and a psychedelic that releases large amounts of the brain’s three main mood-related neurotransmitters (norepinephrine, serotonin, and dopamine), the drug produces an intense feeling of energy, which could lead to mania. At the same time, it changes the brain’s perception of stimuli like touch and sound, which can lead to psychotic symptoms. As it wears out of the body, ecstasy is likely to make depressive symptoms much worse, and the psychotic symptoms are expected to continue.
Abusing substances makes treatment for bipolar disorder much harder because prescription medications cannot regulate brain chemistry as well.
Adhering to a treatment regimen can stabilize brain chemistry in people who have bipolar disorder, and this means getting treatment to overcome substance abuse. Many addiction treatment programs have options to diagnose and treat co-occurring disorders, including bipolar disorders.
Starting psychiatric medication and ending nonmedical drug use has been repeatedly shown to be the best approach to managing symptoms. For example, lithium (a common prescription medication for bipolar I) has been found to eliminate or substantially reduce substance abuse in 75 percent of adolescents with the condition who also struggle with alcohol and drug abuse.
Ecstasy does not cause bipolar disorder, but its use can worsen symptoms. It’s important to get help to avoid substance abuse so that you can prevent this.
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(April 2016). Bipolar Disorder. National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
(October 8, 2018). Substance Abuse and Bipolar Disorder. Psych Central. Retrieved from https://psychcentral.com/lib/substance-abuse-and-bipolar-disorder/?all=1
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