I have long known that self medicating mental illness through alcohol and substance abuse is a major issue. The term "Dual Diagnosis" is a well worn adage referring to those who are dealing with both addiction and mental illness. For the most part, alcoholics and substance abusers are not aware that they are self medicating and are often unable to isolate their mental illness from the symptoms presented by the substance abuse itself. The following article is an interesting take on self medicating with Marijuana.

Given that California has legalized medical marijuana for various uses, the article below brings up a number of questions for me. First, the article refers to the addictive use of the drug marijuana. My experience has been that most pharmaceutic treatments for mental illness are likewise, addictive, and likewise, can become less potent and require higher doses after a person has used the drug for a while. How is Marijuana different? Why are the side effects of marijuana any different (or, worse) than other pharmaceutical interventions? I'd be very interested to know if a long term clinical study has been conducted that has evaluated the efficacy of marijuana in treating depressions and/or bi-polar disease, and likewise, compared its efficacy against other legal pharmaceutic interventions. Do studies like this exist? And if not, is it appropriate for a doctor to provide their clinical impressions of Marijuana against other legal interventions? It's a lot to think about. If anyone has any thoughts or references, I'd love to see 'em.

The article below is from everydayhealth.com

Is Marijuana Good for Bipolar Disorder?

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Q: My 22-year-old son has been diagnosed with a mild case of bipolar disorder. A psychiatrist prescribed Lamictal (lamotrigine; 300 mg daily). After one year, my son felt it was not helping him and caused his hands to shake. He slowly discontinued the medication and is now self-medicating by smoking marijuana a couple of nights a week. He tells me that it has a calming effect and that he sleeps better. What do you know about pot and bipolar disorder?

There is a very high rate of substance abuse among people with bipolar disorder. Probably this is no accident, because drugs like marijuana can be a means of self-medication, of escaping unpleasant symptoms, including anxiety and depression.

Unfortunately, marijuana is not an effective solution. While it doesn’t typically become physiologically addictive, as do cocaine and heroin — that is, marijuana doesn’t cause physical symptoms of withdrawal when you stop using it — it is highly psychologically addictive. Long-term complications of chronic marijuana use include problems with memory and concentration, apathy (a lack of motivation and emotion), reduced libido, and loss of interest in other activities. Because of this, using marijuana frequently is probably sapping your son’s motivation to get effective treatment for his bipolar disorder and lead a productive life. Over time, he'll need to use more to achieve the same effect.

I highly recommend that your son get back into active treatment for bipolar disorder with a psychiatrist or psychologist — the doctor can also help him determine whether specialized treatment for marijuana addiction is indicated.

Last Updated: 06/16/2009

Dr. Carrie Bearden is a clinical neuropsychologist in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles.