I think it's the predominant focus because the bipolar symptoms tend to precede the substance abuse as it is her illness that she's medicating with those chemicals. Prior to cheating on and breaking up with me in 2014 she had been off her meds for a month or two, it was after that event that she began partying. But it's a chicken/egg dilemma because it is ultimately alcohol/drugs that pushes her brain into full-blown mania and/or psychosis. I think both co-concurring disorders are important to treat and focus on as they feed one another.