While they are different conditions, some symptoms are common to both. This can lead to misdiagnosis and delays in getting the right treatment.
Because bipolar disorder and ADHD can look alike, they are sometimes mistaken for each other.
The differences between ADHD and the early symptoms of bipolar disorder are often subtle and can prove challenging when assessing children and younger teens.
What is bipolar disorder?
Bipolar disorder affects around 2% of adults in the United States.
It typically emerges during late adolescence or early adulthood but can occur at any stage of life. There are four different types of bipolar disorder:
- Bipolar I disorder: This involves manic episodes accompanied by depressive episodes.
- Bipolar II disorder: Experts characterize this by hypomanic episodes (less severe than manic episodes) and depressive episodes.
- Schizoaffective disorder: This is bipolar disorder combined with persistent psychotic symptoms.
- Cyclothymic disorder: This involves frequent mood fluctuations, milder highs and lows, and fewer periods of feeling settled.
What is ADHD?
ADHD can affect your ability to concentrate, sit still, and regulate your behavior. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition text revision (DSM-5-TR), along with the Centers for Disease Control and Prevention (CDC), recognize three types of ADHD:
- predominantly inattentive presentation
- predominantly hyperactive-impulsive presentation
- combined presentation
To diagnose the condition, a doctor will typically consider the condition’s signs and symptoms. These symptoms generally fall into two categories: inattentive and hyperactive-impulsive.
Inattentive symptoms include:
- lack of attention to detail
- difficulty focusing and staying on task
- difficulty listening
- difficulty following instructions and completing tasks
- organizational challenges
- distractibility and forgetfulness
Hyperactive-impulsive symptoms include:
- fidgeting, restlessness, and difficulty staying seated
- running, climbing, or being constantly on the go
- excessive talking and interrupting others
- impulsiveness and difficulty waiting for a turn
You can find out more about the symptoms of ADHD here.
Comparing bipolar disorder and ADHD
Doctors and healthcare professionals diagnose bipolar disorder and ADHD through a thorough evaluation that includes a comprehensive psychiatric assessment, medical history review, how long your symptoms last, and their impact on daily life.
The table below shows some of the factors clinicians consider when making their assessment:
| Bipolar disorder | ADHD | |
|---|---|---|
| Characteristics | mood swings between manic and depressive episodes | inattention, hyperactivity, and impulsivity |
| Episode duration | days to weeks or longer | symptoms persist over time |
| Common symptoms | Manic episodes: Elevated mood, increased energy, racing thoughts, impulsivity, decreased need for sleep Depressive episodes: Persistent sadness, loss of interest, changes in appetite and sleep patterns, feelings of guilt or worthlessness | Inattention: Difficulty holding attention, making careless mistakes, forgetfulness Hyperactivity: Fidgeting, excessive talking, difficulty staying seated Impulsivity: Acting without thinking, interrupting others, difficulty waiting for turns |
| Psychosis or delusions | this may apply during manic episodes | N/A |
| Age at diagnosis | typically, late adolescence or early adulthood | childhood, but can continue into adulthood |
Can someone have ADHD and bipolar disorder?
People with bipolar disorder are around 6.7 times more likely to have ADHD when compared to the general U.S. population. Separate research suggests that about 25% of people with childhood ADHD develop bipolar disorder.
When ADHD and bipolar disorder appear together, the data shows that bipolar disorder tends to have an earlier onset, a more severe course, and more frequent episodes of hypomania.
People with both conditions also have a higher rate of suicidal thoughts and behaviors, more frequent involvement in violence, and are more likely to have legal difficulties.
If suicidal thoughts are surfacing:
- Call a crisis hotline, such as the National Suicide Prevention Lifeline, at 988.
- Text HOME to the Crisis Textline at 741741.
- If you feel you’re at immediate risk, reach out to a trusted friend, family member, or healthcare professional. Consider calling 911 or your local emergency number if you can’t get in touch with them.
Treatment
Whether you have bipolar disorder, ADHD, or both, treatment focuses on helping you to manage your symptoms.
Many patients cycle through different medications before they find an effective treatment plan with minimal side effects.
Options for bipolar disorder may include:
- mood stabilizers, like lithium (Lithobid) or valproate (Depakote)
- atypical antipsychotics, like quetiapine (Seroquel) or olanzapine (Zyprexa)
- talking therapies, like psychotherapy, cognitive behavioral therapy (CBT), or interpersonal therapy
Treatment options for ADHD commonly involve:
- stimulant medications, like methylphenidate (Ritalin), amphetamine (Evekeo, Adderall)
- nonstimulant medications, like atomoxetine (Strattera), guanfacine (Intuniv)
- behavioral therapy or counseling to address symptoms and develop coping strategies
Psychiatrists often use mood stabilizers to treat bipolar disorder, but they are generally not the first line of treatment for ADHD. While some mood stabilizers, like lithium, may have limited efficacy in managing ADHD symptoms, they are not typically prescribed solely for ADHD.
When treating ADHD and bipolar disorder together, the primary focus is stabilizing your mood. A doctor or healthcare professional may then prescribe stimulant medications to help manage your ADHD symptoms.
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Both bipolar disorder and ADHD can make life very challenging. People with severe bipolar disorder sometimes need to spend time in the hospital during episodes of mania and depression.
Whether you have bipolar disorder or ADHD, building trusting relationships with loved ones and healthcare professionals is an important part of leading a fulfilling life.
Engaging in therapy, eating a balanced diet, and getting plenty of exercise will help you cope with each day.
For treatment of either condition to be successful, it is also essential to follow the medical treatment plan that a doctor or healthcare team puts in place.
Summary
Bipolar disorder and ADHD are two unique conditions that share some common symptoms. The good news is that with proper diagnosis and treatment, you can effectively manage these challenges and lead a fulfilling life.
By working closely with healthcare professionals, exploring options such as mood stabilizers, antipsychotics, talking therapies for bipolar disorder, stimulant or nonstimulant medications, and therapy for ADHD, you can find strategies that work best for you.
Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.