How to tell if it's bipolar disorder or ADHD
There may be a connection between the two conditions. A study that featured in the Journal of Psychiatric Research found that a person with attention deficit hyperactivity disorder (ADHD) is much more likely to develop bipolar disorder.
Some people have expressed concerns that doctors may be overdiagnosing or underdiagnosing bipolar disorder and ADHD. Diagnosing either condition can take time, and diagnosis is only possible if a mental health professional works directly with the individual to understand their symptoms.
In this article, we look at the similarities and differences between bipolar disorder and ADHD, including their symptoms, diagnosis, and treatment options.
Bipolar disorder and ADHD share some similar symptoms.
Bipolar disorder is a mental health condition that involves episodes of drastic mood changes. Depending on the type of bipolar disorder that a person has, they may experience both low, or depressive, episodes and elated, or manic, states.
Although its presentation can vary, ADHD is a condition that can cause a person to be hyperactive, have difficulty concentrating, and engage in impulsive behaviors.
Bipolar disorder and ADHD have many different symptoms, which we discuss below.
Bipolar disorder symptoms
Healthcare professionals will diagnose an individual with bipolar I disorder if they have experienced a manic episode that lasted for at least 7 days or was so severe that hospitalization was necessary. The person with bipolar I may never experience a major depressive episode.
A person with bipolar II disorder, on the other hand, will experience a hypomanic episode that precedes or follows a major depressive episode. Hypomania is a milder form of mania that causes less-severe symptoms.
These episodes will vary between people. A person may experience episodes just a few times a year or as frequently as every few months, which is called "rapid cycling."
During depressive episodes, people may have the following symptoms:
- feeling very sad or hopeless
- not finding joy in things that they usually enjoy
- decreased activity levels
- low energy or fatigue
- sleep issues, such as sleeping too much or insomnia
- quick to feel worried or anxious
- eating issues, such as binge eating
- having difficulty remembering things
- suicidal thoughts
During manic episodes, symptoms may include:
- feeling unusually elated or euphoric
- excess energy
- increased activity levels
- trouble sleeping or staying asleep
- a tendency to get irritated or aggravated
- talking a lot about many different things
- difficulty staying focused on one thing
- taking on many tasks or projects at once
- impulsive behaviors, such as going on shopping sprees or engaging in risky sexual behavior
It is important to note that these are not the same as the simple mood swings that occur in most people. The symptoms are so severe that they are disruptive to everyday life, and they last for extended periods.
Hyperactivity is a potential symptom of ADHD.
ADHD can manifest in specific behaviors, such as inattention, hyperactivity, and impulsivity. These symptoms are not the same as the inattention that people may experience when tired. They are intense and disrupt a person's ability to function.
Symptoms of hyperactivity include:
- talking excessively
- moving, squirming, or wiggling while at rest
- restless limbs or fidgeting
- difficulty sitting quietly or resting
- feeling constantly energized
Symptoms of impulsivity include:
- interrupting or talking over others
- taking action without thinking the consequences through
Symptoms of inattention include:
- becoming bored very easily
- getting distracted regularly
- difficulty focusing on the task at hand
- difficulty completing tasks or having many ongoing projects at once
- forgetting important details or daily activities
- having difficulty prioritizing tasks
Some of the symptoms of ADHD and bipolar disorder are similar and can overlap, which can make diagnosing each condition more challenging.
Anyone who suspects that they have symptoms of ADHD or bipolar disorder should speak with a healthcare professional who will examine them to rule out a medical cause for their symptoms. In some cases, a primary care provider may refer a person to a psychiatrist or another mental health specialist.
Diagnosis can take a long time and require patience, but it is important to try to get a diagnosis as soon as possible as this will allow for earlier treatment.
To diagnose either condition, the healthcare professional will ask questions about the individual's symptom history, and they may perform a physical examination. They are also likely to ask the person about their family medical history, any medications that they take, and their general physical and mental health.
To accurately diagnose either disorder, the healthcare professional will need to rule out other conditions and factors that could cause similar symptoms, such as:
- sleep disorders
- thyroid disorders
- anxiety disorders
- major depressive disorder
- side effects from medication
- personality disorders
They will check the person's symptoms against the diagnostic criteria for each condition using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Doing this may take time, but the diagnosis must be correct to ensure that the person receives the right treatment.
The medical treatments for ADHD and bipolar are different. Giving someone the wrong kind of medication for their condition may not help their symptoms and could lead to adverse effects.
Treating bipolar disorder
A doctor may recommend medication to treat bipolar disorder or ADHD.
The first line of treatment for bipolar disorder is generally a combination of medication and therapy.
People with bipolar disorder may need to take mood-stabilizing medications, such as:
- valproate (Depakote)
- lamotrigine (Lamictal)
A healthcare professional may also prescribe antipsychotic medications, which may include:
- olanzapine (Zyprexa)
- quetiapine (Seroquel)
- aripiprazole (Abilify)
Stimulant medications are the main treatment option for many people with ADHD. As the National Institute of Mental Health note, stimulants may work for ADHD because they increase dopamine in the brain, which plays an important role in both thinking and attention.
Common stimulants that doctors use to treat ADHD include:
- amphetamine/dextroamphetamine (Adderall)
- dextroamphetamine (Dexedrine)
- methylphenidate (Ritalin)
- lisdexamfetamine (Vyvanse)
Some nonstimulant medications may work for ADHD symptoms as well, especially if the person has adverse side effects from using stimulants. Nonstimulant medications include guanfacine (Intuniv) and atomoxetine (Strattera).
There is not yet a cure for ADHD or bipolar disorder, but with treatment, people can effectively manage their symptoms.
Many people with bipolar disorder can manage their symptoms with medication and therapy. However, their symptoms and episodes may get worse or become more frequent over time. Medical treatment and therapy are important in both ADHD and bipolar disorder.
Bipolar disorder and ADHD share some similar symptoms, but even these shared symptoms vary in terms of severity. It can take some time to diagnose a person with either condition.
There is no cure for bipolar disorder or ADHD. However, with the correct combination of medical treatment and therapy, most people can find ways to control their symptoms and manage the condition.