How are bipolar disorder and ADHD different?

Mental Health
Bipolar disorder and attention deficit hyperactivity disorder (ADHD) are two distinct health conditions. They share some similar symptoms but have several key differences.

ADHD is more common than bipolar disorder. As the two conditions can coexist, misdiagnosis can occur.

In this article, we compare bipolar disorder and ADHD. Read on to learn about the symptoms of each and how they can overlap. We also explain treatments and when to see a doctor.

Bipolar vs. ADHD

Distracted young woman in lesson or exam looking bored
Bipolar disorder affects mood, while ADHD affects behavior.

Bipolar disorder is a long-term mental health condition that can cause unusual shifts between high and low moods.

Bipolar symptoms occur in episodes rather than being ongoing. In addition to affecting how a person thinks and feels, bipolar disorder can influence their behavior.

In contrast, ADHD is a condition that affects a person’s attention, activity, and impulse control. It primarily affects behavior, not mood. Symptoms are ongoing rather than occurring in episodes.


Symptoms

Bipolar disorder and ADHD can share some similar symptoms, especially in relation to manic episodes.

If a person has bipolar disorder, manic episodes may cause them to feel happy and confident and to have excessive energy. During a manic episode, a person might be:

  • moving about a lot
  • talking often, quickly, or loudly
  • interrupting people
  • becoming distracted easily
  • acting impulsively

Manic episodes are not a symptom of ADHD, but a person with ADHD may experience some of the symptoms of a hypomanic episode.

Although there may be some symptom similarities, the underlying causes of bipolar disorder and ADHD are different.

Manic episode symptoms happen because of a mood state, while ADHD symptoms tend to be more consistent.

Sometimes, people think that ADHD is synonymous with “hyperactive” or “impulsive” behaviors, and while this may be the case for some people, this is not universally true. Some children and adults with ADHD have symptoms of inattention.

These symptoms include:

  • inattention to detail
  • trouble focusing
  • daydreaming
  • not listening when people speak to them
  • avoiding mental exertion
  • losing belongings frequently
  • forgetting to complete tasks

The symptoms of inattentive ADHD are not typical of bipolar disorder.

If a person has bipolar disorder and experiences a depressive episode, it may make them feel sad, hopeless, and low in energy. They may also withdraw socially.

Depressive episodes are not a symptom of ADHD, but some people with ADHD may also experience depression.

Bipolar and ADHD in children

Child with hands on painting
Doctors often diagnose ADHD during childhood, whereas bipolar disorder rarely occurs in children.

ADHD is more common in children than adults. Around 8.4 percent of children and 2.5 percent of adults have ADHD.

Bipolar disorder usually starts when a person is in their late teens or early-20s, but it can also affect children. This is called early-onset bipolar disorder.

A child with ADHD may behave in similar ways to a child with bipolar disorder who is having a hypomanic episode. However, there are ways to tell the conditions apart, such as:

  • bipolar symptoms tend to be more severe than those of ADHD
  • ADHD behavior is ongoing, while bipolar symptoms occur during distinct episodes
  • a child with bipolar may experience both high and low moods (depending on the type of bipolar disorder)

During a manic episode, a child or teen with bipolar disorder may be:

  • acting in an unusually silly way for their age
  • being short-tempered
  • talking quickly about many topics
  • sleeping less but not feeling tired
  • having trouble sleeping
  • taking more risks

During a depressive episode, a child or teen with bipolar disorder may be:

  • expressing sadness, guilt, and worthlessness
  • complaining about aches and pains
  • oversleeping or not getting enough sleep
  • having little energy
  • eating more or less than usual
  • losing interest in activities that they usually enjoy
  • talking about self-harm or suicide

If the caregiver of a child with ADHD notices signs of bipolar disorder, they should speak to a doctor as soon as possible.


Coexisting conditions

A person can have both bipolar disorder and ADHD. One study found that 17.6 percent of participants who had bipolar disorder or major depressive disorder also had adult ADHD.

Other studies estimate the rate of comorbidity in adults to be much higher.

Interestingly, the number of people who have both bipolar disorder and ADHD is higher than researchers would expect given the prevalence of each separate condition.

It is possible that this is because the conditions share similar causes, but researchers are still investigating the underlying reasons why they develop.

Treatment

Woman having therapy or counseling with psychiatrist
Psychotherapy is a common treatment for bipolar disorder.

Many different treatments are available for ADHD and bipolar disorder.

ADHD treatments for children include behavior therapy and medication. Caregivers can help manage a child’s behavior by:

  • creating and sticking to a routine
  • managing distractions
  • limiting choices
  • setting goals

ADHD treatments for adults include medication and psychotherapy (talk therapy).

When doctors diagnose ADHD and bipolar disorder together, they may consider bipolar disorder to be the primary condition and treat this first.

The reason for this is that bipolar disorder may cause more severe complications than ADHD. There is also a risk that medications for ADHD could make bipolar symptoms worse.

This approach also allows the doctor to see which attention symptoms persist after a person commences treatment for bipolar and to make better decisions about how to treat those ADHD symptoms.

Before treating ADHD, a person with both conditions may benefit from taking mood stabilizers. They can discuss this option with a doctor.


When to see a doctor

If a person recognizes the signs of ADHD or bipolar disorder in themselves or a child, they should speak to the doctor.

Receiving a proper diagnosis and getting the right treatment is the best way to manage ADHD, bipolar disorder, or both conditions.

If a person or a child has already received a diagnosis of one of these conditions, this does not mean that they do not also have the other. A person can have both bipolar disorder and ADHD.

It is always a good idea to discuss any changes in symptoms with a doctor to help ensure that a person has the right diagnosis and treatment.

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