Relationship Between Bipolar and ADHD.
With the steadily increasing number of people – adults and children alike – being diagnosed with bipolar and ADHD (attention deficit hyperactivity disorder), it raises the questions of why so many people are being diagnosed with these disorders and what the two have in common. In many cases the symptoms of the two disorders can be very similar; because of this, both are commonly misdiagnosed as one or the other.
This is especially true for children and teenagers. As a person in young adulthood goes through puberty, periods of moodiness and irritability are very common. How can one be sure whether a mood swing is due to normal development or part of an underlying mental disorder?
Symptoms of ADHD often mimic symptoms of bipolar disorder. Children and teens with either disorder may present symptoms of restlessness, irritability, impulsive speech, trouble focusing, and defiant behavior.
In adults, mania (the “high” of bipolar) is most commonly associated with symptoms of 
- rapid speech,
- euphoria,
- irritability,
- increased energy,
- decreased need for sleep,
- and feelings of invincibility.
In children, the symptoms of mania are not as pronounced. Some believe that being irritable and cranky may be the only signs of mania in children, but how does that differ from the normal stressors of everyday life in childhood? Most parents will agree that their child exhibits these symptoms on a weekly basis.
Symptoms of ADHD in children include inattention, impulsiveness, and hyperactivity. Again, how do these differ from normal childhood behaviors? At what point does it cease to be normal and start to be an illness? It seems as though the line is very fine.
As children who have ADHD get older, many of their symptoms will begin to dissipate. If a child who was diagnosed with ADHD continues to have symptoms of impulsiveness and hyperactivity, they may need to be re-diagnosed for the possibility of bipolar disorder.
How can you tell the Difference Between Bipolar and ADHD in Children
Bipolar disorder is primarily a mood disorder, while ADHD primarily affects behavior and attention. ADHD is also recognized as a chronic illness, while bipolar tends to come in episodes, with periods of normalcy interspersed with periods of mania, depression, or hypomania (less intense mania). To accurately make a diagnosis, doctors need to find answers to these questions:
• What was the age of onset? ADHD symptoms commonly begin in early childhood, while most cases of bipolar don’t begin until late teens or early adulthood.
• How consistent are the symptoms? As previously mentioned, ADHD is chronic, while bipolar is episodic.
• How rapid do their moods shift? ADHD causes rapid changes in mood, while bipolar typically takes days, weeks, or months to shift to the opposite pole.
• What triggers their mood shifts? Mood changes associated with ADHD are almost always directly related to life events, while those associated with bipolar are usually unrelated to what is happening in the patient’s life.
To complicate things even more, some people can be diagnosed with both bipolar and ADHD at the same time. Many people who have been diagnosed with both disorders fit the majority of these criteria:
• They have more pronounced ADHD symptoms than those diagnosed with only ADHD
• Some bipolar symptoms have been present since childhood
• They have poorer overall functioning and lower productivity than those with only one disorder
The problem with being diagnosed with both disorders is the way in which they are treated. For bipolar patients, those experiencing symptoms of mania or hypomania are given mood stabilizers or anti-psychotics.
Those with ADHD are typically treated with stimulants that speed up functioning in certain parts of the brain. Many treatments for ADHD can actually cause episodes of mania in bipolar patients, so it’s important to get an accurate diagnosis before beginning any treatments. It’s also important to be treated for bipolar before being put on medication for ADHD, as you need to get your bipolar symptoms under control before taking any stimulants.
Additionally, it may be beneficial to look in to medications that can treat both disorders at the same time, such as Wellbutrin.
There is a lot of debate over the misdiagnoses of both of these disorders, and even more debate over the comorbidity (the presence of two or more disorders in the same person) of the two. Can bipolar and ADHD really be present at the same time, or is it merely the overlap of symptoms that causes doctors to believe this is the case?
Many people have been diagnosed with both disorders, only to find out years later that only one was present. Many more are being treated for both, unsure of which they have. Add in the difficulty of diagnosing children and mental health professionals have a lot on their plate.
Carefully watching how patients respond to specific medications is a good first step in determining which illness is present, whether it is one or both. Closely monitoring your symptoms with the help of doctors, friends, and family members will help you determine whether you have bipolar disorder, ADHD, or a combination of the two.
More about the Types of Bipolar
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