Where ADHD and Bipolar May Overlap

Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder are two different mental health conditions, but they can sometimes share similar symptoms and characteristics. The similarities can make it difficult to tell the difference between the two. This is especially true in children.^1,2

What are ADHD and bipolar disorder?

ADHD and bipolar can look different for everyone. They are both mental health conditions.^2,3

Typical symptoms of ADHD include:^2,3

• Daydreaming
• Intrusive thoughts
• Impulsive actions
• Difficulty focusing
• Trouble with motivation
• Difficulty regulating emotion

Emotional swings and manic episodes

Bipolar disorder is a class of mental illnesses. It contains bipolar 1, bipolar 2, and cyclothymic disorder. All bipolar disorders cause emotional swings. Bipolar 1 and 2 both involve cycling between depressive and manic episodes. But in bipolar 1 the manic episodes are much more severe and often dangerous. In cyclothymic disorder, the mood swings are not dramatic enough to be manic or depressive episodes.^1,2

Symptoms during a manic episode in adults can include:^1,2

• Elevated moods
• Talking fast
• Being energetic or overconfident

Mania in children can cause irritability and aggression. Depressive episodes can cause feelings of hopelessness or helplessness.^1,2

How might ADHD and bipolar disorder be misdiagnosed?

Unlike some physical diseases, most mental health conditions cannot use medical tests or imaging for diagnoses. This means doctors must rely on behavior or medical history to make a diagnosis. This can leave room for mistakes, especially if conditions have similar symptoms.^1,2

ADHD and bipolar in manic episodes can cause very similar symptoms, such as:^2,3

• Hyperactivity
• Racing thoughts
• Talking fast and talking a lot
• Restlessness
• Irritability

People with ADHD are also likely to experience depression or depressive symptoms. These can match bipolar symptoms in depressive episodes.^1,3

How are ADHD and bipolar disorder related?

Research shows there is a link between bipolar disorder and ADHD. About 10 percent of people with ADHD have bipolar disorder. Additionally, children who have ADHD are much more likely to develop bipolar disorder later in life. About 1 in 6 people with bipolar disorder also have ADHD.³

We do not know the exact reason for these connections. It could be because people's genetics make them more likely to develop both conditions. Other research shows a link between pregnancy or childhood factors and developing both conditions. More research is needed to confirm any links between the conditions.³

What are the differences between ADHD and bipolar disorder?

One of the biggest differences between ADHD and bipolar disorder is how long symptoms last. In ADHD, symptoms are fairly consistent. But with bipolar disorder, the mood will fluctuate. If there seems to be several days of hyperactive behavior that then goes away, it is more likely to be bipolar.^2,4

Both conditions also develop at different times. ADHD typically develops in children. But the average age of bipolar disorder starting is 25. This does not mean that children can not have bipolar disorder. It can make it more challenging for children to be accurately diagnosed. In most cases, doctors would suspect ADHD first.^1,2

Treatment differences

Bipolar disorder and ADHD are also treated with different drugs. ADHD usually requires a stimulant. Bipolar disorder is usually treated with mood stabilizers. Unfortunately, stimulants may trigger manic episodes in some people with bipolar disorder. However, the benefit of stimulants is that they can start working to treat ADHD very quickly.^3,4

If you are concerned about ADHD and bipolar disorder, talk with your doctor. A good way to get an accurate diagnosis is by providing as much information as possible. These conditions may seem intimidating. But with the right diagnosis and treatment, they can be managed.^1,2