ADHD, Bipolar, or Both? What You Need to Know

A recent article in ADDitude Magazine reminded me that about 20% of people with ADHD will develop Bipolar and about 70% of people with Bipolar also have ADHD.  Wow!  This is a huge overlap, and it’s important to know the characteristics of each, so that you can get treatment right.

It’s easy to confuse ADHD and Bipolar, as both conditions include symptoms commonly associated with ADHD. 

According to Roberto Olivardia, Ph.D., both conditions “include impulsivity, irritability, hyperactivity, emotional dysregulation, sleep problems, a racing brain, and problems with maintaining attention.”  Sounds pretty familiar to anyone who has been diagnosed with ADHD or has a spouse with ADHD.  And lots of docs get these two confused, as part because Bipolar issues might not show up until adutlhood.

However, Bipolar has some very specific characteristics that ADHD does not – depressive and manic ‘episodes.’  Episodic depression is not the same thing as being generally depressed, which many people with ADHD can be.  Various studies put depression as a co-existing condition for those with ADHD at between 16-31% currently, with a lifetime incidence of a bit more than 50% of those with ADHD being depressed at some point or another.  ADHD depression is something that relates to what is going on in your life…you move into it slowly and resolve it slowly.  Bipolar depressive episodes, on the other hand, come and go periodically (perhaps several days of feeling really down) and come regardless of what is going on around you (i.e. not simply related to really depressing stuff happening to you.)  Depressive episodes with Bipolar might also be identified by the depth of stark contrast of the depression vs. other times in the person’s life.

Manic episodes are identifiable by the severity and speed with which they come upon you, with no apparent reason.  This isn’t being elated because you just got engaged…this is being driven to do things (often hyperactively) that you normally wouldn’t have a desire to do…being super charged and, again, not in relationship to what is going on around you.

Treatment and More Information

One of the reasons to be aware of the differences between Bipolar and ADHD is that the treatments for ADHD can make Bipolar worse…so best to get the right diagnosis first time around.  (This is one reason to get a full evaluation, not a cursory 10 minute interview with your primary care provider if at all possible.)

If this sounds familiar, it’s time to learn more.  These resources could help:

And, when it is finally published online, the Olivardia article is worth reading, as well:  Solving the ADHD-Bipolar Puzzle in the Fall, 2016 issue of ADDitude Magazine.