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Edited & medically reviewed by THE BALANCE Team
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ADHD, or attention deficit hyperactivity disorder, and Bipolar disorder are distinct disorders that are increasingly being identified in American children and teenagers and are frequently diagnosed concurrently.

Related : What is Bipolar Psychosis?

Bipolar disorder in children and teenagers is becoming more well-understood by medical science. However, diagnosing the illness is still difficult. This is especially true for adolescents, who often experience moodiness and irritability as part of normal development. A moody adolescent or teen may be going through a challenging but normal developmental phase. They could also have bipolar disorder, which causes mood swings ranging from depression to mania on a regular basis.

When a child is diagnosed with attention deficit hyperactivity disorder (ADHD), he or she may be at increased risk of developing other mental health problems later in life. Major depression, bipolar disorder, and anxiety disorders are examples of these. While researchers are still learning a lot about how the two conditions interact on a neurobiological level, they estimate that 9 percent to 35 percent of adults with bipolar disorder also have ADHD.

Read Also : ADHD Vs Anxiety

Even when their moods are stabilized with the appropriate medication and treatment, many individuals with bipolar illness may find it difficult to meet deadlines, maintain mental focus, and stay organized. They frequently blame themselves for not being sufficiently driven to modify their habits. ADHD may be to blame in these circumstances, and by obtaining treatment for both diseases, individuals can regain control of their emotions, thoughts, and behaviors, as well as enhance their personal lives.

The symptoms of attention deficit hyperactivity disorder (ADHD) and bipolar disorder are very similar. This is so common that they’re frequently misinterpreted as one another. However, this does not rule out the possibility of them showing up together.

ADHD affects around 3 to 6% of the adult American population. As per the National Institute of Mental Health, roughly 4.4% of American adults will have bipolar disorder at a certain point in their lives.

Bipolar disorder and ADHD frequently coexist. Some indicators, like inattention and impulsivity, might be confused with one another. This makes it difficult to tell them apart at times. It’s still unclear why bipolar disorder and ADHD co-occur so frequently. Biological and genetic factors are assumed to be a part of the problem.

It’s challenging enough to get a diagnosis of attention deficit hyperactivity disorder (ADHD or ADD), but ADHD frequently coexists with other physical and mental illnesses. According to one study, 42 percent of persons with ADHD had at least one other serious psychiatric condition. As a result, the diagnostic inquiry is “Is it both bipolar disorder and ADHD?” rather than “Is it one or the other?”

The distinction between ADHD and Bipolar Mood Disorder (BMD) is perhaps the most difficult to make because they have many symptoms, including:

  • Instability of mood
  • Energizing bursts
  • Impatience
  • Talkativeness
  • Restlessness

It’s reported that roughly 20% of people with ADHD also have mood disorder problems on the bipolar spectrum, and getting the right diagnosis is crucial for treating both ADHD and bipolar disorder together.

There is a significant risk of misdiagnosis or missing diagnosis due to the many common traits. Nevertheless, use these six factors as a guide for assessing if you have ADHD or Bipolar Disorder:

1. Age of onset: Attention Deficit Hyperactivity Disorder is a lifelong disorder, with symptoms appearing by the age of 12 (though not always debilitating). While we now know that children can get Bipolar mood disorder (BMD), it is still a rare occurrence. The majority of persons with BMD experience their initial episode of affective disorder after the age of 18, with an average age of 26 at diagnosis.

2. Persistent impairment: ADHD is a chronic condition that is constantly present. BMD comes in waves, with more or less typical mood levels in between.

3. Mood prompts: People with ADHD are impassioned and have strong emotional responses to events in their lives, which are referred to as triggers. Intensely happy, exuberant feelings emerge from happy events. Unhappy situations provoke highly sorrowful sensations, particularly the feelings of being criticized, rejected, or taunted. BMD causes mood swings that are unrelated to events in one’s life.

4. The pace with which mood fluctuations occur: Since mood shifts in ADHD are virtually always caused by life events, they appear to be immediate. Except for their severity, they are typical moods in every sense. Because of the abrupt onset, they are commonly referred to as “snaps” or “crashes.” BMD’s un-triggered mood swings, on the other hand, can take hours or days to transition from one state to another.

5. Mood duration: While reactions to significant losses and rejections can last weeks, mood swings in ADHD are usually assessed in hours. BMD mood swings must last at least two weeks, according to the DSM-V definition. For example, in order to have “rapid-cycling” bipolar disorder, a person just needs to have four mood swings in a 12-month period, from high to low or low to high. In a single day, many persons with ADHD suffer that many mood swings.

6. Family background: Both conditions run in the family, but those with ADHD nearly always have multiple incidences of ADHD in their family tree. Those that have BMD are more likely to have fewer genetic ties.

Overlapping Symptoms

Emotional dysregulation isn’t the only symptom that bipolar mania and ADHD have in common. ADHD can be misdiagnosed as bipolar disorder in children due to these overlapping symptoms. Many behaviors, according to expert medical professionals, could be construed as indicators of either mania or ADHD. Consider the following example:

  • Mania is defined by increased activity, which can resemble the hyperactivity linked with ADHD.
  • Manic irritability resembles the low frustration threshold associated with ADHD.
  • Mania’s poor judgment resembles ADHD’s impulsivity.
  • Distractibility is present in both.
  • Both have issues with sleeping.

The critical difference is that mania is a transient disorder, whereas ADHD is a long-term condition. While a child with ADHD has a poor frustration threshold, a youngster with bipolar disorder may be very irritable for 6 months and then not have another bout for years.

Related: How A Person With Bipolar Thinks

Dr. Carlson adds that the diagnostic techniques clinicians use to examine a child’s behavior, termed structured interviews, may ask parents to grade symptoms but do not ask whether they are episodic and unrelated to other stresses or environmental changes, adding to the potential for misinterpretation. Of course, this information is crucial in ruling out one or the other diagnosis.

Due to the difficulties in separating manic episodes from symptoms of ADHD in some studies, these signs have been counted twice, once as a sign of bipolar illness and once as a sign of ADHD. As a result, children with either bipolar disorder or ADHD may be mistakenly diagnosed with both.

The uncertainty over whether a kid has ADHD, bipolar disorder, or both can make treatment selections challenging. Which should be addressed first if the diagnosis is unclear? ADHD should be treated first, according to medical experts. Because ADHD is considerably more common in kids than bipolar disorder, ADHD is more likely to be the appropriate diagnosis.

However, stimulant drugs, which are the first-line medication for ADHD, result in benefits immediately. Within days or weeks, their effectiveness (or lack thereof) should be apparent. Some professional doctors see children who have been identified with bipolar disorder and whose parents are astonished and delighted to see their symptoms disappear with stimulant medicine because these children have ADHD rather than bipolar disorder.

If a child is diagnosed with bipolar disorder, stimulant medicine has not been demonstrated to have a negative impact on their illness, unlike certain other medications, such as antidepressants, which can cause mania. There is a scarcity of research on the optimal therapy option for persons who have ADHD and bipolar disorder. The treatment of bipolar disorder and ADHD together is now made on the basis of a doctor’s observation rather than a set of established guidelines.

According to a 2017 study published in the Journal of Psychiatry and Neuroscience, treating bipolar disorder symptoms first may be the best approach.

Once the symptoms of bipolar disorder are under check, medication can be used to treat ADHD.

This approach, however, is intended to be a recommendation for clinicians rather than a definitive treatment method. More study is required to determine the optimal treatment option.

Treatment for bipolar illness usually consists of a combination of medications and treatments. Bipolar disorder medications include:

  • Mood stabilizers
  • Antidepressants
  • Antipsychotics
  • Symbyax
  • Benzodiazepines

Medications are frequently used in the treatment of ADHD, with central nervous system enhancers being the most popular.

Stimulants used to manage ADHD have been linked to psychotic and manic episodes in patients with bipolar disorder and ADHD, according to some studies. Other researchers, on the other hand, have discovered that these drugs work effectively for persons with ADHD and bipolar disorder.

The medicine methylphenidate (Ritalin) may be a safe therapy choice for persons with bipolar disorder and ADHD who are on mood stabilizers to control bipolar symptoms, according to a major 2016 study.

Over a three-month period, persons who did not take mood stabilizers had a 6.7-fold increase in manic episodes, according to the study.



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