ADHD With Bipolar Disorder

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.