ADHD vs. Bipolar Disorder: Recognizing Overlapping Symptoms

ADHD and Bipolar Disorder can easily be confused due to shared symptoms like impulsivity, irritability, and mood changes. But these conditions are very different in how they affect your daily life. While ADHD causes constant challenges with focus and self-control, Bipolar Disorder creates disruptive mood episodes.

So, how do you tell them apart? In this article, we’ll break down their differences, highlight overlapping symptoms, and explore how they’re diagnosed and treated.

ADHD and Bipolar Disorder

ADHD affects focus, attention, and impulse control. Bipolar Disorder causes extreme mood swings between mania and depression.

Both conditions impact millions worldwide and require proper understanding.

What is ADHD?

ADHD is a condition that makes it hard for people to pay attention and control their impulses. The American Medical Association says ADHD is one of the most studied disorders in medicine. About 5% of children and teenagers around the world have ADHD.

For most of them, ADHD continues into their early adult years. In the US, nearly 8% of children aged 2 to 17 have ADHD, and 4% of adults do too. Boys are about 2.5 times more likely to be diagnosed with ADHD than girls.

ADHD shows up as ongoing trouble with inattention, hyperactivity, or impulsiveness. These behaviors can make it hard to do well in school, get along with family, and handle emotions. People with ADHD might also be more likely to have accidents, start having children early, or misuse substances.

What is Bipolar Disorder?

Bipolar Disorder is a mental health condition where people experience extreme mood swings. These swings include periods of mania or hypomania and times of depression. Bipolar Disorder affects about 40 million people around the world. Men and women get Bipolar Disorder at similar rates, but women are diagnosed more often. Bipolar disorder usually starts when people are working, and most have symptoms before they turn 25.

Bipolar disorder comes in different types:

• Bipolar I is when you have very high moods (mania) and low moods (depression). These high moods can last a long time and are very intense.
• Bipolar II is when you have less intense high moods (hypomania). These highs only last a few hours or days. You will also experience depressive episodes, but there are also times when your mood is normal.

Brain scans have shown changes in the brains of people with bipolar disorder. These changes include thinner areas of the brain and problems with how different brain parts connect. These areas help control your mood.

Symptoms of ADHD vs. Bipolar Disorder

ADHD and bipolar disorder are different conditions, but they share certain symptoms. That can make diagnosis confusing. You should learn the unique symptoms of each one.

ADHD Symptoms

ADHD can affect focus, task completion, or behavior control. Experts divide these symptoms into three main types: inattentive, hyperactive-impulsive, and combined.

1. Symptoms of Inattentive Presentation

You may lose focus or feel disorganized. This often makes it hard to keep up with responsibilities at home or work.

Common signs include:

• Trouble paying attention.
• Get distracted easily.
• Skip important details or make careless mistakes.
• Struggle to organize tasks and activities.
• Avoid tasks that require a lot of mental effort.
• Misplace items such as keys or wallets.
• Forget daily tasks.
• Start assignments but rarely finish them.
• You seem not to listen when people speak directly to you.

2. Symptoms of Hyperactive-Impulsive Presentation

This type involves restless movement and acting without thinking. You might disrupt classes, work, or relationships.

Possible signs include:

• Move around in your seat or squirm a lot.
• Cannot remain seated when it is expected.
• Feel restless or always in motion.
• Speak too much or too quickly.
• Interrupt others’ conversations or activities.
• Shout answers before questions end.
• Struggle to wait for your turn.
• Run or climb in places where it is not appropriate.
• You feel inner restlessness or agitation.

3. Symptoms of Combined Presentation

You may show both inattentive and hyperactive-impulsive traits. This mix can make daily life and responsibilities even harder.

Bipolar Disorder Symptoms

Bipolar disorder causes intense shifts in mood. You may go from emotional highs (mania or hypomania) to deep lows (depression). These swings can disrupt your usual routine.

Symptoms of Manic Episodes

ADHD manic episode symptoms involve high energy or an irritable mood. This can lead to reckless choices.

Common signs include:

• Elevated or irritable mood for at least one week.
• Extra energy or more activity than usual.
• Less need for sleep.
• Faster or more frequent speech.
• Racing thoughts.
• Easy distractibility.
• Risky actions (such as reckless spending).
• Inflated self-esteem or grand ideas.
• Increased drive to meet goals.
• Hallucinations or delusions in severe cases.

Symptoms of Hypomanic Episodes

An ADHD hypomanic episode, also called hypomania, involves milder manic symptoms that last at least four days in a row rather than a full week. You won’t usually face major disruptions in daily life with hypomania, unlike the serious problems that often accompany mania.

Symptoms of Depressive Episodes

During depressive episodes, you may experience severe sadness or hopelessness. Even simple tasks can feel impossible.

Common signs include:

• Sad or empty mood for at least two weeks.
• No interest in activities you once enjoyed.
• Low energy or fatigue.
• Feelings of worthlessness or guilt.
• Trouble focusing or deciding things.
• Changes in appetite or weight.
• Changes in sleep patterns.
• Restlessness or slowed movements.
• Thoughts of death or suicide.

Overlapping Symptoms

ADHD and Bipolar Disorder share some symptoms, but these show up in different ways.

1. Hyperactivity and High Energy

People with ADHD often feel restless and have trouble sitting still at home, school, or work. This restlessness can cause constant movement. You might tap your feet or fidget without realizing it.

In Bipolar Disorder, hyperactivity appears during manic or hypomanic phases. Sudden bursts of energy take over, and excitement or agitation follows. People switch from one task to another, driven by an unstoppable urge.

2. Impulsivity

Impulsivity in ADHD often includes quick, unplanned moves. You might interrupt others, blurt out answers, or make rash decisions without thinking about what happens next. Regret often comes soon after.

In Bipolar Disorder, impulsivity peaks during manic episodes. People may waste money or dive into unsafe activities. They feel invincible and ignore possible risks.

3. Distractibility

Many people with ADHD face constant distractibility. Tasks feel boring, so they jump from one idea to another. Finishing one chore can seem impossible.

In Bipolar Disorder, distractibility flares up in short bursts during mood swings. Even simple tasks feel overwhelming as thoughts bounce all over the place.

4. Irritability

Irritability in ADHD often arises from confusion or unclear rules. Small problems can spark anger fast, especially if a task demands steady focus.

In Bipolar Disorder, irritability grows stronger during manic or mixed episodes. Anger can last much longer, leading to arguments that harm relationships or disrupt everyday life.

5. Racing Thoughts and Rapid Speech

Racing thoughts are common in ADHD. Ideas flood the mind one after another, so speech can sound jumbled. Listeners may struggle to keep up.

In Bipolar Disorder, racing thoughts and rapid speech reach their peak during manic phases. Thoughts rush at top speed, so a person hops from topic to topic.

6. Mood Instability

Mood instability affects both conditions, but the patterns differ. In ADHD, emotions may shift many times in a single day. A small event can flip your mood from cheerful to sad or annoyed.

Bipolar Disorder involves longer periods of mood change. Manic or hypomanic episodes can stretch across days or weeks, and deep depression often follows.

7. Poor Frustration Tolerance

Poor frustration tolerance appears in both conditions but in different ways. In ADHD, frustration often hits when tasks drag on or rules are too tight. You may feel annoyed or walk away from the task.

In Bipolar Disorder, frustration during manic phases can explode into anger or hostility. Intense outbursts may follow, which can damage personal or work relationships.

Causes and Risk Factors of ADHD and Bipolar Disorder

ADHD and bipolar disorder can affect anyone. They have different causes, but both are linked to your genes and environment.

Causes and Risk Factors of ADHD

ADHD doesn’t have just one cause. Your genes, environment, and brain all play a part. About 1 to 3 out of every 100 children have ADHD. There is strong evidence that ADHD runs in families.

Genetic Factors

Studies show that if a parent or sibling has ADHD, you are more likely to have it too. Think about twins: identical twins, who share all their genes, often both have ADHD. Fraternal twins share some genes and don’t have them as often. Adoption studies also support this.

They found that children adopted into families are more likely to have ADHD if their biological parents have it, compared to their adoptive parents. Scientists believe that about 79% of ADHD comes from genes.

Environmental Factors

Furthermore, the environment around you also affects the chances of getting ADHD. If a mother smokes, drinks alcohol, or experiences a lot of stress during pregnancy, her baby has a higher risk of developing ADHD.

A large study showed that children whose mothers used tobacco or had contact with tobacco smoke during pregnancy faced a much higher chance of ADHD. But the risk was even greater for those who also faced alcohol use. These children were 1.58 times more likely to develop ADHD compared to those who did not face these factors.

Causes and Risk Factors of Bipolar Disorder

Bipolar disorder has many causes, including genetics and the environment. If someone in your family has bipolar disorder, your chance of developing it is much higher.

Genetic Factors

Studies show that if one identical twin has bipolar disorder, there is a 67% chance the other twin will have it, too.

Environmental Factors

Your environment also plays a big role in bipolar disorder. Childhood emotional abuse can significantly raise your risk. Additionally, infections like Toxoplasma gondii may increase the chances of developing bipolar disorder.

Moreover, based on a study, big life changes, such as losing a loved one or going through a divorce, can trigger bipolar disorder in those who are already at risk due to their genes.

Seasonal Factors

Climate is also an important environmental factor. You may notice that when the seasons change, your mood changes too. This is especially true if you have bipolar disorder. One major review found a clear link between the time of year and mood symptoms. Doctors have seen that mania appears more in spring and summer, with another peak in mid-winter. Depression usually appears in winter and spring.

Diagnosis of ADHD vs. Bipolar Disorder

Proper diagnosis ensures the right treatment. Here’s how the are different in terms of diagnosis:

Diagnosis of ADHD

Doctors do not rely on one test to diagnose ADHD. They do a physical exam and may include vision and hearing tests to rule out other conditions that look like ADHD. These other conditions may include anxiety, depression, or sleep disorders.

They also consider a detailed medical and family history. They use:

• ADHD symptom checklists
• Questionnaires
• Interview questions

These tools have rating scales that show if your symptoms match ADHD.

To confirm ADHD, the provider looks for symptoms before age 12. These symptoms must last at least six months and cause serious problems. Children up to age 16 need at least six symptoms. People 17 and older need at least five. Symptoms must appear in at least two settings, home, and school, and they must affect your daily life, and other mental health disorders cannot explain these symptoms.

It’s essential to ensure other disorders don’t explain these symptoms, as studies indicate that ADHD frequently coexists with anxiety of around 50% and major depression, ranging from 45–55%, which is why careful testing is important.

Diagnosis of Bipolar Disorder

Diagnosing Bipolar Disorder focuses on mood swings ranging from mania to depression. The evaluation starts with a psychiatric interview to identify symptom patterns, frequency, and duration. Blood tests and physical exams help rule out conditions like hypothyroidism that mimic bipolar symptoms.

Tools like the Mood Disorder Questionnaire help identify potential cases. It has 13 questions and extra items about symptom clusters and how they affect your daily life.

According to a study, the MDQ identifies 7 out of 10 people who have bipolar disorder. It also excludes 9 out of 10 who do not have it. That means it offers good sensitivity and excellent specificity. A positive MDQ result calls for a complete clinical evaluation.

Treatment of ADHD and Bipolar Disorder

Effective treatment needs specific plans for each condition, focusing on what makes ADHD and Bipolar Disorder different.

ADHD Treatment

Doctors often start with medicines called stimulants, like methylphenidate and amphetamines. These medicines help the brain work better by increasing dopamine and norepinephrine.

Stimulant Medications

Stimulants can be an effective way to treat ADHD. They help you focus on tasks, limit impulsive actions, and reduce hyperactivity. A study showed that about 70% of adults and 70–80% of children respond well to these medications. So you may notice fewer interruptions, less restlessness, and calmer behavior.

Non-stimulant Medications

However, stimulants aren’t always the best choice. Doctors might use non-stimulant medicines. These non-stimulant medications, such as atomoxetine, clonidine, and guanfacine can reduce ADHD symptoms. Their effect is usually in the medium range, and less than the effect of stimulant medications.

According to a study, atomoxetine and guanfacine may enhance daily functioning and quality of life. Researchers have noted longer-term maintenance of benefits with both medications. However, clonidine has not been studied as much in the long term.

Most guidelines place non-stimulants as second-line treatment and rank stimulant medication as first-line. But you should still consider non-stimulants if stimulants are not right for you. You may not see effects right away. Atomoxetine often needs 6 to 12 weeks to show results, and clonidine or guanfacine often needs 2 to 4 weeks.

Bipolar Disorder Treatment

Several treatments can help manage Bipolar Disorder.

Lithium

One of the main medicines used is lithium. Lithium is very effective for long-term treatment and helps prevent both manic and depressive episodes.

According to a study, Lithium extends the time between mood episodes. It also lowers the risk of relapse and improves mood symptoms between episodes. It is best to start lithium early because people with more than three episodes usually respond less to mania and long-term treatments. Many experts recommend beginning lithium after two hypomanic episodes or after one severe psychotic, manic, or mixed episode.

Antipsychotic Medicines

For quick mood stabilization, doctors often use special antipsychotic medicines like quetiapine and olanzapine.

According to a study, olanzapine and quetiapine show antimanic effects and can help maintain stable moods over time. Quetiapine has shown clear benefits in bipolar depression. Olanzapine also helps control manic episodes. This is an important option for bipolar disorder because it manages symptoms in both the short and long term.

Wrap Up

ADHD and Bipolar Disorder share symptoms like impulsivity and mood changes, but they affect your life differently. With ADHD, you find it hard to focus and control your actions every day. Bipolar Disorder causes extreme mood swings that can disrupt your routine.

Doctors use different methods to diagnose each condition. ADHD is treated with stimulant medications that help you concentrate, while Bipolar Disorder is managed with medicines like lithium to stabilize your moods.

If you think you might have ADHD or Bipolar Disorder, talk to a doctor today. Don’t wait—reach out for help now!

FAQs on ADHD and Bipolar Disorder

Can ADHD and Bipolar Disorder occur together?

Yes, they can. About 16.5% of children with ADHD also have Bipolar Disorder.

Is ADHD linked to an increased risk of Bipolar Disorder?

Yes, children with ADHD are 7 times more likely to develop Bipolar Disorder later in life, emphasizing the need for early monitoring.

Are hyperactivity and mania the same?

No. ADHD hyperactivity is a persistent symptom, while bipolar mania is episodic, often lasting for days or weeks.

Do ADHD and Bipolar Disorder have the same onset age?

No. ADHD symptoms typically appear in childhood, before age 12, while Bipolar Disorder often develops in the late teens or early adulthood.