Written by Dr. Valentina Quintana MD on
September 1, 2021
Reading Time: 8 minutes

Medically Reviewed by our Medical Affairs Team

Written by Dr. Valentina Quintana MD on:

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Do you have ADHD and bipolar disorder? Do you think it might be possible to have both disorders at the same time?

This blog post will explore the possibility of having ADHD and bipolar disorder and their differences. We’ll also cover what can happen if they co-occur, treatment options, and more!

What is ADHD?

ADHD or Attention Deficit Hyperactivity Disorder affects roughly 11% of children and about half that number in adults.

People who have the disorder show symptoms including impulsivity, hyperactivity, inability to focus, distractibility, fidgety behavior (known as restlessness), lack of organization skills, etc. 

ADHD is a neurodevelopmental disorder, which means it’s from birth and affects the brain.

Scientists aren’t sure what causes ADHD but believe genetics play a role as well as environmental factors such as exposure to toxins or tobacco smoke while in utero.

The frontal lobe of the brain doesn’t develop properly during pregnancy for those with ADHD, and that’s believed to be the main culprit behind it.

To understand ADHD better, it helps to know about dopamine, a neurotransmitter (brain chemical) involved in many functions such as movement coordination, motivation or pleasure-seeking behavior, addiction development, and reward-driven learning.

Dopamine is very important for those with ADD or ADHD because it’s believed that they don’t produce enough dopamine, or the receptors in their brains are not sensitive to it.

A lack of dopamine is why those with ADHD have trouble maintaining focus, paying attention, and staying motivated.  

Different Types of ADHD

There are three different types of ADHD:

Predominantly Inattentive Type

If you have this kind of ADHD, it means that your symptoms involve not being able to pay attention and focus on tasks, whether they’re interesting or boring.

You may also be forgetful therefore making organization a challenge for you. You can see how this would affect a student in school or an adult at work.

Predominantly Hyperactive/Impulsive Type

If you have this kind of ADHD, it means that your symptoms involve being restless and fidgety, as well as having trouble sitting still or controlling what comes out of your mouth (known as impulsivity).

You can see how ADHD of this form would have an impact on your ability to focus.

Combined ADHD Type

If you have this kind of ADHD, it means that you show symptoms from both categories above (inattentive and impulsive/hyperactive).

It’s important to note here that even though someone may be diagnosed with only one form of ADHD, they may actually have a combination of all three.

What is Bipolar Disorder?

Bipolar disorder, also known as manic-depressive illness or manic depression, is a brain disorder that can cause unusual shifts in your energy levels and mood.  It’s characterized by extreme highs (mania) and lows (depression).

Depressive Episodes: One Side of Bipolar Disorder

In bipolar disorder, depressive episodes may occur without manic or hypomanic ones. People with a depressive episode experience low moods and lose interest in activities they once enjoyed.

The depressed phase of bipolar disorder includes symptoms such as the following:

  • sadness
  • lack of interest in once pleasurable activities
  • loss of energy
  • fatigue or feeling ‘slowed down’ in movements and thought processes
  • sleep problems (either too much or not enough)
  • change in appetite with weight gain/loss

Manic Episodes: The Other Side of Bipolar Disorder

In bipolar disorder, manic episodes may occur without depressive ones. People with a manic episode experience extreme heightened moods and feel extremely happy or irritable for days to weeks at a time and often behave in an impulsive/unrestrained manner that can have dangerous consequences (i.e., poor decision-making).

The manic phase includes symptoms such as the following:

  • inflated self-esteem or grandiosity
  • decreased need for sleep but may feel tired if awoken from sleeping on and off
  • being easily distracted
  • racing thoughts
  • fast speech
  • increased goal-directed activity
  • physical agitation (restlessness)
  • excessive involvement in pleasurable activities without regard for possible consequences such as money problems, relationship conflicts, and poor job performance.

Is it ADHD or bipolar disorder?

It is often difficult to tell if a person has ADHD or bipolar disorder because they share many symptoms. However, there are ways of figuring it out.

For those with ADHD only, if you have the inattentive kind and no hyperactivity/impulsivity, then you could be having ADHD. Most people with bipolar disorder have the combined type.

For those with bipolar disorder only, if you are experiencing manic episodes, you could just be that you have bipolar disorder.

However, there is a possibility of being both as well because most people experience their first episode of mania prior to age 25 years old, which can overlap or come before ADHD symptoms.

Identifying Symptoms of ADHD

There are some ways to tell if you might be more on the ADHD side of things, such as: 

  • Difficulty paying attention and focusing, even when something is interesting or important (e.g., working despite distractions, not following conversations).
  • Organization problems. You may avoid tasks like paperwork and file lots of ‘miscellaneous’ papers instead.
  • Work is often messy, even if it’s something you enjoy doing.
  • Finding time for tasks can be difficult because your mind may wander, or distractions are common (e.g., watching TV while doing work).
  • Procrastination on both simple and complex tasks instead of completing them in a timely manner.
  • Difficulty finishing projects.
  • Making careless mistakes because you didn’t pay attention to details.
  • Not listening when spoken to directly because your mind is somewhere else (e.g., wondering about what’s for dinner).
  • Tendency to lose things, such as keys or an item from a shopping list.
  • People might say you are socially ‘spacey’ or that your mind seems to be elsewhere. For example, you might have trouble staying focused during conversations, so people may wonder if you are listening at all.

Identifying Symptoms of Bipolar Disorder

There are some ways to tell if you might be more on the bipolar disorder side of things, such as:

  • Feeling very ‘up’ almost all of the time. This can happen even when there is no reason for it (e.g., after a good night’s sleep) and last for days or weeks at a time.
  • Having periods of low mood and/or loss of interest in pleasurable activities. This is called a depressive episode.
  • Feeling very irritable or having angry outbursts, even when there is no reason for it (e.g., feeling like yelling at someone). When you feel this way, your thoughts might be racing with anger, or you might be thinking about revenge.
  • Having periods of high energy and/or increased goal-directed activity (e.g., feeling like going out for a run). This is called a manic episode.
  • Feeling like your thoughts are very fast and/or racing (e.g., mind going from topic to topic). Your thinking might become more disorganized, and you may forget things that normally would be easy for you to remember because of the speed at which you think.
  • Having mood swings, such as feeling depressed for days, then feeling ‘up’ (manic) and on top of the world.
  • Having periods where you show little interest or pleasure in doing pleasurable activities that are usually fun for you (e.g., hobbies). This is called anhedonia.
  • Becoming more reckless during a manic episode, such as spending sprees or doing things that could be dangerous (e.g., driving too fast).
  • Having an increase in the amount of time you sleep, eat, and/or exercise without feeling tired because it feels like you don’t need to rest.
  • Feeling very self-important, such as thinking your opinions are better than others.
  • Feeling or acting suspiciously. You might think people are out to get you and that they’re trying to trick you, even when nothing is going on.
  • Having delusions of grandeur, such as thinking you have amazing powers (e.g., being the next President) or special abilities that other people don’t have (e.g., being able to fly).
  • Having more trouble concentrating, such as having a harder time focusing on reading even if it’s something you enjoy. You might find that your mind wanders, and thoughts start going off onto different tangents (e.g., thinking about food instead of the book in front of you).

For both ADHD and bipolar disorder, personality traits such as anxiety or depression could also play a role in the symptoms shared between these two disorders.

It is often difficult for psychiatrists to diagnose ADHD and bipolar disorder accurately without input from family members, friends, or even the patient themselves.

For those with comorbidity, it is important to choose a psychiatrist who has expertise in both disorders because treatment may need to be coordinated between different specialists such as psychiatrists, psychologists (to deal with mood problems), and therapists of all sorts.

Can you have both ADHD and bipolar disorder?

Yes, there are case studies of people who have ADHD and bipolar disorder.

It’s a complicated diagnosis to make because it requires a thorough evaluation before arriving at the right conclusion.

In other words, you can’t just diagnose someone with both conditions without looking into all possible explanations for their symptoms first. 

It could be that they’re showing signs of ADHD and bipolar disorder, or it could be that they have another condition such as anxiety, depression, autism spectrum disorder (ASD), learning disabilities, a sleep disorder like narcolepsy—the list goes on.

The best thing to do is work with a mental health professional who can help you figure out what’s going on in a thorough yet efficient manner. In other words, they’ll help you figure out what’s going on and then how to treat it as well as possible.

What happens with ADHD and bipolar disorder?

If you have ADHD and bipolar disorder, the symptoms of each condition can make those from the other worse.

For example, if you have mania as part of your bipolar disorder but no treatment for it (e.g., antidepressants), then that could exacerbate any attentional deficits you might experience due to having ADHD.

And vice versa; ADHD symptoms can worsen bipolar disorder, increasing the risk for a manic or depressive episode.

In other words, ADHD and bipolar disorder have an unfortunate negative effect on each other’s prognosis (i.e., how it goes).

ADHD and Bipolar in Children

It is possible for children to have both conditions, though it’s more likely that they’ll just have ADHD or bipolar disorder.

In other words, if your child has symptoms of comorbidity, then you should work with a mental health professional who can help pinpoint the right diagnosis and come up with the best treatment plan (e.g., medications, therapy, etc.).

If your child is the opposite and you think they have ADHD, but it’s actually a bipolar disorder, then a mental health professional will help to tease out what is going on.

Once that has been determined, treatment can be started in earnest in order to minimize symptoms of both conditions as much as possible.

In fact, if children are diagnosed with ADHD but it’s really bipolar disorder, they may actually get worse without treatment for the latter.

In other words, if they’re not treated for bipolar disorder, then their ADHD symptoms could get worse. This is because the two conditions share similar symptoms, which can make it difficult to tell them apart.

For example, both can cause problems with concentration and attention as well as irritability (e.g., lashing out at others).

When left untreated, the symptoms of bipolar disorder and ADHD in children can become more severe over time. What’s worse is that when these problems are not addressed promptly, it will be even harder for a child to get better later on.  

ADHD and Bipolar in Adults

In adults, the symptoms of ADHD and bipolar disorder may worsen over time as well.

There are case studies that report people having both conditions who were diagnosed with one or the other many years before they actually received a comorbid diagnosis.

What does this mean? Well, it suggests that if you have either condition, then there is a chance you might have the other as well.

For example, one case study reports a man who had ADHD since he was nine years old but wasn’t diagnosed with bipolar disorder until he was thirty-seven years old!

Another case report describes an adult woman who received her first diagnosis of ADHD when she turned forty and six months later received her bipolar diagnosis.

In other words, if you have been diagnosed with one condition and then later get a comorbid diagnosis of the other, it doesn’t necessarily mean that your initial diagnosis was wrong—it could be that you were misdiagnosed in an earlier time frame.  

So what should you do? If this is happening to you, then it’s important to see a mental health professional right away.

They’ll be able to determine if you have ADHD and/or bipolar disorder by taking into account your symptoms as well as any family history of either condition.

If you are diagnosed with both conditions, then the next step will be coming up with treatment strategies that address both conditions.

In some cases, it may be possible to reduce the symptoms of one condition by increasing doses on your current medication or switching medications entirely.

It’s also quite common for people with ADHD and bipolar disorder to have other psychiatric disorders as well (e.g., anxiety). So if you are being treated for both conditions, then you will need to be on the lookout for symptoms of other psychiatric conditions as well.

In some cases, medications might not work, or you may have serious side effects from them, making it impossible to stay on your prescribed treatment plan.

At this point, a different medication might be needed—but only if you are being treated by a mental health professional who is well-versed in the comorbidity of ADHD and bipolar disorder.

The Bottom Line

If you think that you or your child might have both conditions, then contact a mental health professional right away for an assessment to determine what’s going on.

Don’t wait until things get worse because it will be harder to deal with both conditions at the same time if you wait too long. 

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