Diagnosing ADHD is never an easy task. There are no laboratory tests, no x-rays, no way for a doctor to look at your brain and say you have ADHD. Instead, it is diagnosed based on a list of behavioral symptoms, such as hyperactivity and impulsiveness. Making it even harder to diagnose is the presence of coexisting conditions. Over 40 percent of adults with ADHD also have another psychiatric condition, such as depression or bipolar disorder. And many of the symptoms associated with these other disorders have overlapping symptoms.
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Similarities Between ADHD and Bipolar Disorder
Bipolar disorder can be one diagnosis often confused with ADHD because a number of symptoms of ADHD are similar to those of ADHD.
For example, symptoms similar in both ADHD and bipolar disorder are:
- Problems focusing or inattention
- Hyperactivity, high energy levels (especially during mania stage of bipolar disorder) or restlessness
- Changing emotions or instable moods
- Both conduct disorder and oppositional defiant disorder are frequently seen in individuals with ADHD or bipolar disorder
In addition to the confusion between these conditions because of similar symptoms, it is possible to have both conditions. It is important to have an accurate diagnosis, to know whether it is ADHD, it is bipolar or it is both. The right treatment plan requires the correct diagnosis.
Differences Between ADHD and Bipolar Disorder
Even though ADHD and bipolar disorder share some symptoms, there are also specific differences. Symptoms of bipolar disorder, for example, can be episodic, with symptoms sometimes being severe with periods of "normalcy" in between episodes. ADHD, on the other hand, is always present.
Some of the other differences are:
- ADHD is present from birth, even though it may not be diagnosed until school age. The Diagnostic and Statistical Manual (DSM) indicates symptoms of ADHD must be present before the age of seven. Bipolar disorder normally appears later, with diagnosis often occurring after the age of 18.
- ADHD is often associated with high emotional levels ranging from extreme happiness to intensely sad (although depressive symptoms are not an ADHD trait.) These emotions, in individuals with ADHD, are usually triggered by life events. In bipolar disorder, moods range from elation to depression but are not associated with life events, instead are part of the cycle of the illness.
- Individuals with ADHD can move between moods in a matter of minutes or hours. For example, someone may feel sad after being teased and suddenly become happy when their attention is drawn to a different event. For those with bipolar disorder, moods, either elation during mania stages or depression can last for months.
There may be behaviors that are similar but occur for different reasons. For example, a child with ADHD may break items because of carelessness or inattention to detail where a child with bipolar may break things because of anger and frustration.
The correct course of treatment depends on an accurate diagnosis. ADHD is frequently treated with stimulant medications and behavioral strategies. Bipolar disorder is treated with medications such as mood stabilizers. However, stimulant medications may sometimes trigger a manic episode in someone with bipolar disorder. Usually, the bipolar disorder should be stabilized before beginning treatment for ADHD.
"Attention-Deficit Hyperactivity-or Bipolar?" 2005, May, Author Unknown, PsychEducation.org
"Bipolar Disorder or ADHD," 2011, Feb 21, Reviewed by Marina Katz, M.D., WebMD
"Diagnosing Bipolar vs ADHD", Date Unknown, Dr. Charles Popper, ADHDNews.com