How Often Does ADHD Co-Occur With Bipolar Disorder

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It’s hard to live with one mental condition, let alone two. This is the case for 1 in 6 adults who are currently living with both bipolar disorder and attention-deficit/hyperactivity disorder (ADHD). The symptoms for both of these disorders tend to overlap – they’re often misdiagnosed or confused for one another.

Treating a patient for all of their present conditions is essential in the healing process. A patient can’t properly heal if they have two conditions and only one is being addressed. This is why it’s so important to receive an accurate diagnosis and receive quality, evidence-based care. At Sun Behavioral Health Texas, we see how important it is to properly diagnose and treat ADHD and bipolar disorders when they co-occur.

Why do these two mental conditions co-occur? What symptoms do they share that make it so easy to confuse them for each other? Today, we’ll be discussing the link between bipolar disorder and ADHD, why it’s so common, and how treatment works when someone is experiencing both.

What is ADHD?

ADHD is an extremely common condition that usually presents itself in childhood. Adults either go undiagnosed or begin to develop symptoms later in life. According to the Centers for Disease Control, 10% of children in Texas have been diagnosed with ADHD, and over 70% of those children are currently receiving treatment. Children who are diagnosed with this have a hard time focusing. They can also be reactive and have difficulty controlling impulsive behaviors. It can also present itself as hyperactivity or the “inability to sit still.”

ADHD can present itself a little differently in each person depending on things like age, gender, and personality. Let’s take a look at some of the common symptoms of ADHD in children:

  • Inability to focus on tasks or directions
  • Difficulty keeping track of things like school assignments or personal items
  • Difficulty paying attention
  • Inability to sit still – will often fidget with hands, feet, or toys
  • Regularly interrupting other children and adults
  • Difficulty following directions
  • Avoids tasks that require mental effort
  • Difficulty in school
  • And more

It can often be difficult to diagnose ADHD in some children. The symptoms of ADHD can mimic normal childhood development. For this reason, misdiagnosis is common. Symptoms in adults with ADHD might look like this:

  • Forgetfulness
  • Restlessness
  • Mood swings
  • Trouble controlling anger
  • Frequently triggered by stress
  • Trouble multitasking
  • And more

ADHD makes certain things harder for children and adults. Schoolwork, friendships, and careers can all be impacted. Contrary to popular belief, ADHD is not just the inability to sit still or focus. Living with ADHD can cause things like anxiety and depression because of the complications it can cause in someone’s life.

What is Bipolar Disorder?

Bipolar disorder is a mental condition that includes euphoric highs, devastating lows, and sometimes even the inability to function. Formerly known as manic depression, bipolar disorder is broken up into 3 categories: bipolar I, bipolar II, and cyclothymic. Bipolar I causes manic depressive episodes that can last for weeks. Bipolar II is similar, but the episodes range in severity and typically aren’t as long-lasting or intense as bipolar I episodes. Cyclothymia is classified by its hypomanic episodes that can last for years at a time.

People with bipolar disorder can experience psychosis. They might go through periods of paranoia, which can lead to a misdiagnosis of schizophrenia. Because of the crushing lows involved, bipolar disorder can also be mistaken for depression or anxiety. Some of the behaviors of those living with bipolar are also similar to the behaviors associated with ADHD.

Memory is also impaired in those with bipolar disorder. They will often forget things they’ve said and done during episodes of mania or depression. This makes it challenging for providers and psychotherapists to help.

Because of all of this, bipolar disorder can be difficult to diagnose (and is often misdiagnosed). Treatments and medications for bipolar vary between disorders, so receiving the wrong diagnosis means receiving the wrong treatment. The difference between bipolar and some of these other disorders lies in the episodic highs and lows. While everyone goes through high points and low points, bipolar highs and lows are extreme.

Some of the symptoms of bipolar disorder might look like:

  • Fatigue
  • Feeling down, depressed, or hopeless
  • Eating too much or too little
  • Excessive excitement or euphoria
  • Making “grand plans” or setting unrealistic goals
  • Feelings of grandiosity or inflated ego
  • Racing thoughts
  • Speaking too quickly/interrupting others frequently

People with bipolar disorder might have a hard time keeping up with employment, relationships, or careers. The dramatic shifts in mood can limit their ability to function at times. They may also push people away or lose motivation.

What is the Link Between Bipolar Disorder and ADHD?

Researchers aren’t 100% of why ADHD and bipolar disorder are linked, but studies have validated the connection. A recent study published in the National Library of Medicine found that children with a diagnosis of ADHD were 10 times more likely to develop bipolar disorder later in life. The study also talked about how this dual diagnosis can also result in a higher risk for suicide attempts.

Usually, patients are diagnosed with either one or the other. Because the treatment methods for each disorder are so different, patients won’t get the help they need with just one diagnosis. If the patient is diagnosed with ADHD but their psychiatrist or physician is unaware of the other existing condition, the patient may fail to thrive.

People who have both ADHD and bipolar disorder might become reckless due to their impulsive or dangerous behaviors. They won’t be aware that what they’re doing is dangerous, and if they are, they won’t place importance on safety. If it goes untreated long enough, their actions could unintentionally endanger the people around them. This could hurt their relationships and threaten their sense of safety, pulling them further into depression.

Because bipolar disorders are so rarely diagnosed in childhood, a child is more likely to be diagnosed with ADHD and carry that diagnosis with them. As adults, they may not understand why they feel depressed. They may think episodes of mania are linked to ADHD rather than another condition. The underdiagnosis that comes with this comorbidity can be dangerous.

Another thing to note is that because ADHD is typically diagnosed during childhood, not many adults think about getting evaluated for the disorder. This leads to more undiagnosed patients. Left unchecked, ADHD alone can lead to job loss and impulsivity due to distorted thinking patterns.

What’s the Difference Between ADHD and Bipolar Disorder?

There are a few reasons why ADHD and bipolar disorder are often confused with each other. For one, they share a few of the same symptoms:

  • Racing thoughts
  • Excessive excitement
  • Impulsivity
  • Grandiose thinking

Another thing to consider is that a child is more likely to be diagnosed with ADHD versus bipolar disorder, so physicians are more likely to test for ADHD in children. It isn’t often that a doctor will test a child for bipolar, especially because bipolar disorder and puberty have a lot in common.  Adults, on the other hand, are more likely to be diagnosed with bipolar disorder versus ADHD. While the similarities between the two disorders are common, patients are rarely tested for both. The key to an effective dual diagnosis is to recognize symptoms that are only present in one disorder and absent in another.

Here are some of the things that are usually only present in bipolar disorder:

  • Destructive mood swings. People with bipolar disorder will often experience fits of rage that are highly destructive and long-lasting.
  • Psychosis. Psychosis is not something that usually happens with ADHD.
  • Chronic and debilitating loss of energy. Those suffering from bipolar disorder can spend weeks or even months in bed.
  • Mood is not dependent on a particular situation. Mood swings in those with bipolar disorder are usually random and unpredictable. There may be no trigger. They’re often cyclical, which means they happen after a certain period with no rhyme or reason.
  • Symptoms will improve with mood stabilizers, not stimulants.

Here are some of the things that are usually only present in ADHD:

  • Hyperfocus. This is a very common symptom in those who have ADHD. It’s the ability to focus on something of interest for an unusually long time, sometimes shutting out the world in the process.
  • Hyperactivity. While people with bipolar disorder may present with hyperactive energy during an episodic event, hyperactivity is almost always present in someone with ADHD. This hyperactivity can cause constant movement or fidgeting.
  • Difficulty staying on task and following directions. Someone with ADHD might constantly struggle in school or at work because of this.
  • Symptoms will improve with stimulant medication, not mood stabilizers.

These two disorders are also classified differently. Bipolar disorder is classified as a mood disorder, while ADHD is classified as a behavioral disorder. ADHD affects how someone acts, while bipolar affects how someone feels. If someone presents with both ADHD and bipolar disorder, they’ll display unique symptoms from both categories. Both behavior and mood will be dysregulated.

Treating Bipolar Disorder and ADHD

Simultaneous treatment for both disorders can be difficult. After all, each disorder responds to a different kind of medication. Doctors will usually begin by treating bipolar first. They’ll treat ADHD once someone’s mood has stabilized. One thing to note is that there are medications available that can treat both disorders. Ritalin, for example, has had recent success in treating both bipolar and ADHD. Your doctor or psychiatrist may choose to put you on a medication that he/she thinks will effectively treat both.

There are also coping strategies for healing that work in cases of both ADHD and bipolar disorder. Exercise, healthy eating, and meditation are examples of this. Talk therapy is also effective in both disorders, as is outpatient therapy and group therapy. There are more options than just medication.

Research in the area of treating both disorders simultaneously is a little sparse. This is mainly because different patients respond to different treatments. If you’re struggling with both bipolar disorder and ADHD, it may take a little trial and error to find out what works for you. The most important thing is to receive an accurate diagnosis so you can begin to alleviate some of your symptoms. Relief for both of these conditions is possible with quality treatment.

At Sun Behavioral Health Houston, we understand the importance of dual diagnosis and we’ve seen it change lives. We’re here to help. We offer treatment services for ADHD and bipolar disorder.  Please give us a call if you have any questions or if you’d like to set up a consultation at (713) 796-2273.

FAQs About How Often Does ADHD Co-Occur With Bipolar Disorder

What are the differences between bipolar and ADHD?

These two disorders will sometimes present with similar symptoms like racing thoughts, interrupting others, and high energy. Bipolar disorder is far more likely in people who have been diagnosed with ADHD as a child. Bipolar disorder is considered a mood disorder while ADHD is considered a behavioral disorder.

How common is ADHD comorbid bipolar?

It’s fairly common for someone to present with both bipolar and ADHD. It requires an adequate diagnosis for effective treatment.