Warning – the ADHD bipolar disorder connection is confusing and complex. The difference between bipolar disorder and ADHD can be surprisingly difficult to diagnose.
And as is so often the problem, the wrong diagnosis may do more harm than good. It is vital to the understand the difference!1
This is because some ADHD medications are very stimulating, AND can trigger mania and make bipolar people worse!
And yes, just to further complicate things, there are many people who really do have both.
The high energy of mania can look a lot like the hyperactivity of ADHD. Also, both conditions are characterized by impulsive behavior.
Bipolar Disorder is a mood disorder. Traditionally known as manic depression or manic depressive illness, bipolar is characterized by mood swings that range from highly elevated mood (mania) to deep lows of depression. It develops equally in men and women, usually in late teens or in the 20s.
ADHD stands for Attention-deficit/hyperactivity disorder. It is a developmental disorder mainly found in male children who lag in developing impulse control.
Although there is much confusion and some clinical overlap, ADHD and Bipolar Disorder are very different conditions.
Unlike Bipolar Disorder, ADHD is a is classified as a disruptive behavior disorder.
An important component of understanding the ADHD bipolar Disorder connection is to understand the math. ADHD affects 3% – 5% of children. However, bipolar disorder affects around 1% of adults and is much rarer in young children. In other words, simple statistics give you an approximately 1 chance in 25 that your child has ADHD – BUT LESS THAN 1 chance in 1000 that it is bipolar disorder!
Bipolar and ADHD similarities
This is difficult to generalize about and requires clinical evaluation because just as there are various forms of bipolar disorder and mania, there are also various forms of ADHD.
The ADHD Bipolar Disorder differences and similarities really are complex and confusing!
However, in broad terms we can say that the following similarities may exist during a manic episode.2
1. Restless: This is the notorious “hyperactivity” of ADHD. Lots of motor activity – a seeming inability to “sit still”.
2. Talkative: Not only is there a constant stream of talk, but it may have little to do with what others present are talking about or are interested in, and may often be inappropriate, hurtful or poorly constructed “streams of consciousness”.
3. Impulsive: Reckless behavior and poor judgment are common to both disorders. This impulsiveness may manifest in excessive spending, substance abuse, hyper-sexuality or dangerous driving – to name but a few.
4. Irritability: We often think of ADHD being characterized by a low tolerance for frustration and impatience. However, often the stereotype of the manic person is “the life and soul of the party” – up all night, dancing, talking and socializing. However, mania often takes the form of irritability, anger or even rage and this can look a lot like ADHD.
How can I recognize the ADHD Bipolar Disorder difference?
It is always a good idea to consult an expert, but here are some useful rules of thumb.
A person is more likely to have ADHD than be bipolar if:
1. No matter how chronic or chaotic their behavior is, it is a constant pattern. Bipolar people CYCLE – it is the episodic nature of the disorder that distinguishes it.
2. ADHD people may have trouble getting to sleep, but do eventually go to bed at night. Bipolar people in a manic episode may skip sleep completely, sleep very little or sleep at odd hours.
3. ADHD people tend not to experience the “highs” of bipolar people such as extremely happy moods that are often described as “expansive” or “euphoric”.
With ADHD it is possible to have periods of “hyper-focus” and be ultra-productive, but this is different to the manic certainty of the bipolar person believing they can achieve whatever pops into their head.
4. They are consistently putting themselves down and tend to have low self esteem or a sense of impending failure or doom. Bipolar people may feel this when depressed but, unlike ADHD people, they also experience feelings of grandiosity – a belief they can accomplish anything and everything.
Understanding the ADHD Bipolar Disorder connection – Why does it matter?
Most ADHD medications are stimulants.
These can trigger mania in bipolar people, making them worse.
This is a major reason for always carefully investigating the issue and becoming informed about bipolar disorder vs ADHD.
Ideally consult with a board certified psychiatrist who is familiar with the full range of medications AND with with both bipolar and ADHD.
Good news on ADHD and bipolar disorder
Regardless of the label, there are non-drug based interventions that work equally well for both bipolar and ADHD.
Natural supplements such as omega 3 fatty acids, folic acid and inositol all nourish the brain and will benefit both disorders with no dangerous side effects.
Another effective and natural remedy that may be effective for both is a homeopathic, non-drug, natural form of lithium salts such as lithium orotate.
Creativity in bipolar and ADHD
Interestingly, Kurt Cobain and Courtney Love were both “Ritalin kids”. In an interview before he died, Kurt, who was bipolar, claimed that being given Ritalin as a young child probably encouraged his drug use in later years. Or, as Courtney Love put it:
“When you’re a kid and you get this drug that makes you feel that feeling, where else are you going to turn when you’re an adult? It was euphoric when you were a child – isn’t that memory going to stick with you?”
There is a high coincidence of creativity and higher than typical degrees of talent amongst both bipolar and ADHD people.
This is the upside to any ADHD Bipolar Disorder connection.
Regardless of whether an individual is bipolar or ADHD, or both, that person will often show high creative aptitude. These gifts may help them to become happy and successful in life. However, if these same gifts are frustrated, stifled or inappropriately medicated, then the person may experience much unhappiness and even some serious mental and physical health risks.
My own life improved dramatically when I began to understand that there is a blessing as well as a curse in being a person who “thinks outside the box”. Today, leading bipolar psychiatric experts such as Ronald Fieve MD are suggesting that some forms of bipolar are beneficial.