ADHD Diagnosis How to Tell ADHD and Bipolar Disorder Apart By Keath Low Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. Learn about our editorial process Updated on May 27, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Aron Janssen, MD Medically reviewed by Aron Janssen, MD LinkedIn Aron Janssen, MD is board certified in child, adolescent, and adult psychiatry and is the vice chair of child and adolescent psychiatry Northwestern University. Learn about our Medical Review Board Print JGI/Jamie Grill / Blend Images / Getty Images There are some similarities and overlap in the symptoms of ADHD and bipolar disorder. Both may include hyperactive or restless behaviors, distractibility, poor concentration, impulsivity, and racing thoughts. Both are also thought to have a strong genetic link. Both can result in sleep disturbances, poor social relationships, feelings of anxiety, depression, frustration, and self-doubt. Both can significantly impact daily functioning. In addition, ADHD and bipolar disorder commonly occur together, making it even more difficult to tease them apart. This article discusses the symptoms of bipolar disorder and ADHD. It also explores some of the primary similarities and differences between the two conditions and how to tell them apart. Identifying Symptoms of ADHD The main symptom of ADHD is a disturbance in attention. The main symptom of bipolar disorder is a disturbance in mood. With ADHD, the symptoms of distractibility and/or impulsivity and hyperactivity or restlessness are always present and can be influenced by the environment. Structuring one’s environment, limiting distractions, finding stimulating activities, using visual or auditory reminders and organizational techniques can significantly improve function for an individual with ADHD. Identifying Symptoms of Bipolar Disorder Bipolar disorder results in dramatic mood changes ranging from extreme highs in energy levels and a sense of euphoria and grandness to extreme lows of depression, hopelessness, and rock-bottom energy levels. These mood episodes are more significant than typical mood swings and may alternate with periods of normal mood and function. They occur relatively independently of outside influences within the environment. The cycles of highs, lows, and normal periods may be irregular and without a clear pattern and may last several weeks. An individual with bipolar disorder may experience four main types of mood episodes: Mania These episodes are characterized by high energy level, over-the-top happiness, and elation or extreme irritable and angry mood, feeling of grandiosity and self-importance that may escalate into delusions and loss of contact with reality, impulsive risk-taking behaviors, decreased need for sleep, fast speech and increased talkativeness, distractibility, and/or racing thoughts. The manic episodes can severely impact daily functioning. Hypomania Hypomania is a milder form of mania that may not impact an individual’s daily functioning as severely as a manic episode. People experience hypomania may have a reduced need for sleep, may behave in inappropriate ways, act recklessly, speak rapidly, and experience irritable moods. Depression Symptoms of depression include low energy, fatigue, feelings of sadness and hopelessness, decreased interest in life, perhaps even suicidal thoughts, loss of pleasure in things that previously brought joy, difficulty with concentration and memory, loss of appetite, and sleep disturbances. Mixed Mood The criteria are met both for a manic episode and for a major depressive episode nearly every day during at least a 1-week period. ADHD Disturbance in attention Treated with stimulant medications Responds to increased structure and organizational strategies Bipolar Disorder Disturbance in mood Treated with mood-stabilizing medications May also be treated with psychotherapy Treatments for ADHD vs. Bipolar Disorder Treatment for bipolar disorder usually involves mood-stabilizing medications, education, psychotherapy, and support. The most common drugs used to treat ADHD are stimulant medications. While mood stabilizers may not impact ADHD, stimulants may exacerbate bipolar symptoms and bring about manic or depressive episodes. Individuals with ADHD respond well to increased structure and organizational strategies in their environment and benefit from education, psychotherapy, social skills training, coaching, and support. An in-depth and comprehensive evaluation is required in order to make an accurate diagnosis of bipolar and/or ADHD, as symptoms can certainly appear similar. A Word From Verywell While bipolar disorder and ADHD have some similarities in symptoms, they are distinct and separate conditions. However, it is important to note that the two conditions can and often do occur together at the same time. The presence of both conditions can sometimes complicate diagnosis and treatment, so it is important to discuss all of your symptoms with a healthcare practitioner or mental health professional. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Frequently Asked Questions What’s the difference between bipolar and ADHD? The primary difference between ADHD and bipolar is in the main symptoms. Bipolar disorder is a mood disorder, while ADHD is a neurodevelopmental condition that affects attention and behavior.The duration of symptoms is another distinguisher; ADHD is chronic while bipolar disorder is episodic. For some people, ADHD symptoms lessen or disappear in adulthood, while bipolar disorder is lifelong. How young can bipolar disorder start? Bipolar disorder is usually diagnosed during the teen years or early adulthood. However, symptoms can begin to appear earlier in childhood. The condition can be diagnosed as early as age 6. How often are bipolar and ADHD present together? Evidence suggests that it is not uncommon for the two conditions to occur together. According to a 2021 systematic review and meta-analysis of past research, one in 13 people with ADHD was also diagnosed with bipolar disorder. The review also found that almost one in six adults with bipolar disorder also had ADHD. 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Brus MJ, Solanto MV, Goldberg JF. Adult ADHD vs. bipolar disorder in the DSM-5 era: a challenging differentiation for clinicians. J Psychiatr Pract. 2014;20(6):428-37. doi:10.1097/01.pra.0000456591.20622.9e MedlinePlus. Attention deficit hyperactivity disorder. Waters F, Collerton D, Ffytche DH, et al. Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease. Schizophr Bull. 2014;40 Suppl 4:S233-45. doi:10.1093/schbul/sbu036 Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health. MedlinePlus. Bipolar disorder. National Institute of Mental Health. Bipolar disorder in children and teens. Schiweck C, Arteaga-Henriquez G, Aichholzer M, Edwin Thanarajah S, Vargas-Cáceres S, Matura S, Grimm O, Haavik J, Kittel-Schneider S, Ramos-Quiroga JA, Faraone SV, Reif A. Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2021;124:100-123. doi:10.1016/j.neubiorev.2021.01.017 By Keath Low Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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