How to Tell ADD and Bipolar Disorder Apart

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There are some similarities and overlap in the symptoms of ADD/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.

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 (also referred to as manic-depressive disorder) results in dramatic mood swings 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 swings alternate with periods of normal mood and function and they occur relatively independent of outside influences within the environment. The cycles of highs, lows, and normal periods may be irregular and without a clear pattern.

An individual with bipolar may experience four main types of mood swings:

  • Mania – 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 the need for sleep, fast speech and increased talkativeness, distractibility, and/or racing thoughts. The manic episodes can severely impact daily functioning.
  • Hypomania – a milder form of mania that may not impact an individual’s daily functioning as severely as a manic episode.
  • Depression – 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, 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.


  • 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.

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Article Sources

  • William Dodson, MD. Is It ADHD or Bipolar Disorder? Decoding the Symptoms. Additude Magazine. August/September 2007.

  • National Alliance on Mental Illness. Understanding Bipolar Disorder and Recovery. NAMI Fact Sheet. Arlington, VA.