Exploring Connections Between Bipolar Disorder And ADHD

ADHD and bipolar disorder are two distinct mental illnesses. However, they have several characteristics in common that can make distinguishing between them challenging and, in some cases, they are comorbid psychiatric disorders. Understanding their similarities, differences, and the links between them can be important for an accurate diagnosis of individual or comorbid disorders and proper treatment. Let's take a closer look at both disorders as well as what the research says about how they may be related.

What is attention-deficit/hyperactivity disorder (ADHD)?

Attention-deficit hyperactivity disorder, has a lifetime prevalence of 8.1% in US adults aged 18 to 44. It’s often diagnosed in childhood and persists into adulthood. It typically manifests more as inattentiveness and difficulty concentrating, or as hyperactivity and impulsive behavior—sometimes with a mix of both. People with ADHD may have difficulty with some aspects of daily functioning and may experience additional challenges or disruptions in relationships, work, or school.

Symptoms of ADHD

According to the American Psychiatric Association, the specific signs and symptoms of attention-deficit hyperactivity disorder can vary from person to person. Common symptoms that may lead to a diagnosis include:

• Lack of attention to detail
• Forgetfulness
• Motor hyperactivity (excessive talking, difficulty sitting still, or fidgeting)
• Mood swings or mood episodes
• A tendency to become extremely irritable
• A sense of impatience
• Trouble staying organized
• Impulsive and/or risky behavior

Treatment for ADHD patients

Treatment often includes stimulant medications, and some form of psychotherapy may also be recommended. In addition to these treatments, lifestyle adjustments such as frequent exercise and healthy meals can also help mitigate symptoms. Although the specific cause is unknown, researchers believe genetics play a crucial role in its development. However, environmental factors like toxin exposure or childhood trauma may also contribute. Furthermore, research has revealed that there may be differences in brain structure or function between individuals who have ADHD and those who do not. Untreated instances of childhood ADHD may lead to increased risk of mood disorders like depression.

What is bipolar disorder?

It’s estimated that 4.4% of US adults have bipolar disorder. It’s a mood disorder that is primarily characterized by extreme mood symptoms, or swings between “high” or manic episodes and “low” or depressive episodes. The intensity and duration of these episodes depends on where a person falls on the bipolar spectrum. There are three types: bipolar I, bipolar II, or cyclothymic disorder. Depending on the severity of the condition (as well as the presence of psychiatric comorbidities), symptoms of bipolar disorders can make daily functioning difficult and may negatively impact relationships, work, and school. In more extreme cases, bipolar symptoms may cause a person to put their own safety at risk, and hospitalization is sometimes required.

Symptoms of adult bipolar disorder

Symptoms of a manic episode (hypomanic symptoms) include:

• Extreme happiness or euphoria
• Agitation or irritability
• Restlessness
• Acting impulsively and/or with poor judgment
• Racing thoughts
• Speaking quickly
• In extreme cases, signs of psychosis such as delusions or hallucinations

Symptoms of a depressive episode include: 

• Sadness or hopelessness
• Fatigue
• Significant changes in appetite and/or sleeping patterns
• Difficulty focusing
• A loss of interest in activities once enjoyed
• Social self-isolation
• Thoughts or behaviors of self-harm or suicide; or suicide attempts

Treatment for adult bipolar disorder patients

Adult bipolar disorder patients are often treated with medication, such as antidepressants or mood stabilizers, and psychotherapy, such as cognitive behavioral therapy. The exact causes of bipolar disorder are still being researched, but a systematic review of the available data suggests there may be a strong genetic component. Environmental factors such as stress and trauma may also contribute to the development of this disorder and/or trigger bipolar disorder onset. 

Differential diagnosis: ADHD and bipolar disorder

You may have noticed that ADHD and BD (bipolar disorder) have some overlap in potential symptoms, including difficulty concentrating, irritability, restlessness, and impulsive behavior. These similarities mean it can sometimes be difficult for clinicians to make an accurate diagnosis at first, which is why listing all symptoms to your provider can be important. Additionally, some of the symptoms of both disorders may be misdiagnosed as other mental health conditions, such as eating disorders. ADHD and bipolar disorder often require different treatments, and either one can negatively impact a person’s well-being and even jeopardize their safety if left untreated.

Furthermore, research shows that ADHD is often accompanied by comorbid BD, meaning that it’s not uncommon for them to occur together.

It also notes that adolescents with ADHD are at higher risk of developing bipolar disorder as young adults, with incidence rates somewhere between 7–21%.

The role of therapy in treating these disorders

As mentioned previously, some form of psychotherapy is commonly recommended as part of the treatment plan for those with ADHD and/or bipolar disorder or the presence of another psychiatric comorbidity, often in combination with medication.

Therapy for ADHD

Cognitive behavioral therapy (CBT) is one of the most common forms of psychotherapy recommended for those with ADHD. Difficulties controlling emotions and behavior are common in those with this disorder, and CBT can help in this regard. This modality is based on the idea that beliefs cause thoughts which cause feelings and behaviors. A cognitive behavioral therapist can help an individual learn to become aware of their beliefs and thoughts so they can shift them in order to positively impact behavior. A therapist can also help an individual develop effective, healthy strategies for managing symptoms and improving daily functioning.

Therapy for bipolar disorder

CBT is also one of the most commonly recommended forms of therapy for people experiencing bipolar disorder. First, it can help them learn to identify triggers that may lead to manic or depressive episodes so that they can take preventative measures. It can also help individuals with bipolar disorder to identify flawed or distorted thought patterns that may be contributing to symptoms and learn coping techniques for managing those that they do experience. Other forms of therapy that may be suggested for those with bipolar disorder include interpersonal and social rhythm therapy (ISRT) or family-focused therapy. The best method for a given individual will generally be suggested by a mental health care provider based on the person’s unique symptoms and situation.

Online therapy for ADHD and bipolar disorder

For severe or extreme cases of any mental health condition, in-person treatment is usually recommended. Otherwise, you can often choose between online or in-person therapy according to your needs and preferences. Research suggests that online therapy may be as effective as traditional, in-office methods in some cases, and other studies reflect a similar finding when it comes to online therapy for some individuals with bipolar disorder. Consulting with a professional is typically the best way to find out which method might be right for you.

If you’re interested in meeting with a qualified professional online to help address and/or manage symptoms of a mental health condition that you may be experiencing, you might consider a virtual therapy platform like BetterHelp. You can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging from the comfort of your home to address the challenges you may be facing.