How to Tell ADHD and Bipolar Disorder Apart

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At a Glance

Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder are different disorders that have some overlapping symptoms. Someone can have both ADHD and bipolar disorder, and both conditions need to be treated.

There are some similarities in the symptoms of ADHD and bipolar disorder. For example, both conditions can cause hyperactive or restless behaviors, distractibility, poor concentration, impulsivity, and racing thoughts.

ADHD and bipolar disorder can also lead to sleep disturbances, poor social relationships, feelings of anxiety, depression, frustration, and self-doubt. Both conditions can significantly affect a person's daily functioning. It’s also common for ADHD and bipolar disorder to occur together, making it even more difficult to tell them apart.

Let's take a closer look at the symptoms of bipolar disorder and ADHD, explore some of the similarities and differences between the two conditions, and learn how to tell them apart.

ADHD vs. Bipolar

ADHD and bipolar disorder are different conditions with different symptoms. Bipolar disorder is a mood disorder. ADHD is a neurodevelopmental condition that affects attention and behavior.

ADHD is a chronic condition, but the symptoms may lessen or disappear in adulthood. Bipolar disorder is a lifelong condition with episodes of symptoms that a person can learn to manage.

In terms of causes, ADHD and bipolar disorder are both thought to have a strong genetic link.

Symptoms of ADHD

The main symptom of ADHD is trouble paying attention. With ADHD, the symptoms of distractibility and/or impulsivity and hyperactivity or restlessness are always present. A person's environment can also influence their ADHD symptoms.

ADHD is often diagnosed in children. Caregivers and teachers may notice that a child has a hard time sitting still or paying attention in class. A school counselor or pediatrician may evaluate a child for ADHD or refer them to a child psychologist for a diagnosis.

ADHD can also be diagnosed in adults. A person may have had ADHD symptoms since childhood but was never diagnosed. Sometimes, a parent learns they have ADHD after their child is diagnosed, and they realize that certain traits or challenges they have are symptoms of ADHD.

A person’s provider will usually want to rule out another cause for their symptoms, like a medical or mental health condition, before diagnosing them with ADHD or referring them to a mental health provider.

Symptoms of Bipolar Disorder

The main symptom of bipolar disorder is a disturbance in mood. Bipolar disorder causes 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.

Bipolar disorder is usually diagnosed during the teen years or early adulthood. However, symptoms can appear earlier in childhood. In some cases, bipolar disorder can be diagnosed as early as age 6.

The mood episodes in bipolar disorder are more significant than typical mood swings. The episodes can alternate with periods of typical mood and function. Bipolar episodes usually occur independently of any outside influences in a person's environment.

The cycles of highs, lows, and normal periods can also be irregular and without a clear pattern, and bipolar episodes may last several weeks. There are four types of mood episodes that a person with bipolar disorder can experience: mania, hypomania, depression, and mixed.

Mania

Manic episodes are characterized by high energy levels, over-the-top happiness (elation) or an extremely irritable and angry mood, and a feeling of grandiosity and self-importance.

These feelings in mania can escalate to delusions, 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 affect a person’s ability to function in their daily life.

Hypomania

Hypomania is a milder form of mania that may not affect a person’s daily functioning as much as a manic episode would. People with hypomania typically have less need for sleep, behave recklessly, and speak fast. They may also feel irritable.

Depression

Symptoms of depression in bipolar disorder can include low energy, fatigue, sadness and hopelessness, trouble concentrating, memory problems, loss of appetite, and sleep disturbances. A person experiencing a depressive episode may also feel no interest in life and find no pleasure in things that used to bring them joy. They may even have suicidal thoughts.

Mixed Mood

A mixed episode is when a person meets the criteria for both a manic episode and a major depressive episode nearly every day for at least one week.

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

ADHD and bipolar disorder have different treatments, and treatment needs to be tailored to each person.

People with ADHD respond well to increased structure and organizational strategies in their environment and benefit from education, psychotherapy, social skills training, coaching, and support.

Structuring one’s environment, limiting distractions, finding stimulating activities, and using visual or auditory reminders and organizational techniques can help people with ADHD function better.

Some people with ADHD benefit from taking medication. The most common drugs prescribed to treat ADHD are stimulant medications.

Treatment for bipolar disorder usually involves mood-stabilizing medications, education, psychotherapy, and support. If a person with bipolar disorder is misdiagnosed with ADHD, taking stimulants may make their symptoms worse and bring on manic or depressive episodes.

A careful mental health evaluation is needed to diagnose bipolar and/or ADHD. It’s important that a provider understands both conditions and can tell them apart since they can share some symptoms.

Can You Have ADHD and Bipolar Disorder?

Evidence suggests that it is not uncommon for people to have both ADHD and bipolar disorder. According to a 2021 systematic review and meta-analysis, one in 13 people with ADHD had also been diagnosed with bipolar disorder. The review also found that almost one in six adults with bipolar disorder also had ADHD.

Summary

While bipolar disorder and ADHD are different conditions, some of their symptoms overlap. It’s also possible for a person to have both bipolar disorder and ADHD.

Getting an accurate diagnosis is important because the wrong treatment for bipolar disorder or ADHD can make symptoms worse. If you know which condition you have (or you learn that you have both), you can work with your provider to find the treatment that helps you manage your symptoms effectively.

13 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.
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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.