The girl with ADHD has difficulty sitting still, and is frequently fidgeting around people

Knowing the Nuances: Understanding the Differences between ADHD and Bipolar Disorder

When you seek treatment for any mental health condition, the first step is to ensure that you have an accurate diagnosis. For ADHD and bipolar disorder, the presence of some overlapping symptoms shouldn’t obscure these two very different conditions.

Your mind is racing, you’re eating everything in sight, and you can’t seem to relax enough to sit still, let alone sleep. You may have a sense that something isn’t quite right, but what could it be? One of the most commonly studied and diagnosed mental health conditions, Attention Deficit Hyperactivity Disorder (ADHD) is becoming a more frequent part of conversations particularly around child and teen mental health, but also for adults who experience symptoms like these. However, ADHD often co-occurs with other mental health disorders, and properly diagnosing these can be difficult.

Approximately 20% of people with ADHD have bipolar disorder, and anywhere from 60-70% of people with bipolar disorder have ADHD. Unfortunately, many people with these conditions will be misdiagnosed, and for some who have bipolar but not ADHD, the potential to be misdiagnosed as only having ADHD is quite high. Understanding the relationship and differences between ADHD and bipolar is critical in managing symptoms and accessing effective treatment.

What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a mental health disorder that can cause elevated levels of hyperactivity and impulsivity in both adults and children. ADHD can result in a shortened attention span and difficulty in remaining seated or still, which can cause significant disruptions to academic or professional work. 

Symptoms of ADHD

Some typical behavioural symptoms of ADHD can include:

  • Difficulty concentrating or focusing on tasks
  • Hyper-focus when interested, to the point of being unable to focus on anything else
  • Being easily distracted
  • Forgetfulness
  • Excessive talking and frequent interruptions of others
  • Difficulty sitting still, frequent fidgeting 
  • Unusually high energy or hyperactivity

When symptoms begin to significantly impact the daily life of the person experiencing them, this is an important indication that professional assessment is needed.

What is Bipolar Disorder?

Bipolar disorder is a mood disorder that presents with significant, and in some cases extreme, mood swings. The moods tend to alternate between a feeling of elevated energy called mania or hypomania, and that of depression. Bipolar disorder manifests in several different types, with some having distinct periods of mania and depression, and others tending to present more frequently with one mood, or less obvious mood swings.

Symptoms of Bipolar Disorder

Commonly experienced symptoms of bipolar disorder include:

  • Periods of mania or hypomania
    • Elevated energy, to the point of feeling out of control
    • Rapid speech and thoughts
    • Decreased need for sleep
    • Risky or impulsive behaviour
    • Exaggerated or grandiose statements
  • Periods of depression
    • Exhaustion 
    • Feelings of hopelessness, emptiness, and/or sadness
    • Increased irritability and anxiety
    • Loss of appetite
    • Inability to concentrate
    • Insomnia or oversleeping

Depending on the type of bipolar disorder, these symptoms will appear cyclically, generally with periods of mood stability or “feeling normal” in between cycles. However, severe symptoms can result in hospitalisation.

How is Misdiagnosis Possible?

Because ADHD is a more prevalent condition than bipolar disorder, many doctors are more familiar with its symptoms. There are several overlapping symptoms of bipolar and ADHD, which is why an initial misdiagnosis may occur, or a co-occurring disorder may be missed. These symptoms can include:

  • Rapid, prolific speech and a tendency to interrupt others
  • Increased, intense energy
  • Reduced ability to concentrate
  • Decreased motivation
  • Disturbed sleep
  • Fluctuations in weight

In order to assess whether these symptoms are a result of ADHD, bipolar disorder, or a combination of both, other factors must be considered. Fortunately, there are some distinct differences between ADHD and bipolar disorder that can help indicate the root cause of the symptoms.  

Key Differences between ADHD and Bipolar Disorder

The key difference between ADHD and bipolar disorder is that ADHD primarily affects attention and behaviour, while bipolar disorder impacts mood. Additionally, ADHD is a chronic condition, where symptoms manifest relatively consistent. Bipolar disorder involves cycles of moods between “manic,” or elevated, and depressed states. 

Depressed Moods: ADHD vs. Bipolar Disorder

When people with ADHD feel depressed, generally there is a clear contextual or situational trigger for emotional upset. Changing the environment or their activities to better suit their needs often results in a corresponding boost in mood.

However, for people living with bipolar disorder, moods are often internally generated. This means that while certain challenges or events may help trigger a depressive cycle, it is also likely that life could be going along relatively smoothly and yet the person would still experience deep, severe depression.

Manic Moods: ADHD vs. Bipolar Disorder

Though elevated energy may be one of the most commonly known symptoms of both ADHD and bipolar disorder, it manifests differently in each. For people with ADHD, something that piques an interest may inspire an intense, laser-like focus and action for a period of time, which subsides after the activity is completed. In general, there is a consistent heightened state of activity and energy for people with ADHD, and symptoms like talkativeness and fidgeting are regularly present. 

For those with bipolar disorder, elevated energy is not typically triggered by an external stimulus, but manifests internally as part of the mood cycling characteristic of the disorder. This means that someone with bipolar will experience manic symptoms for a period of time, regardless of what is going on in an outside context, and then shift into another mood that is distinctly different than the manic period. 

When Symptoms Show: ADHD vs. Bipolar Disorder

The time of life when symptoms first manifest is also important. With ADHD, people are born with symptoms that tend to show up in childhood or early adolescence, and are sometimes even apparent in infancy. Bipolar disorder usually develops over time, and more commonly presents in older teens or young adults. 

Research has also indicated that a family history of either condition can increase the likelihood of developing it, so if this information is available it should also be shared with a health professional.

Treatment Options

If you think that you or a loved one might be living with ADHD or bipolar disorder, it is important to seek professional care and review potential treatment options. Psychotherapy, such as cognitive behavioural therapy (CBT), can be especially useful. A goal-oriented type of talk therapy, CBT focuses on helping the client to become aware of negative responses, feelings, and behaviours and to learn how to respond to these in a more effective way. 

Both ADHD and bipolar disorder generally respond well to treatment, and working closely with a specialist can help you learn how to manage symptoms, and better deal with stress and triggers.

Discovering Your Potential at The Dawn

The Dawn Wellness Centre and Rehab offers personalised, inpatient mental health treatment for a variety of mental health conditions, including ADHD and bipolar disorder. Licensed by the Thai Ministry of Health and located in beautiful Chiang Mai, Thailand, The Dawn offers a relaxing respite from the stressors and triggers of daily life where you can focus solely on your needs and personal growth. Our team of Western specialists will work closely with you to help you gain a better understanding of your condition, and identify tools by which to manage it.

ADHD and Bipolar Disorder Treatment in Thailand or Online

If you are currently unable to travel due to the pandemic, but would like to start treatment as soon as possible, The Dawn’s therapists have years of experience providing online counselling to clients. We are currently offering a special Virtual Treatment Programme with the option of transitioning to in-person residential treatment when clients are ready, seamlessly continuing your treatment with a trusted therapist in a safe, peaceful, and stress-free environment. 

Call The Dawn today to learn more about how we can help you lead the life you want.

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