Table of ContentsView AllTable of ContentsWhat Is BD?What Is ADHD?ComorbidityShared SymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
What Is BD?
What Is ADHD?
Comorbidity
Shared Symptoms
Diagnosis
Treatment
Comorbid (coexisting) ADHD and BD can be hard to diagnose. Certain features, like age of onset and the persistence of symptoms, help distinguish the disorders. Treatment can also be tricky, as certain medications used to treat ADHD may worsen symptoms of bipolar disorder.
This article explores the relationship between bipolar disorder and ADHD, and why they can occur together.
What Is Bipolar Disorder?
There are two main types of bipolar disorder:
About 2% to 3% of the world population has bipolar disorder. It takes an average of six to eight years after symptoms begin for most people to receive a diagnosis. Most people diagnosed with bipolar disorder are in their late teens to early adult years.
If You Have Thoughts of SuicideIf you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one are in immediate danger, call911.
If You Have Thoughts of Suicide
If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one are in immediate danger, call911.
What Are the Differences Between Bipolar 1 and 2?
ADHD is one of the most common neurodevelopmental disorders. This chronic disorder is typically diagnosed in childhood and usually causes symptoms that last into adulthood.
ADHD has three main features:
People with ADHD may experience all of these symptoms or a mixture of them. Almost 10% of children between the ages of 3 and 17 are diagnosed with ADHD.About 50% to 60% of these children will continue to meet diagnostic criteria for ADHD into adulthood.
Untreated ADHD in Adults
When Bipolar and ADHD Occur Together
Bipolar disorder and ADHD often coexist within the same person. Determining whether someone has bipolar disorder, ADHD, or both can be challenging, as some symptoms are similar.
Everyone’s experience with bipolar disorder and/or ADHD is different. It’s important to accurately diagnose both disorders, if present, as research indicates the comorbidity of these conditions can significantly affect daily functioning.
Because the exact causes of both bipolar disorder and ADHD are unclear, it’s challenging to determine why they co-occur. However, researchers have identified 33 loci (chromosomal gene locations) that are involved in both disorders.
One study also found that individuals with first-degree relatives of people with ADHD (parents, offspring, and siblings) were more likely to develop bipolar disorder. All this together suggests a strong genetic connection.
How Often Do ADHD and Bipolar Disorder Occur Together?One in 13 people with ADHD have bipolar disorder, and one in six people with bipolar disorder have ADHD. This equates to approximately four million people in the United States and Europe who have comorbid ADHD and bipolar disorder.
How Often Do ADHD and Bipolar Disorder Occur Together?
One in 13 people with ADHD have bipolar disorder, and one in six people with bipolar disorder have ADHD. This equates to approximately four million people in the United States and Europe who have comorbid ADHD and bipolar disorder.
Bipolar Disorder vs. ADHD
Bipolar disorder and ADHD are different conditions that cause a different profile of symptoms. There are also some key differences related to when these conditions develop, and how they affect a person over time. Some of these key differences are as follows:
ADHDNeurodevelopmental disorderMore common in malesSymptoms start before age 12More prominent motor impulsivity and lack of organizationChronic and consistent symptomsSymptoms mostly stay stable throughout lifeNo psychotic symptomsFirst-line treatment is stimulant drugsBipolar DisorderMood disorderMore common in femalesSymptoms start in early adulthoodMore prominent emotional instability and reactivityEpisodic symptoms that worsen under stressSymptoms appear to decrease with agePossible psychotic symptomsFirst-line treatment is psychotherapy
ADHDNeurodevelopmental disorderMore common in malesSymptoms start before age 12More prominent motor impulsivity and lack of organizationChronic and consistent symptomsSymptoms mostly stay stable throughout lifeNo psychotic symptomsFirst-line treatment is stimulant drugs
Neurodevelopmental disorder
More common in males
Symptoms start before age 12
More prominent motor impulsivity and lack of organization
Chronic and consistent symptoms
Symptoms mostly stay stable throughout life
No psychotic symptoms
First-line treatment is stimulant drugs
Bipolar DisorderMood disorderMore common in femalesSymptoms start in early adulthoodMore prominent emotional instability and reactivityEpisodic symptoms that worsen under stressSymptoms appear to decrease with agePossible psychotic symptomsFirst-line treatment is psychotherapy
Mood disorder
More common in females
Symptoms start in early adulthood
More prominent emotional instability and reactivity
Episodic symptoms that worsen under stress
Symptoms appear to decrease with age
Possible psychotic symptoms
First-line treatment is psychotherapy
Relationship Between Bipolar and ADHD
Symptoms commonly seen in both bipolar disorder and ADHD include:
Whereas these symptoms happen periodically in bipolar disorder during manic or hypomanic episodes, they are more chronic and stable in people with ADHD.
Depressive symptoms are not a primary ADHD trait. However, research shows that people with ADHD have a higher risk of depression.
Also, compared to people with only bipolar disorder or only ADHD, people with comorbid ADHD and bipolar disorder tend to:
Help Is AvailableIf you or a loved one are struggling with bipolar disorder and/or ADHD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Help Is Available
If you or a loved one are struggling with bipolar disorder and/or ADHD, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
The large overlap of symptoms and family patterns between ADHD and bipolar disorder can make it difficult to distinguish between the two.
Moreover, some researchers believe that, in some cases, ADHD symptoms in childhood could be a prodrome (early sign) of bipolar disorder, rather than two distinct diagnoses.
Mental healthcare providers consider a few factors when making a diagnosis, especially:
How Is Comorbid ADHD and Bipolar Disorder Diagnosed?You may be diagnosed with comorbid ADHD and bipolar disorder if:You have experienced inattention, hyperactivity, or impulsivity since childhood.You developed sustained, severe mood swings in your late teens to early adulthood.You experience inattention, hyperactivity, or impulsivity even when your mood is stable.Your symptoms interfere with work, relationships, and other daily functions despite being on mood stabilizers (which are used to treat bipolar disorder).
How Is Comorbid ADHD and Bipolar Disorder Diagnosed?
You may be diagnosed with comorbid ADHD and bipolar disorder if:You have experienced inattention, hyperactivity, or impulsivity since childhood.You developed sustained, severe mood swings in your late teens to early adulthood.You experience inattention, hyperactivity, or impulsivity even when your mood is stable.Your symptoms interfere with work, relationships, and other daily functions despite being on mood stabilizers (which are used to treat bipolar disorder).
You may be diagnosed with comorbid ADHD and bipolar disorder if:
Treating Bipolar and ADHD Together
Treatment for co-occurring bipolar disorder and ADHD is not straightforward. More research is needed to determine best practices.
Currently, healthcare providers may approach each case on an individual basis to identify the patient’s needs. However, treating symptoms to stabilize patients is generally considered the first step of treatment.
Medication
Medicationsto treat bipolar disorder include:
Once bipolar symptoms are managed in patients with comorbid bipolar disorder and ADHD, a healthcare provider may add stimulant or non-stimulant medications to target symptoms of inattention.
Some non-stimulant medications used to treat ADHD include:
Stimulants can trigger manic symptoms in some cases, so regular check-ins with a healthcare provider are essential. Medication management with bipolar disorder and ADHD may involve some trial and error.
Therapy
Therapeutic interventions for bipolar disorder such ascognitive behavioral therapy(CBT) and dialectical behavior therapy can teach individuals how to challenge distorted thinking, improve how they regulate their emotions, and increase coping skills.
Additional strategies and behavioral interventions, such as establishing routines and creating systems to support symptoms, may also be helpful.
Lifestyle Changes
Lifestyle changes such as getting regular sleep, eating healthy and balanced meals, and exercise can support people with bipolar disorder and ADHD.
Summary
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Altinbaş K.Treatment of comorbid psychiatric disorders with bipolar disorder.Noro Psikiyatr Ars. 2021 Sep;58(1):41-46. doi:10.29399/npa.27615Comparelli A, Polidori L, Sarli G, Pisollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatr. 2022 Aug;13(1):949375. doi:10.3389/fpsyt.2022.949375Harvard Health Publishing.Bipolar disorder (manic depressive illness or manic depression).Tondo L, Miola A, Pinna M, Contu M, Baldessarini R.Differences between bipolar disorder type 1 and 2 support the DSM two-syndrome concept.Int J Bipolar Disord. 2022 Aug;10(1):21. doi:10.1186/s40345-022-00268-2National Institute of Mental Health.Bipolar disorder.Cerimele J, Fortney J, Unützer J.Bipolar disorder and population health.Psychiatr Serv. 2017 Feb;68(2):192-194. doi:10.1176/appi.ps.201600011Centers for Disease Control and Prevention.Data and statistics about ADHD.Salvi, Virginio, et al.ADHD and bipolar disorder in adulthood: clinical and treatment implications.Medicina. 2021;57(5):466. doi:10.3390/medicina57050466Larsson H, Rydén E, Boman M, Långström N, Lichtenstein P, Landén M.Risk of bipolar disorder and schizophrenia in relatives of people with attention-deficit hyperactivity disorder.British J Psychiatr. 2018 Jan;203(2):103-106. doi:10.1192/bjp.bp.112.120808Michigan Medicine Department of Psychiatry.Is it ADHD? Or bipolar? Could it be both? What. Is. Going. On.Levenberg K, Cordner Z.Bipolar disorder: A review of treatment options.Gen Psychiatr. 2022 Aug;34(4):e100760. doi:10.1136/gpsych-2022-100760Girard R, Joober R.Treatment of ADHD in patients with bipolar disorder.J Psychiatry Neurosci. 2017;42(6):E11-E12. doi:10.1503/jpn.170097Edinoff A, Apgar T, Rogers J, et al.Attention deficit disorder and bipolar disorder: Diagnosis, treatments, and clinical considerations: A narrative review.Psychiatr Int. 2022;3(1):17-28. doi:10.3390/psychiatryint3010002Briguglio M, Vitale J, Galentino R, et al.Healthy eating, physical activity, and sleep hygiene (HEPAS) as the winning triad for sustaining physical and mental health in patients at risk for or with neuropsychiatric disorders: Considerations for clinical practice.Neuropsychiatr Dis Treat. 2020;16(1):55-70. doi:10.2147/NDT.S229206
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Altinbaş K.Treatment of comorbid psychiatric disorders with bipolar disorder.Noro Psikiyatr Ars. 2021 Sep;58(1):41-46. doi:10.29399/npa.27615Comparelli A, Polidori L, Sarli G, Pisollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatr. 2022 Aug;13(1):949375. doi:10.3389/fpsyt.2022.949375Harvard Health Publishing.Bipolar disorder (manic depressive illness or manic depression).Tondo L, Miola A, Pinna M, Contu M, Baldessarini R.Differences between bipolar disorder type 1 and 2 support the DSM two-syndrome concept.Int J Bipolar Disord. 2022 Aug;10(1):21. doi:10.1186/s40345-022-00268-2National Institute of Mental Health.Bipolar disorder.Cerimele J, Fortney J, Unützer J.Bipolar disorder and population health.Psychiatr Serv. 2017 Feb;68(2):192-194. doi:10.1176/appi.ps.201600011Centers for Disease Control and Prevention.Data and statistics about ADHD.Salvi, Virginio, et al.ADHD and bipolar disorder in adulthood: clinical and treatment implications.Medicina. 2021;57(5):466. doi:10.3390/medicina57050466Larsson H, Rydén E, Boman M, Långström N, Lichtenstein P, Landén M.Risk of bipolar disorder and schizophrenia in relatives of people with attention-deficit hyperactivity disorder.British J Psychiatr. 2018 Jan;203(2):103-106. doi:10.1192/bjp.bp.112.120808Michigan Medicine Department of Psychiatry.Is it ADHD? Or bipolar? Could it be both? What. Is. Going. On.Levenberg K, Cordner Z.Bipolar disorder: A review of treatment options.Gen Psychiatr. 2022 Aug;34(4):e100760. doi:10.1136/gpsych-2022-100760Girard R, Joober R.Treatment of ADHD in patients with bipolar disorder.J Psychiatry Neurosci. 2017;42(6):E11-E12. doi:10.1503/jpn.170097Edinoff A, Apgar T, Rogers J, et al.Attention deficit disorder and bipolar disorder: Diagnosis, treatments, and clinical considerations: A narrative review.Psychiatr Int. 2022;3(1):17-28. doi:10.3390/psychiatryint3010002Briguglio M, Vitale J, Galentino R, et al.Healthy eating, physical activity, and sleep hygiene (HEPAS) as the winning triad for sustaining physical and mental health in patients at risk for or with neuropsychiatric disorders: Considerations for clinical practice.Neuropsychiatr Dis Treat. 2020;16(1):55-70. doi:10.2147/NDT.S229206
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Altinbaş K.Treatment of comorbid psychiatric disorders with bipolar disorder.Noro Psikiyatr Ars. 2021 Sep;58(1):41-46. doi:10.29399/npa.27615Comparelli A, Polidori L, Sarli G, Pisollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatr. 2022 Aug;13(1):949375. doi:10.3389/fpsyt.2022.949375Harvard Health Publishing.Bipolar disorder (manic depressive illness or manic depression).Tondo L, Miola A, Pinna M, Contu M, Baldessarini R.Differences between bipolar disorder type 1 and 2 support the DSM two-syndrome concept.Int J Bipolar Disord. 2022 Aug;10(1):21. doi:10.1186/s40345-022-00268-2National Institute of Mental Health.Bipolar disorder.Cerimele J, Fortney J, Unützer J.Bipolar disorder and population health.Psychiatr Serv. 2017 Feb;68(2):192-194. doi:10.1176/appi.ps.201600011Centers for Disease Control and Prevention.Data and statistics about ADHD.Salvi, Virginio, et al.ADHD and bipolar disorder in adulthood: clinical and treatment implications.Medicina. 2021;57(5):466. doi:10.3390/medicina57050466Larsson H, Rydén E, Boman M, Långström N, Lichtenstein P, Landén M.Risk of bipolar disorder and schizophrenia in relatives of people with attention-deficit hyperactivity disorder.British J Psychiatr. 2018 Jan;203(2):103-106. doi:10.1192/bjp.bp.112.120808Michigan Medicine Department of Psychiatry.Is it ADHD? Or bipolar? Could it be both? What. Is. Going. On.Levenberg K, Cordner Z.Bipolar disorder: A review of treatment options.Gen Psychiatr. 2022 Aug;34(4):e100760. doi:10.1136/gpsych-2022-100760Girard R, Joober R.Treatment of ADHD in patients with bipolar disorder.J Psychiatry Neurosci. 2017;42(6):E11-E12. doi:10.1503/jpn.170097Edinoff A, Apgar T, Rogers J, et al.Attention deficit disorder and bipolar disorder: Diagnosis, treatments, and clinical considerations: A narrative review.Psychiatr Int. 2022;3(1):17-28. doi:10.3390/psychiatryint3010002Briguglio M, Vitale J, Galentino R, et al.Healthy eating, physical activity, and sleep hygiene (HEPAS) as the winning triad for sustaining physical and mental health in patients at risk for or with neuropsychiatric disorders: Considerations for clinical practice.Neuropsychiatr Dis Treat. 2020;16(1):55-70. doi:10.2147/NDT.S229206
Altinbaş K.Treatment of comorbid psychiatric disorders with bipolar disorder.Noro Psikiyatr Ars. 2021 Sep;58(1):41-46. doi:10.29399/npa.27615
Comparelli A, Polidori L, Sarli G, Pisollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatr. 2022 Aug;13(1):949375. doi:10.3389/fpsyt.2022.949375
Harvard Health Publishing.Bipolar disorder (manic depressive illness or manic depression).
Tondo L, Miola A, Pinna M, Contu M, Baldessarini R.Differences between bipolar disorder type 1 and 2 support the DSM two-syndrome concept.Int J Bipolar Disord. 2022 Aug;10(1):21. doi:10.1186/s40345-022-00268-2
National Institute of Mental Health.Bipolar disorder.
Cerimele J, Fortney J, Unützer J.Bipolar disorder and population health.Psychiatr Serv. 2017 Feb;68(2):192-194. doi:10.1176/appi.ps.201600011
Centers for Disease Control and Prevention.Data and statistics about ADHD.
Salvi, Virginio, et al.ADHD and bipolar disorder in adulthood: clinical and treatment implications.Medicina. 2021;57(5):466. doi:10.3390/medicina57050466
Larsson H, Rydén E, Boman M, Långström N, Lichtenstein P, Landén M.Risk of bipolar disorder and schizophrenia in relatives of people with attention-deficit hyperactivity disorder.British J Psychiatr. 2018 Jan;203(2):103-106. doi:10.1192/bjp.bp.112.120808
Michigan Medicine Department of Psychiatry.Is it ADHD? Or bipolar? Could it be both? What. Is. Going. On.
Levenberg K, Cordner Z.Bipolar disorder: A review of treatment options.Gen Psychiatr. 2022 Aug;34(4):e100760. doi:10.1136/gpsych-2022-100760
Girard R, Joober R.Treatment of ADHD in patients with bipolar disorder.J Psychiatry Neurosci. 2017;42(6):E11-E12. doi:10.1503/jpn.170097
Edinoff A, Apgar T, Rogers J, et al.Attention deficit disorder and bipolar disorder: Diagnosis, treatments, and clinical considerations: A narrative review.Psychiatr Int. 2022;3(1):17-28. doi:10.3390/psychiatryint3010002
Briguglio M, Vitale J, Galentino R, et al.Healthy eating, physical activity, and sleep hygiene (HEPAS) as the winning triad for sustaining physical and mental health in patients at risk for or with neuropsychiatric disorders: Considerations for clinical practice.Neuropsychiatr Dis Treat. 2020;16(1):55-70. doi:10.2147/NDT.S229206
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