Bipolar Disorder vs. ADHD: How to Tell the Difference

At a quick glance, attention-deficit hyperactivity disorder (ADHD) and bipolar disorder seem to share a lot of symptoms, making it difficult to tell one from the other. However, the two disorders are fundamentally different, with separate causes, reasons for symptoms, and treatments.

At Memphis Neurology, our expert team of neurologists regularly sees cases of behavioral disorders, including both ADHD and bipolar disorder. They understand, too, that they need to approach them with a different focus and tailor treatment to each specific condition. So you can understand behaviors you or your child might be experiencing, they’ve put together this guide on how to tell the difference between bipolar disorder and ADHD.

What is bipolar disorder?

Bipolar disorder is a mood disorder, meaning it doesn’t stem from the environment, but rather from a chemical imbalance in the brain. It’s characterized by extreme mood swings from manic to depressive, abrupt changes in energy levels, and distorted decision-making and risky behavior. The disorder is usually episodic, with periods of a stable, normal mood between bouts of depression, mania, or hypomania.

Adult mania is notable for rapid speech, lack of sleep, euphoria, racing thoughts, and frenetic activity. Depressive episodes are notable for low energy, lack of interest in what’s happening around you, difficulty concentrating, and suicidal thoughts.

In most cases, bipolar disorder develops in the late teens or early adulthood, though an increased number of experts now accept the existence of a pediatric form. All told, it affects about 5.7 million Americans, or 2.6% of the population. It affects men and women equally, as well as people of all races, social classes, and ethnic groups.

The problem is, the mania (euphoric) stage can be mistaken for the hyperactivity of ADHD, and the depressive stage can be viewed as inattention and lack of motivation, also common characteristics of ADHD.

However, unlike ADHD, 1 in 5 people with bipolar disorder will commit suicide, usually during the manic phase when they’re more impulsive and afraid of another depressive episode. That’s 15% higher than the suicide rate in the general population, leading those with bipolar disorder to have a reduced life expectancy of about 10 years compared with unaffected peers.

What is ADHD?

ADHD is an attention disorder, meaning that the individual is affected by what’s going on in the environment around them. Symptoms include rapid or impulsive speech, restlessness, difficulty focusing on a task or completing tasks, inattentiveness, irritability, and defiant or oppositional behavior. If their environment is stimulating and positive, people with ADHD can remain remarkably controlled; if it isn’t, they often become bored or agitated.

ADHD is far more common than bipolar disorder, making clinicians more likely to test for it. Up to 11% of all American children show symptoms of ADHD, and about 60% of those children carry symptoms into adulthood. Unlike bipolar disorder, it’s a chronic condition.

Comorbidity

Some 60-70% of those with bipolar disorder also have ADHD, and about 20% of those with ADHD have bipolar disorder. This rate of comorbidity indicates that people suspected to have one or the other condition should be tested for both. Since the conditions are treated very differently, it’s important to have appropriate diagnoses.

Patients with both disorders also tend to demonstrate bipolar symptoms earlier in life. The early age of onset often comes with a higher incidence of other comorbid psychiatric disorders and poorer overall functioning.

How to tell the difference

The principal difference between ADHD and bipolar disorder is that ADHD symptoms are entirely contextual and situational, while bipolar symptoms come from neurochemical factors.  Those with ADHD always respond to situations in the same way, no matter what their mood, and they can control their feelings and their impulses by changing their environment and stimuli, often with the help of stimulant medications like Adderall or Ritalin, and a course of psychotherapy.

For those with bipolar disorder, they feel fundamentally different when they become manic or depressed, irrespective of what’s going on around them. Stimulant medications can exacerbate bipolar symptoms, causing manic or depressive episodes. Instead, patients benefit from mood stabilizers, antidepressants, and some form of therapy.

If you or your child are experiencing any of the potential symptoms for either ADHD or bipolar disorder, it’s time you or they got tested for both conditions. Once diagnosed, appropriate treatment can be a game-changer. Give Memphis Neurology a call at either of our locations to schedule an evaluation with one of our neurologists, or book online with us today.