Exploring the Relationship Between ADHD and Bipolar Disorder

What’s the relationship between ADHD and bipolar disorder?

Research shows that up to 20% of adults living with bipolar disorder also have a co-occurrence of ADHD.

One study showed that this dual diagnosis is more common in men with bipolar I disorder.

Your genetics certainly appear to play a role, according to several studies. More specifically, it may come down to how your brain was formed.

So far, studies suggest that this comorbidity can occur when there are structural differences in the parts of your brain that affect:

• attention
• emotional regulation
• executive functioning
• language
• memory
• motor function

More research is still needed to figure out exactly which areas of the brain are affected by both conditions (convergence) and which parts are separate (divergence), though there does seem to be significant overlap.

How are they diagnosed?

Research shows that it’s common for ADHD to be diagnosed first, since symptoms usually present in childhood. From there, roughly two-thirds of people continue to have symptoms into adulthood.

Bipolar disorder is usually diagnosed by the time you’re in your late 20s, but not always. Research shows that bipolar disorder can onset, on average, 4 years earlier when ADHD is also present.

To receive a diagnosis of one, or both, conditions, a healthcare or mental health professional will likely work with you over several sessions. They may ask about:

• your symptoms
• when your symptoms started
• family medical history
• personal medical history

From there, they will conduct a psychological evaluation to see if you meet both sets of criteria based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

The main difference between the two is that ADHD creates more consistent patterns of behavior, while bipolar disorder can occur in cycles, with a manic episode mimicking many of the symptoms of ADHD.

There are, however, many other differences and similarities.

How are they treated?

If you‘re diagnosed with both conditions, there is hope. By working with a healthcare or mental health professional, you can learn to manage your symptoms.

Psychotherapy

Research shows that those who live with both ADHD and bipolar disorder have an increased chance of suicidal ideation and substance use disorder (SUD), particularly around alcohol.

For these reasons, it might be a good idea to work with a mental health professional. They can help you identify harmful thought patterns and how they relate to your behavior, as well as help you develop coping strategies for difficult moments.

Research points to three interventions that may be effective:

• cognitive behavioral therapy (CBT)
• dialectical behavioral therapy (DBT)
• communication-focused therapy (CFT)

If you‘re looking for professional support, you can find a mental health professional using our search tools.

Family therapy

Research shows that those who live with both ADHD and bipolar disorder have an increased chance of conflict in the family. It might be helpful to work with a family or group therapist to help address any challenges that arrive in your home dynamic.

Medication

ADHD is treated with medications that stimulate the central nervous system. Bipolar disorder, on the other hand, is often treated with antidepressants, mood stabilizers, or benzodiazepines.

Research shows that stimulants for ADHD can cause manic episodes if you have co-occurring bipolar disorder.

A mental health professional may spend some time working with you to find the right combination of medications. The chance of causing a manic episode is reduced when you’re taking a stimulant and mood stabilizer together.

A 2016 study found that methylphenidate (Ritalin) was a safe medication for those with both ADHD and bipolar disorder.

Self-help strategies

There are many ways to support your wellness journey. Some ideas include:

• developing a meditation practice
• doing stress-relieving hobbies and activities
• eating a balanced diet of nutritious foods
• exercising moderately at least 5 days a week
• getting 8 hours of sleep per night
• journaling about your feelings
• spending time in nature every day

Next steps

ADHD and bipolar disorder often show up together, even though researchers still aren‘t sure exactly why this is.

For some, it can be difficult to receive one diagnosis, let alone two, but remember that you’re not alone and there is support available.

It may take some time, but it’s possible to find the right combination of therapy, medications, and lifestyle changes to help you manage your symptoms.

You may also find it helpful to join a support group, like:

• National Alliance on Mental Illness (NAMI)
• Depression and Bipolar Support Alliance
• Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
• Attention Deficit Disorder Association (ADDA)