Mood shifts, inattentiveness, and hyperactivity can occur with bipolar disorder and ADHD, yet they are separate conditions. Here’s how to tell the difference.

Bipolar disorder and attention deficit hyperactivity disorder (ADHD) are common conditions that, on the surface, might seem different, but they can have some symptom overlap.

There’s so much overlap that an estimated 60% to 90% of children with bipolar disorder are also diagnosed with ADHD.

This makes it challenging to determine whether someone has ADHD, bipolar disorder, or is experiencing both conditions. Adding to that difficulty, both can present differently in children and adults.

Still, there are distinct differences between the two conditions that can help identify which one is present.

Bipolar disorder involves significant shifts in energy level and mood. You might experience extreme highs (mania or hypomania), lows (depression), or both.

There are some similarities in the manic and depressive symptoms of bipolar disorder and ADHD. In addition, the two can occur together.

According to a 2021 review, approximately 1 in 13 adults with ADHD also have bipolar disorder, and up to 1 in 6 adults with bipolar disorder have co-occurring ADHD.

Another 2021 review suggests that because the symptoms of both conditions can overlap, it can result in a missed diagnosis or misdiagnosis, which can impact treatment plans and symptom management. This is especially seen in children.

At a glance: Differences and similarities between ADHD and bipolar disorder

Review authors noted these key differences and similarities between the two conditions.

ADHDBipolar Disorder
PersistentEpisodic (can come and go at intervals)
Often diagnosed at 6 to 12 years oldOften diagnosed at 18 to 25 years of old
Affects attention and behaviorAffects mood and behavior
Consistent sleep problemsDecreased need to sleep during mania
Increased energyIncreased energy during mania
Increased sexual activity is not often presentIncreased sexual activity in mania
Psychosis not presentPsychosis possible during severe mood episodes
Easily distractedEasily distracted during mania
ImpulsivityImpulsivity during mania
Lower self-esteemIncreased self-esteem during mania
Difficulty with memoryDifficulty with memory
Talking too fast or too muchTalking too fast or too much during mania

Symptoms of ADHD and bipolar disorder can look different from person to person.

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During a depressive episode, people with bipolar disorder may experience:

  • low mood, excessive fatigue, and sadness
  • increased or decreased appetite
  • loss of interest in activities once enjoyed
  • sleeping too much or too little
  • difficulty with concentration and focus
  • thoughts of death or suicide

If you’re considering acting on suicidal thoughts, please seek professional support immediately.

Calling or texting a crisis helpline will connect you with a trained counselor 24/7, any day of the year, completely free of charge:

During a depressive episode, a person with bipolar disorder may have difficulty with attention and focus — symptoms similar to ADHD.

The sleep disturbances associated with bipolar disorder-related depressive states can also mimic those experienced by people with ADHD.

But there are differences.

For example, if you have ADHD, you may have trouble concentrating and focusing, but these symptoms occur consistently. Whereas if you have bipolar disorder, you may experience challenges with attention and focus only during a depressive or manic phase.

Symptoms often observed during the manic episodes associated with bipolar disorder may include:

  • feelings of grandiosity or inflated self-esteem
  • excessive energy
  • speech pattern changes such as talking too fast or rapidly changing the subject
  • increased distractibility or racing thoughts
  • irritability or aggressive behavior
  • changes in sleep patterns, such as less need for sleep
  • an increase in impulsive or reckless behaviors

Symptoms that can occur during a bipolar disorder-related manic phase can mimic the symptoms experienced by someone with ADHD.

These include:

  • distractibility
  • less need for sleep
  • excessive talking
  • impulsivity
  • increased energy levels

If you have bipolar disorder, this heightened physical or emotional state may happen only during a manic episode, but it can occur daily in people with ADHD.

ADHD may be diagnosed more often in children than bipolar disorder, but it is possible. It’s estimated that approximately 1% to 3% of children and teens can be diagnosed with bipolar disorder.

Because the symptoms of bipolar disorder can mimic ADHD, bipolar disorder is frequently misdiagnosed in children and adolescents.

In a 2011 study, children and adolescents (ages 7 to 18 years old) were overdiagnosed with ADHD and underdiagnosed with bipolar disorder.

Some symptoms that may indicate the presence of bipolar disorder rather than ADHD in children include:

  • Tantrums or heightened emotions that can last for days and not be soothed in the typical ways, such as with distractions.
  • Unexplained elevation of mood lasting for days that’s not triggered by positive events or circumstances, alternating with a noticeable depressed mood or lack of interest in activities.
  • Episodes of excessive energy without the need for sleep and not accompanied by fatigue that’s typically associated with sleep deprivation.
  • Frequent episodes of speech patterns that are fast and chaotic alternated with periods of typical speech.

If your child has ADHD and you’ve noticed that their behavior has been more intense than what is usually observed, consider reaching out to your child’s doctor.

They can determine underlying causes for this change in behavior and recommend strategies to help manage any new symptoms.

Although research is limited, there are effective treatment options for co-occurring ADHD and bipolar disorder. But it might take some trial and error before finding the best approach for you and your family.

A 2017 article suggests that mood stabilization is often the first step when treating someone with both ADHD and bipolar disorder.

Bipolar disorder medications are commonly used to help manage symptoms. These can include:

Medications for ADHD might also help improve attention and focus. These can include stimulants such as amphetamines (Adderall) or nonstimulants such as atomoxetine (Strattera).

Therapy can also help manage symptoms of both conditions. The type of therapy recommended will depend on several factors, such as your age and the severity of your symptoms.

Some therapies that could be helpful include:

Although ADHD is more common than bipolar disorder, both can occur in children and adults.

Many symptoms associated with these conditions can overlap, making it challenging to obtain an accurate diagnosis.

But a mental health professional can assess your symptoms, including their duration and possible triggers, and help identify whether you have bipolar disorder, ADHD, or both.

If you or your loved one has one or both conditions, know that you’re not alone, and there are treatment options that can help lessen mood changes and symptoms.

Although it may take time to find the treatment that works for you, try not to lose hope. Effective management of these conditions is possible.