ADHD vs Bipolar: The Gap and The Connection

So, here’s the headscratcher. 

Some well-known ADHD symptoms are inability to focus, distractability, fidgeting, and restlessness.

What are some of the well-known symptoms of bipolar disorder? Inability to focus, distractibility, fidgeting, and… restlessness.

Yeah, I’m not fooling around here; BP and ADHD can look like twins…at a glance. If you look closer, you’ll find out that they can’t be more different, which is why it’s very important not to get misdiagnosed by one over the other.

How to tell them apart, and why should you do that?

All of that (and more) in today’s read!

In this article, you’ll learn:

• What is bipolar disorder (BP)
• Depressive and manic symptoms of BP 
• Bipolar vs ADHD: differences and simliarities
• What happens if you have both ADHD and bipolar

Are you ready?

Let’s dig in! 

[What is Bipolar Disorder]What is Bipolar Disorder? 

Bipolar disorder is a mental health disorder, the most recognizable trait hidden in its name. “Bi-” means two, while “polar,” in this context, refers to diametrically opposite states. 

The “two polarities” of bipolar disorder, then, are two states - depression and mania, and the person suffering from this diagnosis will frequently shift between the two states, often unpredictably. 

Each of these states has unique symptoms, so it’s best to look at each side of the coin separately. 

[Depressive Symptoms] Bipolar Disorder: Depressive Symptoms

The depressive state of BP is not unlike depression, as the symptoms tend to get quite similar. 

• Low mood
• Difficulties with concentration
• Suicidal ideations
• Constant feelings of fatigue
• Abnormal sleeping patterns (insomnia or too much sleep)
• Lack of appetite
• Social distancing, ghosting
• Loss of interest in hobbies and pastimes

[Manic Symptoms] Bipolar Disorder: Manic Symptoms

However, what separates BP from depression is that the depressive symptoms will often be replaced by manic ones, which can include:

• Increased impulsivity
• Risk-taking behavior
• Over-inflated ego
• Racing, uncontrollable thoughts
• Heightened irritability
• Hyper-focus on a particular activity, pastime
• Overabundance of energy

Have you noticed that there are certain overlaps with ADHD symptoms here? Good! That means you have been paying attention. Indeed, while these are completely separate conditions (i.e., one doesn’t necessitate the presence of the other), the symptoms do sometimes overlap. This makes it challenging to make a proper diagnosis, especially when a person has ADHD and BP both. 

[ADHD vs Bipolar] ADHD vs Bipolar: How Do They Differ?

ADHD and BP can indeed make you feel hyper. Both conditions can indeed make one prone to experiencing mood swings and being unintentionally rude during conversations. Having unbreakable focus on a specific activity, issues with sleep…are we still talking about different conditions? 

Yes, they are quite similar. But the devil, as always, is in the details, so let’s examine precisely the points of overlap and divergence. 

Mood Swings & Impulsivity

ADHD’s mood swings are rapid, frequent, and reactionary. They exist as a response to external events, thoughts, or realizations. Someone trapped in ADHD paralysis, for example, might quickly shift from being happy-go-lucky to feeling sad and disappointed.

In short, we can (almost) always say that this specific thing caused ADHDer to react this way. And, maybe the most important distinction is that these mood swings go as fast as they come and don’t tend to linger. 

BP’s mood swings, on the other hand, are characterized by their strong episodic nature. If a person is currently going through a depressive episode, they will probably remain confidently grounded in that state. Vice versa with a hypomanic high. 

Although there’s no fixed duration for each episode, these can last for weeks, if not months, and will persist irrespective of external circumstances and stimuli. 

Impulsivity pretty much follows the same rule. ADHDers will have a generally static propensity for impulsive behavior. Sure, some states and circumstances can make one more or less aware of these tendencies, but it’s not like there will be a radical and persistent shift. 

Someone with BP, however, will have their impulsivity closely tied to their current episode, bouncing between complete lack of interest in things (let alone impulsive ones) from making it their M.O. 

Hyperfocus and Restlessness

ADHD is perhaps a poster child for hyper-focusing because when we go at it, oh boy, nothing is stopping us from doing exactly this thing at this exact moment. 

Yet, there comes a time and a place where our biology catches up to us, and we feel tired. No matter how much we want to continue doing the thing, our body betrays us. 

During a manic episode, people with BP don’t have such a stopgap. Sounds great, right? Infinite time to do your favorite thing! 

Well, no. There’s too much of a good thing. A person with BP going through a manic episode might be so goal-driven that they won’t sleep for days because they just have to do it. Worse, in some circumstances, a person might understand that they really need to hit the sack, but their body won’t let them. 

I shouldn’t explain this, but if you need a reminder, not sleeping for a week is bad. Not “skating down the school hallway” bad. Really bad. By the end of such a sleepless binge, a person might start experiencing hallucinations and psychotic episodes, let alone the strain it puts on their body. 

So, yeah, not really comparable that. 

Social Interactions and Attention Span

We ADHDers do love interrupting or oversharing, but it’s not because we’re rude (I hope you’re not rude 😡).  Most of the time, it’s because we’re too distracted to notice social cues like, oh, I don’t know, our friend having the most frustrated look on their face? 

But yeah, when ADHDers struggle with interpersonal relationships, it’s mostly because we got distracted and stopped listening to whatever the person was saying 10 minutes ago or because we’re on our hyper-focusing episode and are in the process of info dumping about the rise of the Sumerian empire.

TL;DR: ADHDers are rude because we don’t notice it.

For people with BP, however, it’s more akin to being trapped in their own body, more or less unable to react in the way they want. So, a person with BP will be fully aware that they’re hopping from one topic to another but cannot stop, prevent, or discern the reasons for these shifts. 

Likewise, a person going through a manic episode might be uncharacteristically rude or mean to their friend, either because of a temporarily inflated ego or irritability. 

In contrast to ADHDers, people with BP are aware when they are being socially inept, but they can’t do much about it. 

In Sum: Chronic vs. Episodic Natures

As you may have surmised by now, the main difference between symptoms of ADHD and BP (even though they’re similar) is the tendencies and ability to influence them. 

Sure, ADHDers might have challenges regulating their mood swings, sleep schedule, ability to focus, etc. Yet, with the right mindset, discipline, and ability to recognize the specific cues and triggers, a person with ADHD can severely diminish the negative influence of their condition. And that’s even before we bring medication into the equation. So, ADHD is a condition with a certain degree of plasticity and capability to change.

What about BP, though? Well, because it bounces between too diametrically opposite states, it sometimes becomes difficult to do anything about it. 

Let me explain. Consider a person going through a mania episode of BP. They feel full of energy and restless, their ego is supercharged. In this hyper-agitated state, they can convince themselves that this is it. This is their new baseline, and they never will regress to a depressive episode. Yet, as soon as the pendulum swings and they wake up in a depressive episode, all these declamations go out of the window. 

When you have BP, you can just wake up one day feeling fundamentally different from yesterday, and there’s nothing you can do to influence that change. 

[ADHD + Bipolar] ADHD and Bipolar: A Dangerous Combination

Well, now, what happens when you blend ADHD and Bipolar disorder in one concoction? As you may have guessed, it’s not great for several reasons.

Risk of Misdiagnosis

We have established that ADHD and BP have similar symptoms that sometimes make it difficult to discern one from another.  If the person has both, that means that if a doctor isn’t paying proper attention, they can miss one. So, a person will receive only half the treatment they need.

Not only such a half-measure is ineffective, but it can also feel frustrating to the recipient. Let’s say you have ADHD and BP but have been diagnosed only with the former. So, the medication and the regime you have been put on don’t do much to help with your BP, which might make you feel like your medication isn’t doing anything. 

Increased Intensity of Symptoms

What happens when you combine the hyperfocus of ADHD and that of BP? Well, it’d be nice and dandy if they somehow canceled each other out, but no. Instead, they amplify and feed on each other, making already intense symptoms even more…intense. 

This resonant relationship makes proper treatment even more imperative than in separate diagnoses of ADHD or BP. For instance, one particular study found that in patients with bipolar disorder, the number of suicide attempts was strongly correlated with ADHD symptoms.²

Bipolar + ADHD: Medication Nuances

Regarding the treatment, most of the time, bipolar is treated with medication, either mood stabilizers, anti-psychotics, or anti-convulsants. 

Obviously, don’t take any advice or suggestions about “which meds to take” from some blog on the Internet; these decisions are between you and your healthcare practitioner. But there is one word of caution that I think I ought to give.

Unlike other ADHD comorbidities, like depression, if a person has both ADHD and BP, the medication you take should acknowledge the dual diagnosis. That’s because there’s some research to suggest that stimulant medication used to treat ADHD (e.g., Ritalin, Adderall) can sometimes trigger a BP manic episode.³ But that conclusion isn’t a one-size-fits-all mind, so, I repeat, the final decision should be made by your doctor. It’s just something to be aware of once you start the treatment. 

[Numo: ADHD App] Numo: Your ADHD Helper App

So, the conclusion that is begging to be made here, as with many other topics that we have been exploring thus far, is that the world of ADHD is that of uncertainty.

There are so many things and aspects of the condition where the research is still in its infancy that it makes it kinda difficult to discern right from wrong, the proper approach from the wrong one. 

And in such circumstances, at least sometimes, I have always found myself turning to my fellow ADHD enjoyers. Tapping into their experience and their understanding of what works and what doesn’t, I oftentimes found solutions for my own predicaments. And, if everything else failed, I at leat found support and understanding.

That premise is basically why we have created Numo - our ADHD helper app. Although it has many cute gizmos inside (more on that in a second), the core of the Numo experience is our squads and tribes, tightly-knit communities where we exchange laughs, cries, victories, and losses. 

So, if you have always looked for a place to belong, we’d be elated if you give us a chance 🤗

And just to sweeten the deal, let me tell you about the other cool things that Numo has in store:

• We have a pretty fun and easy-to-use ADHD planner you can use to keep track of all your doings and activities, a perfect thing to keep that ADHD mind chaos in check. 
• For the moments when you feel like everything is just too much, we also have a static noise generator. Many ADHDers have found relief from using static background noise to mask…er… noise in their head, bringing the order into chaos.
• Finally, we also have a bunch of cool short reads on coping techniques and things like that to give you the much-needed daily dose of the ADHD lore 🤯

I might be biased, but it’s a pretty cool app! So, give it a try 😉

[Conclusion] Conclusion

Now, let’s summarize what we have learned today 🤓

• Bipolar disorder is a mental health diagnosis characterized by the oscillations between depressive and manic states.
• Symptoms of bipolar disorder depend on the current state. In the depressive episode, BP is similar to the depression, for example.
• External factors rarely influence bipolar shifts. This means a person can fall asleep during a depressive episode and wake up manic, without any particular rhyme or reason.
• This propensity separates BP from ADHD, as external events and stimuli can influence the latter.
• Despite this distinction, ADHD and BP are often confused with each other due to a huge overlap in symptoms. 
• That confusion can be exceptionally problematic if the person suffers from both ADHD and BP, as they run a risk of receiving only half the treatment that the person needs. 

The biggest takeaway from today’s exploratory journey is the importance of the right diagnosis at the right time. 

While many comorbidities can mask ADHD and thus make it difficult to identify, BP is one of those cases where neglect can be dangerous and detrimental to the person’s well-being.

So, if you feel like you might have both, then it would be a good time to pay the doctor a visit. 

Sources

¹ Medicina. ADHD and Bipolar Disorder in Adulthood: Clinical and Treatment Implications

² Journal of the Korean Academy of Child and Adolescent Psychiatry. The Association between Attention Deficit/Hyperactivity Disorder Symptoms and the Number of Suicide Attempts among Male Young Adults with Unipolar and Bipolar Depression 

³ Journal of Psychiatry and Neuroscience. Treatment of ADHD in patients with bipolar disorder 

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