ADHD vs Bipolar Disorder: Key Differences

Attention-Deficit/Hyperactivity Disorder (ADHD)
Read Time: 5 Minutes
Written by:Minkyung Chung, MS, LMHC

Published On: August 17, 2022

Medically reviewed by: Elizabeth Keohan, LCSW-C, MSW

Reviewed On: August 17, 2022

Updated On: November 1, 2023


Are you constantly in motion, talkative, and finding yourself racing from one project to the next? These symptoms are the hallmarks of a type of attention deficit hyperactivity disorder (ADHD) known as hyperactive-impulsive ADHD, but they can also describe a manic phase of bipolar disorder.

Simply put, the key difference between ADHD vs bipolar disorder is that ADHD is a disturbance in attention, whereas bipolar disorder is a disturbance in mood.

People living with ADHD benefit greatly from structuring their lives so there’s less opportunity for distraction. Those with bipolar `disorder generally need mood-stabilizing medication combined with therapy to treat their condition effectively. The same medications used to treat bipolar disorder can actually worsen some symptoms of ADHD, which is just one major reason why getting a correct diagnosis is so essential.

Read on to learn about the differences between ADHD and bipolar disorder, because while there’s no cure to either condition, there are very effective treatments for both.

Symptoms of ADHD vs Bipolar Disorder

While some symptoms of ADHD and symptoms during the manic phases of bipolar disorder can overlap — such as fast-talking and hyperactivity — the conditions are vastly different.

One of the primary differences between ADHD and bipolar symptoms is that symptoms of ADHD are chronic (ongoing). Symptoms of bipolar disorder, however, are episodic (here for a while and then disappear) and vary between manic (extreme highs) and depressive (extreme lows) states.

ADHD symptoms

There are two general types of ADHD, each with its own set of symptoms.

Inattentive ADHD is marked by:

  • An inability to focus
  • Making careless mistakes
  • Losing things frequently
  • Being easily distracted

Symptoms of hyperactive-impulsive ADHD include:

  • Fidgeting and squirming while seated
  • Pacing around
  • Climbing instead of staying seated
  • Talking too much
  • Being impatient
  • Feeling restless
  • Making a lot of noise
  • Interrupting others

Note, there’s also a third form of ADHD — combination type — that has symptoms of both inattentive and hyperactive-impulsive ADHD. Also, the symptoms of adult ADHD are not as obvious as the symptoms of childhood ADHD. The only way to confirm if you are experiencing ADHD symptoms is to get a diagnosis.

Bipolar disorder symptoms

Bipolar disorder symptoms include dramatic mood changes that swing from mania to depression. The mood changes are categorized into two stages, namely bipolar I and bipolar II. Bipolar I is when the person experiences a manic episode while during bipolar II, the person goes through a depressive episode.

The shift between bipolar mania and bipolar depression can be surprisingly quick. Someone with bipolar disorder may be so depressed one day that they can’t bring themselves to get out of bed, and the next day or days, they may be full of energy, making grandiose plans, and talking a mile a minute.

The hallmark of bipolar disorder is the contrast of these extremes. When depressed, someone with bipolar disorder can become barely able to function. When they’re in a manic state, they’re excited to the extreme.

Causes of ADHD vs Bipolar Disorder

The exact causes of ADHD or bipolar disorder aren’t fully understood. However, researchers have some clues.

First, it’s widely suspected that there may be a genetic factor to both conditions, since someone is more likely to have ADHD or bipolar disorder when there’s a family history. For the most part, though, the similarities regarding potential causes end there.

iconExpert Insight

“There are no known causes of either ADHD or bipolar disorder. Family histories of similar diagnoses have been found to be common in patients with these diagnoses. Medication and therapy can help address the symptoms of these diagnoses.”
Licensed Mental Health Counselor (LMHC), MS Minkyung Chung

ADHD causes

It’s estimated that roughly 2.5% of adults and 8.4% of children are living with ADHD. Some of the things believed to cause ADHD, in addition to genetic factors, include:

  • Traumatic brain injury
  • Tobacco or alcohol use during pregnancy
  • Low birth weight
  • Premature delivery
  • Environmental toxins, such as lead, may also play a role

Bipolar disorder causes

In the United States, bipolar disorder affects around 4.4% of adults at some point during their lifetime. Beyond heredity, some potential causes of bipolar disorder that are believed to contribute to this mental health condition can include:

  • High stress
  • Sexual, physical, or emotional abuse
  • A traumatic event (like the death of a loved one)
  • Drug and alcohol abuse
  • Brain functioning and structure

Diagnosing ADHD vs Bipolar Disorder

It takes a trained and licensed doctor, psychiatrist, or psychologist to diagnose bipolar disorder vs ADHD. There are strict guidelines for these diagnoses that are set out in the APA’s Diagnostic and Statistical Manual, Fifth Edition (DSM-V). In general, symptoms must be present for at least 6 months for a diagnosis to be made.

For an ADHD diagnosis, criteria in the DSM-5-TR include that symptoms:

  • Were present before age 12
  • Are seen in 2 or more settings (for example, at school and home)
  • Interfere with the ability to function
  • Can’t be explained by another mental health condition

For a bipolar disorder diagnosis, someone must have had at least 1 manic or hypomanic episode (for bipolar 1) and at least 1 depressive episode (for bipolar 2).

The DSM-5-TR criteria for mania includes having at least 3 or more of the following symptoms:

  • Inflated sense of self or grandiosity
  • Not needing sleep
  • Increased talkativeness
  • Racing thoughts
  • Being easily distracted
  • An increase in activities that are goal-directed
  • Engaging in behaviors that have the potential for negative consequences

Can bipolar disorder get misdiagnosed as ADHD?

It’s easy to see where bipolar disorder and ADHD symptoms overlap. Further complicating an accurate diagnosis is the fact that it’s estimated somewhere around 20% of people living with ADHD also have bipolar disorder. Since ADHD is more common, unfortunately, misdiagnosis is possible. When that happens, it can delay or hamper treatment, since what works for one condition may actually exacerbate the other.

Bipolar Disorder vs ADHD Treatment

Both ADHD and bipolar disorder can be effectively treated through various forms of therapy and/or medication.

ADHD is best treated with therapy designed to teach skills and coping mechanisms that allow a person to manage their symptoms. Behavior therapy and cognitive behavioral therapy are both commonly used as therapy for ADHD.

Therapy for bipolar disorder might aim more at getting to the root of the emotional cause for symptoms. Some effective types of therapy used to treat bipolar disorder include:

  • Family-focused therapy
  • Interpersonal and social rhythm therapy
  • Dialectical behavior therapy (DBT)

Medication used for each condition will also be different. Stimulants are the most prescribed type of medication for ADHD, whereas mood-stabilizers, antidepressants, and sometimes antipsychotics are generally used to treat bipolar disorder.

iconExpert Insight

“Treating ADHD and bipolar disorder often starts with finding the right course of medication to help stabilize the client. Once medication management is established, working with a mental health professional to help manage some of the symptoms and learn to cope with a diagnosis would be extremely advantageous for successful management of the symptoms of these diagnoses.”
Licensed Mental Health Counselor (LMHC), MS Minkyung Chung

Finding the Right Diagnosis

While ADHD and bipolar disorder are similar in many respects, it’s imperative to get an accurate diagnosis so that your mental health team can correctly address your symptoms and help you learn to manage your condition.

Diagnosing and treating bipolar vs ADHD can be tricky, but with a good diagnosis and a sound treatment plan, people with either condition can have an excellent quality of life, despite any mental health challenges they face.

Talkspace is an online therapy platform that’s changing how people access and use mental health care. It’s an affordable, easy-to-use, convenient approach to getting therapy. Find out how Talkspace can help you navigate your ADHD or bipolar diagnosis today.

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Minkyung Chung

Minkyung Chung has over 10 years of experience and specializes in multicultural issues, specifically issues unique to the Asian American population. She enjoys working within the Asian American community to help reduce the stigma associated with seeking mental health services and normalize the process of it. Her passion for this topic has led her to focus her research efforts in examining how to help the Asian American community.

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