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Bipolar 1 and ADHD: 4 Differences

Medically reviewed by Andrew Turner, M.D.
Updated on April 11, 2024

​If you have bipolar 1 disorder or attention-deficit/hyperactivity disorder (ADHD), it might be helpful to learn about the similarities and differences between these two conditions. Like many different mental health conditions and mood disorders, they have several symptoms in common, which can make it difficult to get the right diagnosis. It’s also possible to have both ADHD and bipolar 1 disorder at the same time.

Understanding how these mental health conditions differ can help you and your doctor reach an accurate diagnosis and decide on the best treatment approach for you.

1. ADHD Symptoms Are Often Stable Over Time, Whereas Bipolar 1 Symptoms Fluctuate

A key difference between bipolar 1 and ADHD is how constant their respective symptoms are. ADHD symptoms are typically stable over time, whereas bipolar disorder symptoms might change.

What Are the Symptoms of ADHD?

ADHD has a variety of symptoms, including difficulty focusing and hyperactive motor movements (like fidgeting). This condition can lead to significant challenges at school, work, or social settings.

ADHD is most often diagnosed in kids, but adults can also have it. Symptoms of adult ADHD can include:

  • Problems with controlling emotions
  • Impulsivity
  • Disorganized thinking
  • Restlessness
  • Difficulty functioning in work or personal relationships

​Several conditions can coexist with ADHD, especially mood and personality disorders. In particular, bipolar disorder has some overlapping symptoms with ADHD. This can cause bipolar disorder to be underdiagnosed and undertreated.

What Are the Symptoms of Bipolar 1 Disorder?

People living with bipolar 1 disorder experience intense, shifting mood swings that include manic episodes interspersed with periods of normal emotion or depression. Manic episodes include symptoms like:

  • Having increased energy or agitation
  • Having decreased need or desire for sleep
  • Having abnormal talkativeness and racing thoughts
  • Being abnormally jumpy or upbeat
  • Making unexpected, poor life or financial decisions, or engaging in risky behaviors

In bipolar 1 disorder, hypomania and hypomanic episodes can also occur, which are less extreme than full-blown manic episodes. During hypomania, individuals experience a heightened mood — they may feel very happy, excited, or easily irritated. They also have more energy and creativity than usual, but not to the same intense degree as in full mania.

Bipolar 1 disorder and ADHD have some overlapping symptoms like impulsivity, an irritable mood, and problems with sleeping.

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These mood changes can make everyday tasks hard. For example, it might be tough to concentrate at work or school, have good relationships with family and friends, or keep to a regular schedule because your moods keep changing.

Overlapping Symptoms

Distinguishing between bipolar and ADHD can be difficult because the conditions share similarities, including:

  • Inattention
  • Impulsivity
  • Distractibility
  • Irritable mood
  • Sleep disturbances

2. Symptoms of ADHD Usually Start Earlier Than Those of Bipolar 1

Signs of ADHD usually show up when a person is young and become noticeable by age 12. Bipolar 1 disorder is usually diagnosed a little later — in one’s early 20s. However, it’s possible to experience symptoms and be diagnosed with either disorder at a younger or later age.

3. An Initial ADHD Diagnosis May Change as You Get Older

More than half of kids who are diagnosed with ADHD continue to have adult ADHD, but for some, the diagnosis can change with age. This means a doctor may change your diagnosis from ADHD to a different mental health condition, or they may add another mental health diagnosis to your medical history.


A diagnosis of major depression might be changed to a diagnosis of bipolar 1 disorder in adulthood if new symptoms arise.

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A diagnosis of bipolar 1 disorder seems to be more stable over time. This means that the diagnosis may not change as a person diagnosed with bipolar 1 gets older. A 2020 study discovered that a bipolar 1 disorder diagnosis is somewhat stable, compared to the diagnosis of some other mental health conditions.

A diagnosis of major depression or a series of depressive episodes can be changed to a diagnosis of bipolar disorder in early adulthood if new symptoms arise. Because symptoms of several mental health conditions can change throughout early life and adulthood, it’s important to keep in mind that nothing is set in stone. Always let your doctor know about any symptom changes.

4. Different Medications Are Used To Treat Bipolar 1 and ADHD

ADHD treatment aims to address symptoms like difficulty with concentration and memory. Treatment typically includes a combination of medications, behavior therapy, and other lifestyle adjustments. ADHD medications include:

  • Methylphenidate (Ritalin)
  • Atomoxetine (Strattera)
  • Amphetamine salts

Treatment options for bipolar 1 also include psychotherapy, such as cognitive behavioral therapy (CBT), symptom management, and medication. Through CBT — a form of talk therapy — a person can learn to change negative thoughts and behaviors and acquire practical skills to manage problems and improve their mood.

Some common medications for treating bipolar 1 include:

  • Mood stabilizers like lithium (Lithobid), carbamazepine (sold as Equetro or Tegretol), valproic acid, and divalproex sodium (Depakote)
  • Antipsychotics like risperidone (Risperdal), olanzapine (Zyprexa), olanzapine and samidorphan (Lybalvi), or quetiapine (Seroquel)
  • Antidepressants
  • Anti-anxiety medications

Antidepressants are used less often than mood stabilizers and antipsychotics in the treatment of bipolar disorder, as antidepressants may trigger a manic episode. When antidepressants are prescribed for bipolar disorder, they’re usually given along with a mood stabilizer or antipsychotic.

Read more about specific medications in this list of treatments for bipolar 1 and other mental health conditions.

Somewhere between 10 percent and 20 percent of adults with bipolar disorder also have ADHD.

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For people living with both bipolar disorder and ADHD, an important goal of treatment is mood stabilization. For treating both conditions, the combination of stimulant medication with a mood stabilizer (for bipolar 1) hasn’t been well-studied. Stimulant medications used for ADHD can sometimes trigger a manic episode in someone with bipolar disorder. This is more likely to occur in a person who already isn’t consistently taking mood-stabilizing medication.

It’s important to always tell your health care provider about all the medications you’re taking and whether you’re taking them as prescribed.

It’s Possible To Have Both Bipolar 1 and ADHD

Many studies show that a person can have ADHD and bipolar disorder at the same time. The National Comorbidity Survey Replication, considered to be the largest mental health survey available in the United States, estimated that about 21 percent of people with an ADHD diagnosis also had bipolar disorder.

Another study in the U.S. found that people living with bipolar disorder had a 6.7 higher chance of also having ADHD as compared to the general population.

Is It Bipolar 1 or ADHD? Getting the Right Diagnosis

A study from the journal Medicina estimated that 10 percent to 20 percent of adults with bipolar disorder also have ADHD. A younger age at the diagnosis of bipolar disorder seems to be linked with a higher likelihood of having both.

If you’re unsure about your diagnosis or treatment, talk to your primary care doctor. They can help you and make sure you’re getting the right care. Ask specific questions about how your doctor came to a diagnosis of bipolar disorder or ADHD. Before deciding on treatment, you may want to get a second opinion.

Once you’ve found a psychiatry provider you trust, it’s important to do your best to follow up with that same provider regularly. Being consistent with your treatment gives doctors the best chance to track your mood changes and progress with different medications and dosages. Be sure to ask questions about your condition, and always take your medication as prescribed.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression or bipolar 1 disorder and their loved ones. On MyDepressionTeam, more than 146,000 members come together to ask questions, give advice, and share their stories with others who understand life with mental health conditions.

Have you been diagnosed with bipolar 1, ADHD, or both conditions? Do you have questions about the differences between the two conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. What Is ADHD? — Centers for Disease Control and Prevention
  2. Bipolar Disorder — Mayo Clinic
  3. Attention-Deficit/Hyperactivity Disorder in Children and Teens: What You Need To Know — National Institute of Mental Health
  4. Diagnostic Stability in Bipolar Disorder: A Systematic Review — Actas Españolas de Psiquiatria
  5. The Age-Dependent Decline of Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Follow-Up Studies — Psychological Medicine
  6. Bipolar Disorder — National Alliance on Mental Illness
  7. Olanzapine/Samidorphan (Lybalvi) — National Alliance on Mental Illness
  8. ADHD and Bipolar Disorder in Adulthood: Clinical and Treatment Implications — Medicina
  9. Comorbidity Between Attention Deficit Hyperactivity Disorder (ADHD) and Bipolar Disorder in a Specialized Mood Disorders Outpatient Clinic — Journal of Affective Disorders
  10. The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication — The American Journal of Psychiatry
  11. Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication — Archives of General Psychiatry
  12. Attention Deficit-Hyperactivity Disorder in Adult Bipolar Disorder Patients — Journal of Affective Disorders
  13. Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative — Archives of General Psychiatry
  14. A Systematic Review of Rates and Diagnostic Validity of Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Bipolar Disorder — Journal of Clinical Psychiatry
    Updated on April 11, 2024
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    Andrew Turner, M.D. completed medical school at Creighton University School of Medicine. Learn more about him here.
    Remi A. Kessler, M.D. is affiliated with the Medical University of South Carolina and Cleveland Clinic. Learn more about her here.

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