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Many mental health conditions have symptoms that overlap, which can make diagnosis tricky. If you’re living with bipolar 1 disorder (also written as “bipolar I disorder”) or attention-deficit/hyperactivity disorder (ADHD), learning about the similarities and differences between them can help you better understand what you’re experiencing.
ADHD and bipolar 1 share some symptoms, which can make it hard even for experienced clinicians to tell them apart. It’s also possible to have both bipolar 1 and ADHD.
Knowing which symptoms are unique to each condition can help you get the right diagnosis — an essential first step in finding the most effective treatment. Here are four important ways to tell whether your symptoms may be related to bipolar 1 or ADHD.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), ADHD includes a variety of symptoms, including difficulty focusing and frequent movements (like fidgeting). Although ADHD is typically diagnosed in early life, adults can have it as well. Symptoms of adult ADHD can include:
These symptoms can make it harder to succeed at work, in school, or in social situations.
Bipolar 1 disorder is a mood disorder that causes dramatic shifts in mood, energy, and behavior. People living with bipolar 1 disorder experience intense mood shifts or “mood swings.” Manic episodes — or “emotional highs” — can be followed by periods of depression or more stable mood.
Manic symptoms may include:
Some people with bipolar 1 also experience hypomania, a milder version of mania. Hypomanic episodes are generally less extreme than full manic episodes. During hypomania, a person may feel excited, unusually happy, or easily irritated. They often have more energy and creativity than usual, but not to the extreme levels seen in full mania.
Distinguishing between bipolar 1 and ADHD can be difficult because these conditions share similar symptoms, including:
Additionally, several conditions can co-occur with ADHD, especially mood and personality disorders. This can lead to missed or delayed diagnoses for bipolar 1 disorder.
Here are four key differences between the two conditions.
A key difference between bipolar 1 and ADHD is how symptoms of bipolar disorder show up. ADHD symptoms tend to be steady, while symptoms of bipolar disorder often come and go in cycles.
ADHD is a condition where the core symptoms — like inattention, impulsivity, and restlessness — stay fairly consistent over time and across different situations. Bipolar 1, on the other hand, is defined by mood episodes. Between episodes, a person may feel quite stable or return to their usual self. This episodic course is one of the clearest ways to tell the two apart.
ADHD symptoms often appear in early life, with age of onset usually before age 12. In contrast, bipolar 1 is often diagnosed in a person’s early 20s or occasionally at a younger age. That said, it’s possible to experience symptoms — and get diagnosed — with either condition earlier or later in life.
Many people continue to feel the effects of ADHD into adulthood, and symptoms can shift over time. In some cases, your doctor might update or add another diagnosis, especially if new symptoms appear.
A diagnosis of major depressive disorder or a series of depressive episodes can change to a diagnosis of bipolar disorder in early adulthood if new symptoms arise.
Treatment options for bipolar 1 include psychotherapy, like cognitive behavioral therapy (CBT), and medications. Through CBT (a form of talk therapy), a person works with a mental health professional to identify and shift negative thought patterns, improve coping strategies, and manage mood episodes.
Some common medications for treating bipolar 1 include:
ADHD treatment manages symptoms like difficulty with concentration and memory. Treatment plans typically include a combination of medications and behavior therapy.
ADHD medications include:
The exact causes of both ADHD and bipolar 1 are not fully understood. Both conditions involve changes in the brain and have genetic components, meaning they can run in families.
However, ADHD is more often linked to early development, including factors before birth such as smoking, alcohol exposure, or nutrition during pregnancy. In contrast, bipolar disorder is more strongly connected to life experiences over time, especially stressful events like childhood maltreatment, divorce, or job loss.
The two conditions also differ in how they affect the brain. In ADHD, there are changes in brain chemicals related to attention and focus, but brain imaging doesn’t show one clear pattern across all people with the condition.
For bipolar disorder, research shows more consistent physical differences in the brain, such as changes in brain structure and connectivity between brain regions.
Bipolar 1 disorder is also linked to imbalances in mood-related chemicals like dopamine and serotonin, while ADHD mainly affects the systems involved in attention and self-control.
Yes, ADHD can be misdiagnosed as bipolar disorder, and the reverse can also happen. Because the two conditions share many of the same symptoms, it can be difficult to tell them apart without a thorough evaluation.
One important clue is the pattern of symptoms over time. ADHD symptoms are usually present from an early age and stay fairly steady. Bipolar 1 tends to come in episodes, with clear shifts between feeling elevated and feeling depressed or stable. If someone’s symptoms come and go in cycles, that could mean they have bipolar disorder. If symptoms have been consistent since early life, ADHD may be the better explanation.
Getting the right diagnosis may take time and more than one evaluation. If you feel your diagnosis doesn’t quite fit your experience, it’s reasonable to ask questions or seek a second opinion.
If you’re unsure about your diagnosis or treatment, talk to your primary care doctor. They can help 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 them regularly. Being consistent with your treatment allows doctors to better track your mood changes and progress with medications. Be sure to ask questions about your condition, and always take your medication as prescribed.
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 diagnosis of bipolar disorder was linked to a higher likelihood of having both conditions.
For people living with bipolar disorder and ADHD, mood stabilization is an important treatment goal. Research on using stimulant medications alongside mood stabilizers — particularly in people with both bipolar 1 and ADHD — is still limited. One large study found that stimulants used without a mood stabilizer were linked to a higher risk of manic episodes, but that when a mood stabilizer was already in place, stimulants didn’t appear to increase that risk. Talk to your doctor before making any changes to your treatment plan.
On MyDepressionTeam, people share their experiences with depression and other mental health conditions, get advice, and find support from others who understand.
Have you been diagnosed with both bipolar 1 and ADHD or wondered if one was mistaken for the other? Let others know in the comments below.
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It is for my adult daughter that I am seeking as much understanding as possible. Yet,as I read through some articles, I recognize some personal traits. Is it possible that this is inheritated? SANDY
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