How Often Does ADHD Co-occur with Bipolar Disorder?
When you have a mental health disorder of any kind, you will experience several symptoms that make it difficult to function and that can cause distress. Commonly, those symptoms will lead you to seeking the help of a mental health practitioner or therapist, who will evaluate your symptoms and work with you toward finding the correct diagnosis. And of course, the treatment plan and road to a healthier life will follow. But just like everything else in life, diagnoses are complex and some mental health conditions are especially difficult to address. In addition to those challenges, there are many illnesses that have common symptoms, which can lead to misdiagnosis and mistreatment. However, a common circumstance is for two illnesses or conditions to be occurring at once, or co-occurring.
ADHD (Attention Deficit Hyperactivity Disorder) and Bipolar Disorder are two conditions that can very commonly co-occur. In this article we’ll be talking in depth about both ADHD and Bipolar Disorder, and just how often they co-occur. If you are experiencing symptoms of either of these disorders or are in the process of seeking a diagnosis, keep reading for more useful information.
Attention Deficit Hyperactivity Disorder
What is it?
Attention Deficit Hyperactivity Disorder, also known as ADHD, is an extremely common disorder that impacts a great percentage of our population. In fact, 3 to 6 percent of adults are diagnosed with ADHD. And of course, there are an abundance of people who have yet to be diagnosed. Attention Deficit Hyperactivity Disorder (ADHD) is a psychological condition that creates challenges in a person’s ability to focus, accomplish tasks, manage time and control impulsivity. ADHD makes an immense impact on a person’s ability to function in our society, thrive in their career or even carry out relationships both romantic and not. Because of the nature of this condition, things like going to school at any age and successfully maintaining a job of any kind are especially difficult and often unsuccessful without the help of treatment.
What does it look like?
There are several symptoms of ADHD. Some of the most common symptoms of ADHD include:
Disorganization or poor planning
Hyperactive behavior
Uncontrollable impulsivity
Reckless decision making
Lack of follow-through
Inability to focus on many things at once
Short attention span
Irritable or short-tempered
Poor time management
Low productivity
Lack of motivation even for things that matter
Anxiety
Depression
Low Self-esteem
Rejection sensitivity
Restlessness
Mood swings
A person with an ADHD diagnosis will experience some, if not all, of the classic symptoms listed above. If you are experiencing any of these and worry that you may be suffering with ADHD, it is important to seek the help of a mental health professional who can help to evaluate, diagnose and treat you appropriately.
How to get help
The best way to get a diagnosis of ADHD or to seek that option, is to begin by visiting a psychiatric specialist or even your primary care practitioner – who can then point you in the direction of the right specialist for you. The process of being diagnosed can be a series of appointments or even a full psychiatric evaluation, which is just a more intensive series of tests and assessments to find a clear and direct diagnosis. Once you’ve been diagnosed, the process of treatment can begin. Because ADHD looks different for each person, the treatment plans are also unique to the individual. As with other mental health conditions or psychological disorders, it is never a universal experience and therefore the treatment will never be a “one size fits all” approach.
There are three general types of treatment for ADHD. Those treatments are as follows:
Behavior Therapy (mostly used for children/teens)
These treatments are often used together. For example, someone will be in weekly talk-therapy, while also being treated by an ADHD medication to manage and process their condition. To learn more about these ADHD treatments, click here.
Bipolar Disorder
What is it?
Bipolar Disorder is a mental condition that can impact shifts in mood, ability to focus, activity levels, motivation and basic ability to function in the day-to-day. It is an illness that causes a person’s mood to cycle from high highs, to low lows uncontrollably. A person with Bipolar Disorder will experience depressive episodes, typically followed by some form of manic episode – at different paces. There are three different types of bipolar disorder.
They are:
Bipolar I Disorder: is a disorder defined by manic episodes that last at least 7 days in duration, or that are so extreme they cause symptoms of psychosis, which include immediate need for hospital care. Typically, depressive episodes follow – lasting sometimes as long as 2 weeks. In some situations, both depressive symptoms and symptoms of mania can occur at the same time with Bipolar I.
Bipolar II Disorder: defined by depressive episodes that are usually followed by hypomanic episodes. Hypomania is a milder form of mania, therefore those with Bipolar II Disorder don’t usually experience the extreme manic episodes of Bipolar I.
Cyclothymic Disorder (Cyclothymia): defined by long term episodes of depression and hypomania, lasting at least 2 years in duration – or one year in children and adolescents.
What does it look like?
There are several classic symptoms of Bipolar Disorder, which can sometimes make it difficult to directly diagnose which type of Bipolar one has. Usually, getting diagnosed with the type of mood disorder you have takes time and monitoring of your behavior over longer periods.
Some of the most common symptoms of Bipolar Disorder include, but are not limited to:
In episodes of mania:
Feeling very “up” with an elevated mood, or irritable and touchy
Being acutely restless and unable to sleep or feel tired
Decreased need for sleep
Racing thoughts
Decreased appetite
fast and rambling speech
feelings of invincibility or ability to do anything
increased recklessness and impulsivity (making poor choices with lifestyle and money habits)
feelings of heightened importance – powerful and talented
In episodes of depression:
Feeling overwhelmed, worried or hopeless
Loss of motivation or will to accomplish basic life tasks
Increased appetite and weight gain
Trouble with concentrating or making decisions
Small tasks appear too daunting
Suicidal thoughts and ideation
Change in libido or inability to experience pleasure
Finding little to no joy in any experience of things that once brought joy
There are times when someone with Bipolar Disorder experience both mania or hypomania and symptoms of depression at the same time, which is referred to as an episode with mixed features. It is also common to have very mild symptoms of any Bipolar Disorder, which can lead it to go undiagnosed. It’s important to note that it is still Bipolar disorder, even if your symptoms are mild and you should still seek the help of a psychiatric specialist to manage your condition.
How to get help?
The first step to seeking help in managing your Bipolar disorder is to seek the help of a doctor or other care provider to receive an accurate diagnosis. If you are already seeing a psychiatrist or therapist, it is important to talk to them about the symptoms you are experiencing so they can further investigate or refer you to a specialist that can help you further. A psychiatric care provider will be able to evaluate your symptoms, look into your medical history and family medical history and gather information about your behavior from you and your partner or loved ones, in order to get a really clear diagnosis of your condition.
Once you have been given a diagnosis, the treatment options are as follows:
Medication management (mood stabilizers, antipsychotics, antidepressants or anti-anxiety medication)
Psychological treatments such as talk therapy (Cognitive Behavioral Therapy)
Lifestyle choices including diet, substance use, exercise, sleep and activities that bring you joy and balance
As with the treatment options of ADHD, you and your doctor may choose one, two or all of these forms of treatment to manage your condition. Sometimes it is as “simple” as medication management – but it is always important to recognize your triggers and things in your lifestyle that both help and hurt your disorder and adjust accordingly.
Shared Symptoms of ADHD and Bipolar Disorder
There are several symptoms of ADHD and Bipolar Disorder that overlap. While they aren’t all the same, some of the most classic symptoms of each disorder are similar or the same – which not only makes it hard to diagnose but can also lead to an overlook of comorbidities. While ADHD and Bipolar Disorder can occur at the same time in a person, they also can simply look like the same illness and be completely different diagnoses.
The most common shared co-occuring symptoms of ADHD and Bipolar Disorders are:
Impulsivity and poor judgement
Inability to focus on tasks or sit still
Increased agitation and irritability
Increased restlessness
Rapid speech
Easily distracted or derailed thoughts
These symptoms occur with both conditions very often, so it can be extremely difficult to distinguish between the two. Often there can be a misdiagnosis, which leads to a mistreatment of a condition and that can be dangerous. Some medications to treat ADHD (stimulants) can lead to worsening symptoms of Bipolar Disorders. Eventually after the symptoms increase or change, a doctor will be able to recognize more clearly the actual diagnosis of Bipolar Disorder or ADHD – but again, these diagnoses and differentiations take time.
How often does ADHD co-occur with Bipolar Disorder?
Oddly enough, these two disorders co-occur often. Doctors and specialists are not sure exactly why there are such frequent comorbidities between ADHD and Bipolar disorders, other than biological predisposition and other genetic factors. Regardless of the reason, the two illnesses occur together more often than many realize. It is found that the incidence rate of Bipolar Disorder was 30 percent higher in people with a prior diagnosis of ADHD, than those without.
There have been many studies on the comorbidities of Bipolar and ADHD, and in a recent study of 2021, the researchers found that about 1 in 13 adults with ADHD was also diagnosed with bipolar disorder, and 1 in 6 adults with bipolar disorder had ADHD.
Another researcher’s data shows that people with ADHD had an earlier onset of their bipolar symptoms, a higher frequency of mood episodes and increased violence against themselves. When ADHD co-occurs with bipolar, there is also a higher rate of suicide attempts.
How to treat both disorders at the same time?
Because of the way ADHD medication (stimulants) can impact someone who also has bipolar, it is recommended by most clinicians to begin by treating and managing the Bipolar Disorder before then treating the symptoms of ADHD. To treat both illnesses at the same time, psychiatric specialists will often treat both conditions with medication management – usually a mood stabilizer and/or antipsychotic, as well as a stimulant to manage the ADHD. It is always recommended to work through and manage these conditions through other modalities such as talk therapy and lifestyle management.
Because of the nature of these illnesses, another comorbidity of both ADHD and Bipolar disorder is substance abuse issues. Often people turn to substances to manage or numb their symptoms and overwhelming life because of their conditions. While this actually has the very opposite effect, it can complicate treatment and add another layer or illness management such as inpatient or outpatient rehabilitation, substance abuse groups or programs and even use of other medications to manage symptoms of withdrawal and addiction.
It is so crucial if you are experiencing any or all of the symptoms listed above, to first seek the help of a professional. They will be able to support you and help to manage your symptoms before they worsen or become out of hand. The help and support of a medical professional can be the difference between a happy and functioning life and an unhealthy, damaging and even impossible one.