ADHD and bipolar disorder are two distinct mental health conditions that can share certain overlapping features. Because both can involve mood changes and difficulty regulating focus or energy, they’re sometimes mistaken for each other. However, they function very differently and require different treatment approaches.
Key Takeaways
ADHD typically begins in childhood and involves ongoing challenges with attention, activity level, and impulse control. Bipolar disorder usually appears later, often in the teen or young adult years, and involves distinct periods of elevated or depressed mood.
The biggest difference is that ADHD symptoms are relatively consistent over time, while bipolar disorder involves episodic mood changes that can last for days, weeks, or months.
Because symptoms can overlap, getting a professional evaluation is essential. Some people may experience both conditions at the same time.
What Is ADHD?
ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition that affects how the brain manages attention, activity level, and impulse control.
It affects about 6% of children, and for many, symptoms continue into adulthood.
Common ADHD Symptoms
People with ADHD may experience:
Difficulty sustaining attention on tasks
Making frequent mistakes due to inattention
Appearing not to listen when spoken to
Losing or misplacing important items
Becoming easily distracted or forgetful
Symptoms related to hyperactivity or impulsivity may include:
Fidgeting or feeling restless
Difficulty remaining seated
Talking frequently or interrupting others
Acting quickly without considering consequences
What Is Bipolar Disorder?
Bipolar disorder is a mood condition characterized by significant shifts in energy, activity, and mood that go beyond typical ups and downs.
It affects about 3% of adults and most often begins in the late teen or early adult years.
Types of Bipolar Disorder
Bipolar I: Involves at least one manic episode, which may require hospitalization or cause major disruption in daily life.
Bipolar II: Involves episodes of depression and milder “highs” called hypomania.
Cyclothymic Disorder: Involves ongoing mood fluctuations over at least two years that are less intense than full manic or depressive episodes.
What Mood Episodes Look Like
Manic or hypomanic episodes may involve:
Elevated or irritable mood
Increased energy and activity
Needing less sleep
Talking rapidly or having racing thoughts
Taking more risks or feeling unusually confident
Depressive episodes may include:
Persistent sadness or loss of interest
Fatigue and changes in sleep or appetite
Difficulty concentrating
Feelings of hopelessness
Thoughts of death or suicide
These episodes have distinct beginnings and endings, unlike ADHD symptoms, which are typically steady over time.
How ADHD and Bipolar Disorder Differ
Age of Onset
ADHD symptoms usually appear early—often before age 12. Bipolar disorder typically develops later, with the average age of onset around 25.
Symptom Pattern
ADHD symptoms are fairly consistent, even if they fluctuate in intensity.
Bipolar disorder involves distinct mood episodes—periods of mania or depression separated by stable mood.
Mood and Energy
In ADHD, emotional shifts often happen in response to immediate events and tend to pass quickly.
In bipolar disorder, mood and energy changes are more extreme, last longer, and can occur without clear external triggers.
Sleep Patterns
Sleep difficulties are common in both conditions, but their patterns differ:
In ADHD, trouble falling asleep or staying asleep tends to be ongoing.
In bipolar disorder, sleep drastically changes during mood episodes—sleeping very little during mania and much more during depression.
Thinking and Focus
People with ADHD often experience consistent challenges with attention and organization.
In bipolar disorder, thinking speed and clarity shift with mood—racing thoughts during mania, slowed thinking during depression.
Symptoms That Overlap
Some symptoms appear in both conditions, though their causes differ.
Impulsivity
In ADHD, impulsive behaviors—like interrupting or acting quickly—are ongoing.
In bipolar disorder, impulsivity tends to occur during manic or hypomanic episodes and may involve higher-risk behavior.
Concentration Difficulties
In ADHD, difficulty focusing is present most of the time.
In bipolar disorder, focus problems often occur during mood episodes and may resolve between them.
Emotional Regulation
In ADHD, emotions can shift quickly based on immediate circumstances.
In bipolar disorder, mood changes last much longer and may not align with current events.
Why Diagnosis Can Be Challenging
Research suggests that ADHD and bipolar disorder can be misdiagnosed. This happens because:
Symptoms can appear similar on the surface.
Some individuals experience both conditions.
Other mental health or medical conditions can add complexity.
Accurate diagnosis requires looking at long-term patterns rather than a single moment in time.
What Causes These Conditions?
Both ADHD and bipolar disorder involve complex interactions between genetics, brain differences, and environmental factors.
ADHD
Strong genetic links: it often runs in families.
Brain imaging shows structural and functional differences in regions involved in attention and impulse control.
Early life factors (such as premature birth or prenatal exposure to alcohol or nicotine) may increase risk.
Bipolar Disorder
Family history is one of the strongest predictors.
Stressful life events, trauma, or disrupted sleep can trigger episodes in those who are genetically predisposed.
Imbalances in brain chemicals that regulate mood play a role, though researchers are still studying how.
Treatment Approaches
Because the two conditions differ, their treatments do as well.
ADHD Treatment
Medication: Stimulants (like methylphenidate or amphetamine-based options) and non-stimulants (like atomoxetine) can improve attention and focus.
Therapy: Behavioral therapy, coaching, and mindfulness can help with organization and emotional regulation.
Lifestyle support: Regular exercise, structured routines, consistent sleep, and healthy eating all improve outcomes.
Bipolar Disorder Treatment
Medication: Mood stabilizers (such as lithium, valproate, or lamotrigine) and, when needed, atypical antipsychotics help regulate mood episodes.
Therapy: Cognitive-behavioral therapy, psychoeducation, and family-focused therapy support long-term stability.
Lifestyle management: Maintaining regular sleep and routines, managing stress, avoiding substance use, and tracking mood changes are essential.
When to Seek Professional Help
Consider consulting a healthcare provider if you notice:
For ADHD:
Ongoing inattention or impulsivity that interferes with work, school, or relationships
Symptoms that began in childhood and persist into adulthood
For Bipolar Disorder:
Extreme mood changes lasting days or weeks
Unusually high energy or risky behavior
Severe depression or thoughts of suicide
If you or someone you know is having thoughts of self-harm, seek help immediately by calling emergency services (in the U.S., dial 988 for the Suicide and Crisis Lifeline).
Getting an Accurate Diagnosis
A thorough evaluation typically includes:
A detailed history of symptoms across time
Input from family members or close contacts
A medical exam to rule out other causes
Possible psychological testing
Tracking of mood, sleep, and energy patterns over time
Self-diagnosis or online quizzes can be misleading. Both ADHD and bipolar disorder respond well to evidence-based treatment when properly identified.
Medical Disclaimer
This article is for educational purposes only and does not constitute medical advice. The information provided should not replace consultation with a qualified healthcare provider. Individual responses to medications can vary significantly, and what applies to one person may not be safe for another.
Always consult with your doctor or pharmacist before making any decisions about medication changes, discontinuation, or interactions with other substances. If you're experiencing concerning symptoms or side effects, please seek professional help from a healthcare provider. In case of a medical emergency, contact your local emergency services immediately or call 911. For mental health emergencies, contact the National Suicide Prevention Lifeline at 988.
Important: This information is not a substitute for professional medical advice. Never stop taking prescribed medication or make changes to your treatment plan without consulting your healthcare provider first. Your safety and well-being are the top priorities.
