A recent article in ADDitude Magazine reminded me that about 20% of people with ADHD will develop Bipolar and about 70% of people with Bipolar also have ADHD. Wow! This is a huge overlap, and it’s important to know the characteristics of each, so that you can get treatment right.
It’s easy to confuse ADHD and Bipolar, as both conditions include symptoms commonly associated with ADHD.
According to Roberto Olivardia, Ph.D., both conditions “include impulsivity, irritability, hyperactivity, emotional dysregulation, sleep problems, a racing brain, and problems with maintaining attention.” Sounds pretty familiar to anyone who has been diagnosed with ADHD or has a spouse with ADHD. And lots of docs get these two confused, as well...in part because Bipolar issues might not show up until adutlhood.
However, Bipolar has some very specific characteristics that ADHD does not – depressive and manic ‘episodes.’ Episodic depression is not the same thing as being generally depressed, which many people with ADHD can be. Various studies put depression as a co-existing condition for those with ADHD at between 16-31% currently, with a lifetime incidence of a bit more than 50% of those with ADHD being depressed at some point or another. ADHD depression is something that relates to what is going on in your life…you move into it slowly and resolve it slowly. Bipolar depressive episodes, on the other hand, come and go periodically (perhaps several days of feeling really down) and come regardless of what is going on around you (i.e. not simply related to really depressing stuff happening to you.) Depressive episodes with Bipolar might also be identified by the depth of stark contrast of the depression vs. other times in the person’s life.
Manic episodes are identifiable by the severity and speed with which they come upon you, with no apparent reason. This isn’t being elated because you just got engaged…this is being driven to do things (often hyperactively) that you normally wouldn’t have a desire to do…being super charged and, again, not in relationship to what is going on around you.
Treatment and More Information
One of the reasons to be aware of the differences between Bipolar and ADHD is that the treatments for ADHD can make Bipolar worse…so best to get the right diagnosis first time around. (This is one reason to get a full evaluation, not a cursory 10 minute interview with your primary care provider if at all possible.)
If this sounds familiar, it’s time to learn more. These resources could help:
https://www.additudemag.com/adhd-bipolar-symptoms-overlap/
https://www.additudemag.com/bipolar-mood-disorder-and-adhd/
And, when it is finally published online, the Olivardia article is worth reading, as well: Solving the ADHD-Bipolar Puzzle in the Fall, 2016 issue of ADDitude Magazine.
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Comments
Another fan letter
Melissa, thank you for this post. It truly helps people forward in their inquiry. Your site, in all of its parts, has emphatically convinced me that the best way by far to deal with the possibility of diagnosis is what you advise, go get a full, careful diagnosis by a capable professional.
From having lived with someone bipolar for awhile, and now living with a husband with ADHD (both of them professionally diagnosed and treated), maybe I can make this small contribution to the argument for professional assessment: the work arounds at home for ADHD havent for me been the same as those if there is bipolarism in the home.
Also, A passing comment, there seems to be confusion online over the relationship and differences among Narcissism (clinically defined and diagnosed), ADHD and bipolarism (clinically diagnosed).More reason to seek out trained therapeutic assessment, in my opinion.
I'm so grateful to you for this site, Melissa, and for what you publish I always check to see if you've put up a new blogpost : )
Yes...I Appreciate This Information Especially
And thanks for the confirmation Melissa. I actually just read this article myself before it was brought to my attention here. That 20% figure....really hit home....that's not a small amount in terms of the possible people out there who have both. It was also confirming to me to hear what you just said about depression and it is exactly what I experience myself. More situational rather than episodic. This is really difficult for me to even tell since it is so slow in coming on....you can't really tell until you are actually coming out of it which again....go in and back out at about the same rate. Very slowly. It's that boiling frog principle in action for sure.
Something also just occurred to me....with all this talk about attachment theory and dissmissive/avoidant personalities. As I've said in the past....my insecure brand of attachment when present....is anxious-preoccupied. But if I'm around an avoidant personality for too long without a break....I start to take on those same qualities myself and begin to behave that way. My situational depression...coincides with this transition when I begin to become more like that myself. Interesting...isn't it?
And too the point....if I'm not careful, and I'm not paying attention to this....what other people with see and feel from me....will be the same thing I feel and become....when I begin to change who I am...and become something I'm not.....just from being around it for too long?
And since I have you here Melissa....I wanted to point out something that I haven't said before....speaking to the forum as a whole. If I didn't know better....and didn't know what I know.....I'd swear, most of the ladies here from just my interactions in general...and the general tenor and feeling I have coming from my side of things...I'd swear that as a group....most who are here speak and appear to me...as dismissive themselves?
But since knowing what I know....and knowing how this works....I'd say, that probably....just the opposite is true.
Like me....an anxious-preoccupied attached person as an insecure one....is going to spend a lot of time, thinking about what to do and how to fix this problem or dilemma they've found themselves in. An anxious-preoccupied....will be the first one to seek out help or try and find a solution to fix the problem just like me.
An anxous-preoccupied....is going to be the first responder compared to the avoidant who will avoid at all costs and will drag their feet.
Just based on those facts as it works....would mean ....the most likely people to be here in the first place...would be anxious-preoccupied people like myself. It is how it works.
And if that is true...;.and there are a whole of anxious- preoccupied folks here...who have been around a dissmisive/avoidant for too long.....you'll end up with a whole of frustrated, anxious and depressed people coming here...who'll be acting very dismissive....and probably have no idea...they're being dismissive since this is not how they normally are like I said about myself.
I didn't want to say anything at first....because I thought this would just fly over everyone heads (not because of any fault or inability to understand) but;;...it's really confusing to see yourself one way....but then to behave another way which is so counter-intuitive and difficult to see in yourself and know this is what you're are doing...simply without realizing this yourself. Are you kidding me? You're preaching to the choir here!!! LOL
Anyway....what good is it....if you can't give constructive criticism or feedback....unless you can hear it...and trust the person saying so ....on your behalf. It never feels good when you hear things about yourself that you don't like and I'm no different....but for my own benefit....I would want to know that myself if it were me....not being who I really am....and have changed in some way not for the better right?
I'd want to know that if it were true...and I also have ADHD....but my particular brand of insecure attachment...when it rises to the surface....is the perfect compliment to an avoidant personality even though....an unhealthy one none the less. It seems to be the pairing that is most common as well...by those numbers again. (those percentages).
Anyway ....for what it's worth....these are the things I notice in myself and can use as a barometer for my own personal health and well being if I begin to become depressed and notice a change happening with me.
It's also what I feel at times coming through to me as that "funny feeling" again....which tells me this exactly happening with me....and thinking.....possibly happening with many who come here as well. It's just a feeling I have...I really don't have any way to prove it or back it up other than to just give you the feedback as it comes though to me...and the reasons why I feel this way? What more can you do right?
J