The Relationship Between ADHD and Bipolar Disorder

Research shows that up to 20 percent of adults living with bipolar disorder (BD) also have a diagnosis of attention deficit hyperactivity disorder (ADHD).


ADHD and bipolar disorder have similar symptoms—so much so that they’re often confused with one another. Symptoms such as impulsivity and inattention can overlap. This makes it difficult to tell the two disorders apart.


A 2018 Danish study found that BD was almost 11 times more likely in people with a prior diagnosis of ADHD, compared with people who had no prior diagnosis of ADHD or anxiety. It is not clear why ADHD and bipolar disorder so frequently occur together. Genetic and biological factors are believed to be partially responsible.


It is common for ADHD to be diagnosed first since symptoms usually begin to present in childhood. Approximately two-thirds of ADHD patients continue to have symptoms into adulthood.


Bipolar disorder is often not diagnosed before individuals are in their 20s. According to the National Alliance of Mental Illness, more than half of all cases begin between ages 15–25. 


“The main difference between the two is that ADHD creates more consistent patterns of behavior, while bipolar disorder can occur in cycles, with a manic episode mimicking many of the symptoms of ADHD,” wrote Hilary Lebow in December on PsychCentral.


Lebow offered a tabular overview of the differences and similarities.


ADHDBipolar Disorder
Often diagnosed in childhoodOften diagnosed in adulthood
Impact on attention and behaviorImpact on mood and behavior
Chronic or persistentEpisodic (occurs in cycles)
Increased energyIncreased energy during mania
Easily distractedEasily distracted during the manic phase
Talking too much or too fastPressured speech during mania
ImpulsivityImpulsivity during the manic phase
Motor hyperactivity or agitation (fidgeting)Motor hyperactivity during mania
Lower self-esteemIncreased self-esteem during mania
Consistent sleep disturbancesDecreased need for sleep during mania
Difficulty with memoryDifficulty with memory


Bipolar disorder is a serious mental illness—especially with co-occurring ADHD. BD is characterized by psychosis, a severe condition in which the person’s ability to recognize reality and emotional responses, thinking processes, judgment, and ability to communicate are so affected that functioning is seriously impaired. Colorado Recovery offers residential treatment for people with psychosis and our bipolar treatment program is highly regarded.


“Research shows that those who live with both ADHD and bipolar disorder have an increased chance of suicidal ideation and substance use disorder (SUD), particularly around alcohol,” warned Lebow in her article.


ADHD is routinely treated with medications that stimulate the central nervous system. Bipolar disorder, on the other hand, is often treated with antidepressants, mood stabilizers, or benzodiazepines. People with both conditions require thorough assessments and careful calibration of their medications as stimulants for ADHD can cause manic episodes if a co-occurring bipolar disorder is present.


“Medications are an important part of treatment but they are only part of the answer,” wrote the late Colorado Recovery founder Richard Warner, MD, in 2000. The mental health professionals at Colorado Recovery utilize a holistic treatment approach to help adults with serious mental health issues stabilize their illness, minimize symptoms, improve functioning, and enhance each person’s social inclusion, quality of life, and sense of meaning in life.


If you have questions about our services to treat schizophrenia, bipolar disorder, and similar mental illnesses, call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.