View Full Version : "Bipolar ADHD" - Bipolar people similar to ADHD people.


mrsmith
06-26-12, 07:51 AM
I understand many bipolar persons are very similar to ADHD people (including forgetfulness etc.)

Can one call this "Bipolar ADHD" as a distinct condition and population from regular ADHD?

(That you don't have a continuum with varying degrees of ADHD and Bipolar)

I think it is different because reaction from medication is different from mainstream ADHD.

Is there a better terminology for this (than "Bipolar ADHD")

Is such "Bipolar ADHD" stable through life, independent of bipolar cycles?

Can you have Bipolar ADHD without being bipolar enough to have bipolar episodes?

Is it like most Bipolar people are normal as young, and a minority are similar to ADHD?

I don't know so much about this, but my understanding is that Bipolar is something you are or you are not,
and you are bipolar if you will have bipolar episodes at some point in life.

ginniebean
06-26-12, 09:24 AM
The big problem is that adhd and bipolar II share 16 of 18 symptoms and this leads to a lot of confusion for many psychiatrists. Dr. Barkley has stated that if there is a diagnosis of ADHD there should not be a diagnosis of BPII comorbid because all of the symptoms can be explained by the ADHD.

mrsmith
06-26-12, 10:23 AM
What exactly is a "BPII comorbid" diagnosis?

Anyway, if the individual is Bipolar, it will show up later, right?
So it a question about uncertainty, not that the individual is in-between the two?

ginniebean
06-26-12, 10:28 AM
It means being diagnosed with both ADHD and bipolar II

shamrock
06-29-12, 03:43 PM
The big problem is that adhd and bipolar II share 16 of 18 symptoms and this leads to a lot of confusion for many psychiatrists. Dr. Barkley has stated that if there is a diagnosis of ADHD there should not be a diagnosis of BPII comorbid because all of the symptoms can be explained by the ADHD.


I didnt know that ginniebean. I have never read anything yet from Dr Barkley that I didnt agree with but I have now found my first.

I had Add PI all my life. Bp2 started in my late 20s after a lot of stress and trauma. The two disorders are almost 30 years apart in origin in me so there is no way they could be the same.

The only other explanation I could think of would be that Add somehow evolves dramatically and I mean dramatically to mimic bp2 in your late 20s and I have never heard anything like that.

I experienced the onset of my bp as a major catastrophic event to the extent where I divide my life mentally into two ie before it happened and after it happened. if you saw photos of me just before I got it and 5 years after i got it you would be shocked at how much I had aged.

So unless he has an explanation for this major catastrophic event I am going with the onset of a new disorder.

I believe they are totally linked though. Posts asking "Does Add turn into bipolar?" fascinate me but there is no proof that it can.

Im not sure whether thats because it cant or whether it can and they just havent found the reason yet. Sometimes I suspect the latter but really I have no idea.

CheekyMonkey
06-29-12, 03:48 PM
The big problem is that adhd and bipolar II share 16 of 18 symptoms and this leads to a lot of confusion for many psychiatrists. Dr. Barkley has stated that if there is a diagnosis of ADHD there should not be a diagnosis of BPII comorbid because all of the symptoms can be explained by the ADHD.

How does that work? Medication-wise they are very different treatments.

daveddd
06-29-12, 03:52 PM
I didnt know that ginniebean. I have never read anything yet from Dr Barkley that I didnt agree with but I have now found my first.

I had Add PI all my life. Bp2 started in my late 20s after a lot of stress and trauma. The two disorders are almost 30 years apart in origin in me so there is no way they could be the same.

The only other explanation I could think of would be that Add somehow evolves dramatically and I mean dramatically to mimic bp2 in your late 20s and I have never heard anything like that.

I experienced the onset of my bp as a major catastrophic event to the extent where I divide my life mentally into two ie before it happened and after it happened. if you saw photos of me just before I got it and 5 years after i got it you would be shocked at how much I had aged.

So unless he has an explanation for this major catastrophic event I am going with the onset of a new disorder.

I believe they are totally linked though. Posts asking "Does Add turn into bipolar?" fascinate me but there is no proof that it can.

Im not sure whether thats because it cant or whether it can and they just havent found the reason yet. Sometimes I suspect the latter but really I have no idea.

you sure you developed BP or maybe ptsd

daveddd
06-29-12, 03:55 PM
and no adhd doesnt turn into BP


that FACT is most neurological conditions that persist into adulthood will include a mood disorder or 2

or 3 or 4

depending on how many comorbids your doctor is comfortable labeling you with

mrsmith
06-29-12, 07:36 PM
The big problem is that adhd and bipolar II share 16 of 18 symptoms and this leads to a lot of confusion for many psychiatrists. Dr. Barkley has stated that if there is a diagnosis of ADHD there should not be a diagnosis of BPII comorbid because all of the symptoms can be explained by the ADHD.

Diagnostic policy is a bit different, I think. Also:

1) I am asking about continium, not if you can have 2 different disorders.
and
2) I am asking about relation to typical impulsive ADHD (including a good response to Ritalin).

Otherwise I see there is BD-NOS - "sub-threshold" bipolar. I guess these persons can have "Bipolar ADHD", and this should be diagnosed as ADHD, if it is knows that they are bipolar.

mrsmith
06-30-12, 01:03 AM
> if it is knows that they are bipolar.
if it is not known the individual is bipolar

sarahsweets
06-30-12, 07:12 AM
They xn often be comormoid but not cause each eother.

ginniebean
06-30-12, 10:15 AM
Diagnostic policy is a bit different, I think. Also:

1) I am asking about continium, not if you can have 2 different disorders.
and
2) I am asking about relation to typical impulsive ADHD (including a good response to Ritalin).

Otherwise I see there is BD-NOS - "sub-threshold" bipolar. I guess these persons can have "Bipolar ADHD", and this should be diagnosed as ADHD, if it is knows that they are bipolar.


There is no continuum. There is comorbidity. Otherwise I'm still not getting what you're asking. Tho I am trying.

ginniebean
06-30-12, 10:17 AM
I didnt know that ginniebean. I have never read anything yet from Dr Barkley that I didnt agree with but I have now found my first.

I had Add PI all my life. Bp2 started in my late 20s after a lot of stress and trauma. The two disorders are almost 30 years apart in origin in me so there is no way they could be the same.

The only other explanation I could think of would be that Add somehow evolves dramatically and I mean dramatically to mimic bp2 in your late 20s and I have never heard anything like that.

I experienced the onset of my bp as a major catastrophic event to the extent where I divide my life mentally into two ie before it happened and after it happened. if you saw photos of me just before I got it and 5 years after i got it you would be shocked at how much I had aged.

So unless he has an explanation for this major catastrophic event I am going with the onset of a new disorder.

I believe they are totally linked though. Posts asking "Does Add turn into bipolar?" fascinate me but there is no proof that it can.

Im not sure whether thats because it cant or whether it can and they just havent found the reason yet. Sometimes I suspect the latter but really I have no idea.

ADHD and catastrophic event could just as easily be ADHD comorbid with PTSD (racing thoughts/hightened emotional dysregulation.. etc..)

I'm no psychiatrist.. I'm just reporting and asking questions.. I have NO definitive knowledge.

ginniebean
06-30-12, 10:25 AM
How does that work? Medication-wise they are very different treatments.


yes indeed they are. My mother was treated for damned near everything including bipolar 2, it wasn't until a few years ago she was finally diagnosed adhd. In one week she was doing things she hadn't in YEARS. After years of being treated for bipolar and her being slooooowed down to the point of zombification.

I do question the prescribing factor that ADHD meds are disfavoured by many psychiatrists because they are schedule II and that means oversight and risk, tho much less harmful to the patient in terms of not only long term use but also side effects. And hassle free meds (from the psychiatrists point of view) for bipolar. Even tho long term use and side effects are more dangerous.

mrsmith
06-30-12, 11:53 AM
There is no continuum. There is co-morbidity.
IMHO ADHD might have many different basic Pathologies. Like dr Amen has 6 types of ADHD:
http://add.about.com/od/adhdthebasics/a/Interview-With-Dr-Daniel-Amen.htm

BP might consentrate in one of these. IF somebody with "invincible" BP has ADHD, it is likely to be the same as somebody with visible BD. I find it natural to call this "Bipolar ADHD"

If you read the reference to comorbid below, you will see that a varying degree of BD and Bipolar ADHD is not really comorbidity (or its a bit more than that)
Also if BD excludes a diagnosis of ADHD, you would have to say something like comorbidity between BD and "Satisfies the diagnostic criteria for ADHD"

http://en.wikipedia.org/wiki/Comorbidity
<sup id="cite_ref-0" class="reference">1] (http://en.wikipedia.org/wiki/Comorbidity#cite_note-0)</sup>
In medicine, comorbidity describes the effect of all other diseases an individual patient might have other than the primary disease of interest.
Many tests attempt to standardize the "weight" or value of comorbid conditions, whether they are secondary or tertiary illnesses. Each test attempts to consolidate each individual comorbid condition into a single, predictive variable that measures mortality or other outcomes. Researchers have validated such tests because of their predictive value, but no one test is as yet recognized as a standard.
The term "comorbid" has two definitions:


to indicate a medical condition existing simultaneously but independently with another condition in a patient (this is the older and more "correct" definition)
to indicate a medical condition in a patient that causes, is caused by, or is otherwise related to another condition in the same patient (this is a newer, nonstandard definition and less well-accepted).<sup class="reference" id="cite_ref-0">[ (http://en.wikipedia.org/wiki/Comorbidity#cite_note-0)</sup>

mrsmith
06-30-12, 12:59 PM
There is no continuum. There is comorbidity.
Are you saying there is no continium :-) or that comorbidity is the correct phrase?

mctavish23
06-30-12, 01:44 PM
There's a well established "One Way Comorbidity" between Bipolar and ADHD.

Specifically, over 90% of children / adolescents with (authentic) Early Onset

(Pediatric) Bipolar Disorder also have ADHD, while the opposite is not true.

The empirically (research) supported characteristics found to accurately

differentiate between the two groups (Bipolar + ADHD vs ADHD alone), are

as follows :

1) Elevated and expansive moods (either with or without subsequent depression)
(The length of time helps determine which "type" is more likely);

2) Grandiose or "Know it all" behavior, even for things they know nothing about
(For little kids, that translates to "bossy");

3) Racing thoughts / Flight of ideas (so many thoughts they can't express them all
or visibly struggle trying to);

4) Decreased need for sleep (able to get by on just a few hours sleep (or none),
and still adequately function the next day);

5) Hypersexualized behavior (self-stimulation, excessive pleasure seeking, blurting
out sexualized language in public,etc.).

Two excellent references on the above data are :

Barbara Geller, MD and James Chandler, MD.

Hope that helps.

tc

mctavish23

(Robert)

mrsmith
06-30-12, 01:50 PM
What about Bipolar Type ADHD instead of Bipolar ADHD?

Note that part of my question if this is a useful concept the way I define it.

Typical ADHD would be the the most common genetic hyperactive ADHD responding well to Ritalin. I think it is different from Bipolar ADHD, and that it is not common with BD, partly because of the response to Ritalin.
(But I don't know so much about this).

So there would be no continuum towards ADHD or typical ADHD, but I am not sure about Bipolar ADHD.

mrsmith
06-30-12, 02:08 PM
There's a well established "One Way Comorbidity" between Bipolar and ADHD.


If this is a ADHD type which is a small subset of ADHD, then the cormorbidity the other way would be much higher, the same if we include more invisible BD.

mctavish23
06-30-12, 09:46 PM
I apologize if that wasn't clear enough.

Here's the deal....

Comorbid obviously means "co-occurring."

In this sense, Bipolar is the principal diagnosis, with ADHD being ancillary (secondary).

The "type" I was referring to dealt with Bipolar Disorder.

As you know, there are several distinct types, just like ADHD.

One thing to keep in mind is that these are both highly genetic.

However, ADHD individuals without a family history of Bipolar Disorder, are not going

to suddenly "become" Bipolar, without some outside catalyst, like methaphetamine

induced mania.

Also, no one with ADHD -PI Type (aka "ADD") is going to viewed as "manic."

That would be a classic oxymoron.

I hope that clearer.

Once again, those are excellent references to check out.

tc

mctavish23

(Robert)

Abi
07-14-12, 08:42 PM
Mr Smith,

For the love of GOD and all that is good, could you PLEASE STOP SAYING "BIPOLAR ADHD"

THERE IS NO SUCH THING AS BIPOLAR ADHD

Saying "bipolar ADHD" is the equivalent of saying "high blood pressure diabetes"

It is nonsensical and EXTREMELY ANNOYING

mctavish23
07-14-12, 10:37 PM
Agreed. There is no such thing as "Bipolar ADHD".

There is NO subset with ADHD.

They are two separate and distinct disorders.

tc

mctavish23

(Robert)

mrsmith
07-17-12, 03:52 AM
Mr Smith,

For the love of GOD and all that is good, could you PLEASE STOP SAYING "BIPOLAR ADHD"

THERE IS NO SUCH THING AS BIPOLAR ADHD

Saying "bipolar ADHD" is the equivalent of saying "high blood pressure diabetes"

It is nonsensical and EXTREMELY ANNOYING

I think it should be quite clear from the question what I mean, so I think you should propose a better expression, or come with more well-funded answer to the questions.

About "high blood pressure diabetes". With high blood pressure it is probably more likely to be diabetes II, so "high blood pressure" does say something about the nature of the diabetes, but as the conditions are well understood it doesn't make sense to see them together this way.
(I don't think you will find a forum called "High Blood Pressure and Diabetes" :-)

Also, beeing disposed for high blood pressure is not quite the same as being disposed for "visible" Bipolar Disorder.

sarahsweets
07-17-12, 05:07 AM
I think it should be quite clear from the question what I mean, so I think you should propose a better expression, or come with more well-funded answer to the questions.

About "high blood pressure diabetes". With high blood pressure it is probably more likely to be diabetes II, so "high blood pressure" does say something about the nature of the diabetes, but as the conditions are well understood it doesn't make sense to see them together this way.
(I don't think you will find a forum called "High Blood Pressure and Diabetes" :-)

Also, beeing disposed for high blood pressure is not quite the same as being disposed for "visible" Bipolar Disorder.

I am not quite clear of what you are getting at. Are you asking or proposing that a new subset be developed called bipolar adhd? As far as proposing a better expression, unless you re-vamp the entire DSM you will only have BP with adhd or adhd with BP, the two may be connected but not their own subset. Plenty of people with adhd do not have BP and plenty of people with BP do not have adhd. Keeping the two linked as you seem to be proposing would be a disservice to those who have one or both of the disorders because by lumping them in together you are not giving..."fair" treatment to the disorders on their own. My daughter has some mood issues along with adhd but I wouldnt want this magical new subset to be slapped on her if indeed she did actually have bipolar. I would want each disorder throuroughly evaluated and treated.

mrsmith
07-17-12, 08:12 AM
I am not quite clear of what you are getting at
I am not "getting at" anything. I am just asking some questions.


unless you re-vamp the entire DSM you will only have BP with adhd or adhd with BP, the two may be connected but not their own subset.
I do think ADHD is a collection of different conditions, but actually in the DSM you have different subtypes. If for example the distribution between these, and the response to medication is the same as in other ADHD populations, it would indicate that it is the "same" ADHD.
(I though since stimulants are "bad" for people with BP, it would be a "different kind" of ADHD. I understand now that this is not the case, as the problem is in the interaction with the BP issues)



Keeping the two linked as you seem to be proposing

I am not linking them more than others I think.

(I will reformulate my question in a new post in about 1/2 hour)

mrsmith
07-17-12, 08:45 AM
When I wrote my question, I though Bipolar diagnosis would exclude an ADHD diagnosis, I apologize for the confusion.

Is the ADHD in comorbid Bipolar/ADHD, the same ADHD as in other ADHD populations? (I am thinking a bit about dr Amens different ADHD types).
Is it as stable through life as in other ADHD populations?

Is it like have completely independent conditions, with no particular characteristics except those associated with the conditions?

If the BPness is not "visible" (Not Developed or sub-threshold for example) is it just like any other ADHD?

Lunacie
07-17-12, 09:30 AM
I think it should be quite clear from the question what I mean, so I think you should propose a better expression, or come with more well-funded answer to the questions.

About "high blood pressure diabetes". With high blood pressure it is probably more likely to be diabetes II, so "high blood pressure" does say something about the nature of the diabetes, but as the conditions are well understood it doesn't make sense to see them together this way.
(I don't think you will find a forum called "High Blood Pressure and Diabetes" :-)

Also, beeing disposed for high blood pressure is not quite the same as being disposed for "visible" Bipolar Disorder.

I do see what Abi was saying. I have ADHD and cormorbid Anxiety.

I don't write this as ADHD/Anxiety. I say I have ADHD and Anxiety.

I haven't seen a forum called "ADHD and Bipolar" either, so I don't get your point there?

ginniebean
07-17-12, 10:24 AM
I think the problem here is the development of a crude diagnostic theory. In the OP's experience she thinks she's been seeing something she's determined as bipolar/adhd.

This is a part of the learning process, to come up with ideas but when the information is partial it's easy to get thrown off track.

This is most certainly not unique to the OP, you can see this when people start diagnosing others on the forum, or suggesting potential diagnosis.

mrsmith
07-17-12, 01:03 PM
I think the problem here is the development of a crude diagnostic theory. In the OP's experience she thinks she's been seeing something she's determined as bipolar/adhd.

This is a part of the learning process, to come up with ideas but when the information is partial it's easy to get thrown off track.

This is most certainly not unique to the OP, you can see this when people start diagnosing others on the forum, or suggesting potential diagnosis.

For me this is complete nonsense. At least its not related to me.

(I used the expression "Bipolar ADHD". I used "bipolar/adhd" only as in "comorbid bipolar/adhd")

ginniebean
07-17-12, 01:38 PM
Otherwise I see there is BD-NOS - "sub-threshold" bipolar. I guess these persons can have "Bipolar ADHD", and this should be diagnosed as ADHD, if it is knows that they are bipolar.

Ok. I was not trying to hurt your feelings or insult you, I do see you grasping to understand and quotes like the above kinda make that clear.

I have no problem when people are searching for answers and I don't care to make people feel stupid. We can all learn more.

daveddd
07-17-12, 05:55 PM
there has definitely been studies into an adhd subset that has shown rapid or somewhat rapid mood shifts

these patients respond differently to medication than bipolar 1 or clearcut bipolar 2 patients

there has been relationships linked to circadian rythyms along with genetics involving them

daveddd
07-17-12, 06:16 PM
I do see what Abi was saying. I have ADHD and cormorbid Anxiety.

I don't write this as ADHD/Anxiety. I say I have ADHD and Anxiety.

I haven't seen a forum called "ADHD and Bipolar" either, so I don't get your point there?

all and all though with the amount of genetic AND idiopathic phenotypes

we might see that shortly

instead of saying i have ADHD primarily hyperactive, social anxiety with gaze aviodance , hyper arousal, tactile defensiveness , general anxiety nos, AVPD, dermatophagia, ocd, major depression, learning disabilities , and panic attacks

they may say i have fragile x syndrome pre mutation

stimulants plus an ssri plus and anti psychotic handle it

ADHD that's me
12-03-12, 12:39 AM
For me I was faced with the same dilemma, bipolar diagnosed first then ADHD after. My school reports justified to ADHD diagnosis, the dilemma? Was my bipolar misdiagnosed am I just a very high scale ADHD person? The test I decided to run on myself once both conditions medically supervised and treated was to see what happens when bipolar meds (mood stabilizer) is removed. The result? Hyperactivity increase to the point of Mania, and grateful it wasn't depression cycle coz that would have hurt. Back onto meds and "normality" resumes. The same test applied to ADHD medication intake resulted in a similar hyperactivity increase but stopped less than halfway than the other test result, only difference was an increased anger level way above "Normal". My conclusion, yes I have a comorbid issue consisting of bipolar2 and Adult ADHD, both recently stabilized by industry professionals leaving me with the task of reshaping my life with information, medication, meditation and diet. In summary ADHD has a certain level for its highs and lows, hypothetically let's rate it with a 5/10 for highs and -5/-10 for lows, where as bipolar would be 10/10 for highs and the opposite for lows. Anything outside that scale is insanity for the highs and homocide/suicide for the lows. The only dilemma I have left is Attention Deficit Hyperactivity Disorder makes sence when it's shortened to ADHD but why bipolar I & II or 1 & 2 shortened to BP1 (BPI) or BP2 (BPII)??? Bipolar is one word so shouldn't it be B1 & B2??? Lol! Let me kno if u got the pun intended... ❤ ADHD, that's me ;)