View Full Version : Overlapping symptoms of ADHD and bipolar disorder


Fuzzy12
02-19-13, 09:00 AM
I've often heard on this forum that bipolar disorder shares 16/18 symptoms with ADHD. I didn't even know that there were 18 diagnostic symptoms of ADHD.

Can anyone explain this to me? What are these overlapping symptoms? And if it's true that there are so many overlapping symptoms how do doctors differentiate between ADHD and BD? How does co-morbidity influence the diagnostic process?

saturday
02-19-13, 11:26 AM
I think its the other way around. ADD has 16 of the 18 symptoms of Bipolar.

One way to differentiate is to find out if the person ever has periods of NO symptoms at all. This would indicate a mood disorder, rather than ADD which is always present.

keliza
02-19-13, 01:51 PM
It seems like the best way to differentiate ADHD from bipolar disorder is to get the BD episodes under control, and then see what's left. If what's left during euthymia (normal mood) meets the criteria for ADHD, then you can diagnose ADHD. If there are no major residual symptoms left once the mood episodes are under control, probably not ADHD.

I say "major" because it's not really conceivable to have ALL of your symptoms disappear, even during times when you're not actively having any mood episodes. Many people will still have some low-level residual symptoms, but it doesn't bother them because relatively, it's no big deal. Por ejemplo, even when I'm not manic, I still sometimes have racing thoughts and hypomanic behavior. I usually can't tell if I'm having breakthrough hypomania or if I'm just having a good day. It's only when other people point out that I might be rocking a little towards mania that I become self-aware and think about my actions and thought processes and consider the notion. (That only works for hypomania. When I'm truly manic, there's no telling me about it, because I wouldn't believe you - I would probably just believe that I am gifted beyond compare, that what 'they' perceive to be illness is really my superior understanding of the universe, haha.)

But anyway, that is, in my understanding, the best way to distinguish whether or not a person with bipolar disorder also has ADHD. You have to get the BD symptoms under control so you can look past them and see what's left. That's when you can diagnose comorbids like ADHD, anxiety disorders, etc.

Fuzzy12
02-19-13, 02:22 PM
So which are these 16 symptoms, they are supposed to share :scratch:

emploding
02-19-13, 07:30 PM
A pretty good way to tell if you have bipolar or ADHD is with medication - mood stabilisers won't do **** for ADHD, but will help bipolar. Stims won't do **** for bipolar (will usually make it muchmuch worse) but may help ADHD, etc

My ADHD wasn't diagnosed until my bipolar was under control with meds, which was about 15 years after my initial bipolar diagnoses. Only now can we start to work on the ADHD.

But like anything, diagnostics isn't an exact science as there isn't a blood test for bipolar or ADHD or anything to say "yes, you have this" or "no, you don't".

edited to add: ADHD symtoms have to be present as a kid, bipolar doesn't. So that's one way of seeing which is which.

crystal8080
02-20-13, 12:10 AM
I think what you are looking for are the two symptoms of bipolar disorder that are not a symptom of ADHD.

1) Grandiosity

2) Hypersexuality

Idiota
02-21-13, 12:07 PM
A pretty good way to tell if you have bipolar or ADHD is with medication - mood stabilisers won't do **** for ADHD, but will help bipolar. Stims won't do **** for bipolar (will usually make it muchmuch worse) but may help ADHD, etc

My ADHD wasn't diagnosed until my bipolar was under control with meds, which was about 15 years after my initial bipolar diagnoses. Only now can we start to work on the ADHD.

But like anything, diagnostics isn't an exact science as there isn't a blood test for bipolar or ADHD or anything to say "yes, you have this" or "no, you don't".

edited to add: ADHD symtoms have to be present as a kid, bipolar doesn't. So that's one way of seeing which is which.

I find this simply unacceptable. My potential ADHD has hindered me significantly in terms prospects/education/work and I can't tolerate that much longer. Ugh.

Lamictal hasn't done anything for my ADHD.

emploding
02-22-13, 12:56 AM
I find this simply unacceptable. My potential ADHD has hindered me significantly in terms prospects/education/work and I can't tolerate that much longer. Ugh.

Lamictal hasn't done anything for my ADHD.

That's because lamtical isn't an ADHD medication.

Raye
02-22-13, 05:18 AM
Fuzzy-

i wonder about this too. My adhd isn't being treated with stimulants or non stims, yet my depressive episodes/moods are very stabilized with Lamictal.

emploding- you're right. Lamictal is an anti epileptic, and a mood stabilizer for bi polar. It can also be used for very hard to treat depression.

starry
02-22-13, 06:22 AM
Both ADHD and BP people may have depression that may last for periods of time, or mood swings, but only one experiences "mania" and those are the people who have BP.

"Mania" or "being manic" is not same as just being in a good mood. Even though some people with BP experience only slight mania at times, it's still very different than simply being in a good mood.
Often times it can be a full personality change, excessive splurging (often in unusual, new things like buying a piano even though they don't play and never cared for learning to play it before etc), taking risks, doing things out of character, picking up new hobbies, being too social, talking too much, overdoing things, staying up for days hyper-focusing on things (like a new hobby for example or a task for example like painting the house), travel, being too trusting as well as too giving (opening one self to being taken advantage of or ending up in a dangerous situation), sign up for new things like volunteering jobs or paid membership type of stuff, get a new pet, new friends, go out a lot, get overly excited or overly enthusiastic about things etc
This period can last a few minutes if one is a rapid cycler or weeks or months.

When I asked my doc how I could find out if I was BP, since ADHD and BP shared many traits, he said the diagnosis is made by finding out if the person has any manic episodes. Since the depressive episodes don't always indicate that someone has BP. But the mania is unique and specific to BP.
He said that it's usually difficult to tell for the person experiencing mania, that it's any different than that they're out of their depression and finally in a good mood, so it usually requires a test to find out if one has BP.
We did the test, where he asked me a bunch of questions. He said I don't have it.

I do tend to get SAD though (Seasonal Affective Disorder) every/most winters at the same time. Which is a depressive period similar to that in BP, due to lack of sunlight. And it lifts in spring and I was worried I was being manic, when it did and I felt good again. I'm happy to know that it's not mania, but just a rise in my serotonin levels triggered by the sun being closer (and brighter) again.

daveddd
02-22-13, 06:56 AM
for a different perspective


http://books.google.com/books?id=4H1Wk7aKEsQC&pg=PA121&dq=adhd+emotional+regulation&hl=en&sa=X&ei=hiIiUYrPG8HhrAHSkoGYCQ&ved=0CF4Q6AEwBw#v=onepage&q=adhd%20emotional%20regulation&f=false

dannn
02-23-13, 06:05 PM
According to my psych, the main difference is that in BP there is significant disturbance in sleep pattern.

Idiota
02-25-13, 10:58 AM
Haha. So I went to the psychiatrist and Friday and he finally considered some ADHD medication because I'm treading water, getting nowhere, in debt, but I have to get an on actual mood stabilizer for six weeks to be able to try a non-stimulant medication. Kind of sucks that even non-stimulant medication is that hard to get. This is just terrible. I basically decided after graduating back in August that I'm not going to bother with taking classes or anything because I'm not going to remember anything and I'll be exclusively going to classes and turning stuff in just to pass while investing most of my energy, so this doesn't help. I was just planning on getting some job, but being in a depressive phase made that impossible and I haven't had luck lately either. The medication would help me because I could actually "be there" and maybe learn some skills so I won't be at a dead end in life. Ugh.

Is everyone here on stims or do you have non-stims? I really need results.

Fuzzy12
02-25-13, 12:04 PM
According to my psych, the main difference is that in BP there is significant disturbance in sleep pattern.

I don't have disturbed sleep patterns. :eek:

Haha. So I went to the psychiatrist and Friday and he finally considered some ADHD medication because I'm treading water, getting nowhere, in debt, but I have to get an on actual mood stabilizer for six weeks to be able to try a non-stimulant medication. Kind of sucks that even non-stimulant medication is that hard to get. This is just terrible. I basically decided after graduating back in August that I'm not going to bother with taking classes or anything because I'm not going to remember anything and I'll be exclusively going to classes and turning stuff in just to pass while investing most of my energy, so this doesn't help. I was just planning on getting some job, but being in a depressive phase made that impossible and I haven't had luck lately either. The medication would help me because I could actually "be there" and maybe learn some skills so I won't be at a dead end in life. Ugh.

Is everyone here on stims or do you have non-stims? I really need results.

I'm not on stims but then I haven't been diagnosed with ADHD. Just good old BP II. :rolleyes:

Abi
02-25-13, 12:04 PM
Are you diagnosed with ADHD and Bipolar or just Bipolar?

I'm the latter - I tried Ritalin, it made me manic. Wellbutrin helps.

Idiota
02-25-13, 12:52 PM
I haven't even gotten a BiPolar diagnosis since I only had mania once and it was related to anti-depressants.

He told me no on ADHD medication first, put me on lithium, and then i got off lithium and on lamictal and now I have to take tryvectal(sp) for six weeks and then he might prescribe a non-stimulant. Apparently, non-stimulants could also induce mania. I hate my life.

Scooby Dude
02-25-13, 01:27 PM
My psychologist said that diagnosing a person with ADHD and BP is damned difficult, and can take a long time to really figure out. But diagnosing a person with ADHD or BP but not both, is pretty easy.

Look at your core ADHD symptoms, the ones that overlap with BP. Are there significant periods of time where they are drastically reduced or virtually eliminated, only to resurface later just as strong? Then it's BP. Do your core ADHD symptoms stay present at all times, stretching back to childhood? Then it's ADHD.

Fuzzy12
02-25-13, 01:55 PM
My psychologist said that diagnosing a person with ADHD and BP is damned difficult, and can take a long time to really figure out. But diagnosing a person with ADHD or BP but not both, is pretty easy.

Look at your core ADHD symptoms, the ones that overlap with BP. Are there significant periods of time where they are drastically reduced or virtually eliminated, only to resurface later just as strong? Then it's BP. Do your core ADHD symptoms stay present at all times, stretching back to childhood? Then it's ADHD.

My ADHD like symptoms are always present, irrespective of if I'm depressed, hypomanic or the rare episodes where I feel somewhat normal. They were present during childhood as well but a lot less severe.

Scooby Dude
02-25-13, 02:00 PM
My ADHD like symptoms are always present, irrespective of if I'm depressed, hypomanic or the rare episodes where I feel somewhat normal. They were present during childhood as well but a lot less severe.

Any chance you have both?

Fuzzy12
02-25-13, 02:04 PM
Any chance you have both?

It's possible. I'm pretty sure I have some kind of mood disorder going on. I can't regulate my moods at all and the mood swings are really bad. Though it's more of the daily mood swings, circadian cycling apparently that troubles me rather than my actual periods of hypomania and depression (though depression sucks..always). But circadian cycling isn't even a core symptom of bipolar disorder and though some publications in the literature acknowledge it, there isn't much info or awareness about it, it seems.

It's complicated though. My ADHD like symptoms make me so dysfunctional that it depresses and stresses me and any source of stimulation excites me and makes me feel euphoric. I also wonder if I might have borderline personality disorder since I react so strongly to every little trigger.

I've been evaluated for ADHD but my first psychiatrist decided that all my ADHD like symptoms are caused by severe depression and the second psychiatrist I saw said that though I have all the symptoms of adult ADHD now he can't diagnose me with ADHD since I don't show enough impairment in childhood.

Abi
02-25-13, 02:05 PM
My ADHD like symptoms are always present, irrespective of if I'm depressed, hypomanic or the rare episodes where I feel somewhat normal. They were present during childhood as well but a lot less severe.

Same for me.

I'm not sure if you know that research has shown that cognitive impairments in bipolar people can persist through euthymic (ie. stable mood) phases as well.

Fuzzy12
02-25-13, 02:07 PM
Same for me.

I'm not sure if you know that research has shown that cognitive impairments in bipolar people can persist through euthymic (ie. stable mood) phases as well.

Yup, I've read about that. What's strange though is that in general the cognitive impairments they found in bipolar patients are only marginally worse than in the general population. I've also read in a paper that the cognitive impairments in general aren't that severe irrespective of the current mood.

Scooby Dude
02-25-13, 02:47 PM
It's possible. I'm pretty sure I have some kind of mood disorder going on. I can't regulate my moods at all and the mood swings are really bad. Though it's more of the daily mood swings, circadian cycling apparently that troubles me rather than my actual periods of hypomania and depression (though depression sucks..always). But circadian cycling isn't even a core symptom of bipolar disorder and though some publications in the literature acknowledge it, there isn't much info or awareness about it, it seems.

It's complicated though. My ADHD like symptoms make me so dysfunctional that it depresses and stresses me and any source of stimulation excites me and makes me feel euphoric. I also wonder if I might have borderline personality disorder since I react so strongly to every little trigger.

I've been evaluated for ADHD but my first psychiatrist decided that all my ADHD like symptoms are caused by severe depression and the second psychiatrist I saw said that though I have all the symptoms of adult ADHD now he can't diagnose me with ADHD since I don't show enough impairment in childhood.

This resonates with me. I had some discussions about a lot of this with my therapist, a Harvard Med School trained ADHD specialist and sufferer. What I'm saying is not my own informed opinion, but a 2nd hand account of what someone else thinks.

He said that one of the most misunderstood parts of ADHD is the mood regulation problems that it can cause as a direct symptom of the disorder. I described to him what I called "Juvenile Moods", or the feeling that I would overreact, positively or negatively, to small stimuli, get out of sorts (again, good or bad) for a few hours, then realize much later on that this was an irrational level of emotion.

He said I was describing the condition known as "Cyclothymia", and that many ADHDers can have mood regulation problems severe enough to meet the direct diagnostic criteria for Cyclothymia (aka Cyclothymic Disorder), not as a resultant mood disorder brought on by living with ADHD, but basically as a direct ADHD symptom.

He said it works a little like this: your Reptilian Brain (which interacts directly with your senses) processes everything as basically an on/off. So a stubbed toe and a gunshot wound both trigger something like Physical Distress Fear, on; Volume 10 (max volume). This is why lizards, fish, and other cold blooded animal seem so jumpy and erratic in their behavior.

Your Mamalian Brain is supposed to then modulate and regulate the volume before it gets sent to your Human Brain/Consciousness. Your Consciousness then reacts in proportion to the volume it receives. So stubbed toe? The volume gets turned down to a 2. Gunshot wound? Send it through as a 10. And this modulation is subconscious.

For many with ADHD, this modulation performs poorly. Thus, often the volume on a stubbed toe gets modulated only to a 6 1/2 instead of a 2, and the conscious mid reacts strongly to that high volume. Thus, for example, the extremely high rate of road rage amongst ADHDers.

He went on to explain that this can be confused for BP.

I have no idea if any of this applies to you, but here's a link to the wiki for Cyclothymia:

http://en.m.wikipedia.org/wiki/Cyclothymia

Fuzzy12
02-26-13, 07:54 AM
I think, a huge source of my depression is the inability to work (which could be ADHD related, if that's what I have). So yesterday, the student I helped out sent me a thank you e-mail and called me a star. :o I felt better. Instantly!! I always feel better when I manage to do something productive but the fact that I do very little that is productive depresses the hell out of me.

daveddd
02-26-13, 08:00 AM
It's possible. I'm pretty sure I have some kind of mood disorder going on. I can't regulate my moods at all and the mood swings are really bad. Though it's more of the daily mood swings, circadian cycling apparently that troubles me rather than my actual periods of hypomania and depression (though depression sucks..always). But circadian cycling isn't even a core symptom of bipolar disorder and though some publications in the literature acknowledge it, there isn't much info or awareness about it, it seems.

It's complicated though. My ADHD like symptoms make me so dysfunctional that it depresses and stresses me and any source of stimulation excites me and makes me feel euphoric. I also wonder if I might have borderline personality disorder since I react so strongly to every little trigger.

I've been evaluated for ADHD but my first psychiatrist decided that all my ADHD like symptoms are caused by severe depression and the second psychiatrist I saw said that though I have all the symptoms of adult ADHD now he can't diagnose me with ADHD since I don't show enough impairment in childhood.

if you do enough digging, there is a very high correlation between ADHD and circadian cycling

also extreme emotional reactivity

no need to tac on any additional dx

daveddd
02-26-13, 08:02 AM
Are you diagnosed with ADHD and Bipolar or just Bipolar?

I'm the latter - I tried Ritalin, it made me manic. Wellbutrin helps.

its crazy how different, yet the same we can be

ritalin is highly effective for me (but i quickly build a tolerance)

and wellbutrin sent me into a delusional mania

Fuzzy12
02-26-13, 08:06 AM
if you do enough digging, there is a very high correlation between ADHD and circadian cycling

also extreme emotional reactivity

no need to tac on any additional dx

Um..I've been diagnosed with bipolar disorder II but not ADHD. :scratch: My psychiatrists won't even consider ADHD (and definitely not till my mood issues are sorted). But if my mood problems are caused (at least to a substantial extent) by ADHD, then I guess they won't subside till the ADHD gets treated. Even if I really have ADHD rather than BD it's unlikely that anyone will ever diagnose me with it. :scratch:

daveddd
02-26-13, 08:09 AM
Um..I've been diagnosed with bipolar disorder II but not ADHD. :scratch:

ok, thought you thought were ADHD



you sure seem like it

daveddd
02-26-13, 03:51 PM
learning about affect regulation and emotional flooding, and avoidance, really helped me a ton

it didnt fix me or anything, but it helped

Idiota
02-26-13, 05:43 PM
To be frank, I almost wish I had a physical disability instead of this because of the stigma against mental disorders in general. They aren't perceived the same as being in a wheel chair or anything.

Can anyone describe how exactly this has affected them?

To be honest, I've always had the problem that I become mentally fatigued really quickly. Even college is somewhat a kid gloves thing compared to the real world with only having to go maybe 4 hours a day to class, but my brain would give out. It would take forever for me to even finish four page assignments, while others were pumping out more than that. Even now, the time just slips by and I can't really get much done.

I thought I was finally getting somewhere because I had done Cogmed, but it was all mania and I couldn't recognize it. I seriously thought "I'm going to win this essay contest and redeem myself and maybe I can get into grad school." Man that was really delusional.

medbahr
03-03-13, 11:01 AM
(first posting - Hi!) As an adult with both Bipolar disorder and ADHD, it has been a major struggle to find the right balance of treatments that satisfy the needs of all conditions - if not for my new wife's experience with the disorders (in both personal professional life), I never would have considered I was Bipolar, due to the stigma it carries!
David DDD's posting of the book Adults with ADHD shined a light on my condition. I was the youth with many mood and attention disorders, but because I attended schools long before the naming of ADHD, I was merely considered obstinate and troubled. The belief that one 'grew out of it' kept me untreated through my young adult years, and numerous broken relationships and failed careers later, I was finally diagnosed with dysthymia from the V.A., from which I received a small pension. It wasn't until age 40 that I was diagnosed with ADHD. I started taking Adderall - which did not help. It got me wired but also magnified the depressive condition. The doctor tried Lexapro - which made the inattentiveness worsen. The doctor switched me to Wellbutrin, and Oh my GOD did I go bonkers!!!!!!!
Living with the two coexisting conditions has been pure hell at times. It takes such an effort just to stay within the lines of normalcy that moving forward is a struggle those without either condition cannot appreciate.
FINALLY, last year, my wonderful wife tenderly suggested that I might be bipolar. After my fierce attempts at denial faded, I took a detached look at the symptoms, and there it was - I couldn't deny it any longer. It wasn't JUST ADHD; it wasn't JUST BPD - I had both conditions.
I went to my doctor with the results, and he started me on Lamictal. It immediately stabilized the mood swings! I foolishly disregarded the ADHD (oops I forgot I had ADHD - go figure!), and stopped taking the Ritalin regularly - DUH!
So here I am. After all the angry denials, skipped regimens and damaged professional opportunities, I now accept the reality of BPD/ADHD coexistence in this 50-something year old body. It's an effort to ensure that I take my meds religiously.
I just know that above all I am sick and tired of the damage this untreated coexistence has wrought in my life.
Is there anyone out there with a similar story?