View Full Version : executive function in bipolar


daveddd
07-17-13, 08:59 AM
so the executive function impairments are exactly the same in bipolar and ADHD

some say its comorbid, some dont bother

but if they are the same they should be regarded as the same

is it just a case of if you meet the symptoms of ADHD you have it

or is it a more complex relationship
http://books.google.com/books?id=v-KLQLTRb48C&pg=PA390&dq=borderline+personality+disorder+executive+funct ion&hl=en&sa=X&ei=JJbmUeXQKOLbyQHu1YGgDw&ved=0CEQQ6AEwAg#v=onepage&q=borderline%20personality%20disorder%20executive% 20function&f=false

Dizfriz
07-17-13, 09:38 AM
so the executive function impairments are exactly the same in bipolar and ADHD

some say its comorbid, some dont bother

but if they are the same they should be regarded as the same

is it just a case of if you meet the symptoms of ADHD you have it

or is it a more complex relationship http://books.google.com/books?id=v-KLQLTRb48C&pg=PA390&dq=borderline+personality+disorder+executive+funct ion&hl=en&sa=X&ei=JJbmUeXQKOLbyQHu1YGgDw&ved=0CEQQ6AEwAg#v=onepage&q=borderline%20personality%20disorder%20executive% 20function&f=false

You do post some interesting questions.

I can speak better on children than adults but in any case let me take a stab at it because it is a subject of interest to me.

There are a number of similarities between ADHD and Bipolar. They are considered to be one-way comorbidies. What I mean by that is that most ADHDers will not be Bipolar but a large percentage of Bipolars can be diagnosed also as ADHD.

It is my thought, which I cannot support with evidence, is that ADHD symptoms are an integral part of Bipolar with a connected but somewhat different genetic linkage. ADHD has a significant heritability factor and Bipolar has very strong, well documented genetic basis. I suspect that in the future we may well find that a number of similar disorders are neurobiologically linked and may turn out to be part of a broader neurobiological syndrome. In my mind ADHD and Bipolar may turn out to be different manifestations of the same general disorder.

Keep in mind that his are just some thoughts and the evidence, at least currently, will not back this up to any useful degree so I cannot defend these ideas. I do think it likely though that this is the way it may well turn out.

Just some speculations.

Dizfriz

daveddd
07-17-13, 10:53 AM
you can call me crazy

but there even seems a link between presentations of ADHD, and bipolar types

involving certain characteristics that occur in high percentages of ADHD people

fracturedstory
07-21-13, 10:14 PM
My sister (diagnosed bipolar) doesn't have my focus issues. The way I see it executive function issues in ADHD are generally always happening, apart from those few rare days and in bipolar it depends on the episodes.

Something I've also noticed is lack of sleep for me makes my ADHD worse. I don't become more manic. Well, not the type of manic that needs little sleep to be functioning at 200% the next day. And when I do get manic I burn out so quickly.

They should not be regarded as the same. The present differently. One is a serious mental illness that is completely detrimental to the person's well being. ADHD is too but to a lesser extent. I've always been able to learn a certain number of skills to control my neurological disorder symptoms but once the chemical imbalances happen I'm just out of control. Secondly, they require different forms of medication and if you give one to the person that should take the other there can be very bad reactions. Even the person with both can react badly to them.

The reason why medical diagnoses are split up is because of treatment. I think so at least.

I've only recently developed bipolar from all the medications a person with the markers for bipolar should never go on, and I can really tell the difference between just ADHD (Inattentive with AS) and bipolar.

So I wouldn't say that the executive function issues are exactly the same. When it comes to millions of peoples brains nothing is ever experienced the same. But seriously, my sister has a bit in common with ADHD but she doesn't have them to the point of impairment.

Most neurological disorders share similar symptoms. I used to try to find a link between autism and epilepsy. It's fun looking for the links but I don't think just two disorders will share a link. It's all the same disorder that manifests differently and requires different levels of treatment. < theory.

Abi
07-21-13, 10:19 PM
Fractured, I didn't know you were bipolar? :)

When were you diagnosed?

daveddd
07-22-13, 05:11 AM
My sister (diagnosed bipolar) doesn't have my focus issues. The way I see it executive function issues in ADHD are generally always happening, apart from those few rare days and in bipolar it depends on the episodes.

Something I've also noticed is lack of sleep for me makes my ADHD worse. I don't become more manic. Well, not the type of manic that needs little sleep to be functioning at 200% the next day. And when I do get manic I burn out so quickly.

They should not be regarded as the same. The present differently. One is a serious mental illness that is completely detrimental to the person's well being. ADHD is too but to a lesser extent. I've always been able to learn a certain number of skills to control my neurological disorder symptoms but once the chemical imbalances happen I'm just out of control. Secondly, they require different forms of medication and if you give one to the person that should take the other there can be very bad reactions. Even the person with both can react badly to them.

The reason why medical diagnoses are split up is because of treatment. I think so at least.

I've only recently developed bipolar from all the medications a person with the markers for bipolar should never go on, and I can really tell the difference between just ADHD (Inattentive with AS) and bipolar.

So I wouldn't say that the executive function issues are exactly the same. When it comes to millions of peoples brains nothing is ever experienced the same. But seriously, my sister has a bit in common with ADHD but she doesn't have them to the point of impairment.

Most neurological disorders share similar symptoms. I used to try to find a link between autism and epilepsy. It's fun looking for the links but I don't think just two disorders will share a link. It's all the same disorder that manifests differently and requires different levels of treatment. < theory.

when there is 90% comorbid, there is a link

coincidences like that dont exist

the executive function impairment is the same, perception may be different

Fuzzy12
07-22-13, 07:10 AM
Dave, this is something that bothers me a lot. As you know I've been diagnosed with BP II but not ADHD. In fact, I have been diagnosed with NOT having ADHD though I have all the symptoms (except for hyperactivity).

My cognitive function is impaired, no doubt about that. Executive function seems to be non existent. I can relate more to ADHD than to bipolar. Yes, I have mood swings. Yes, I'm depressed but I've only had one or two classic hypomanic episodes. The depression and the ADHD symptoms are what I live with every day.

I can accept that BP II is causing all my executive function problems but where does that leave me? Without an ADHD diagnosis, I can't get stimulant medication. The mood stabilisers don't help with ADHD symptoms. But if I have ADHD symptoms, shouldn't I take ADHD meds? What is the alternative? Do I have to resign myself to be impaired for the rest of my life because I have BP II rather than ADHD? I feel as if I've fallen into a diagnostic gap, a grey area, a limbo, which very few experts bother to fill.

Is the physiological basis for executive function impairment the same in BP as in ADhD?

Is it true that there is a 90% comorbidity between ADHD and BP?




My sister (diagnosed bipolar) doesn't have my focus issues. The way I see it executive function issues in ADHD are generally always happening, apart from those few rare days and in bipolar it depends on the episodes.

Fractured, cognitive impairments including executive function has been shown to be present during euthymic periods as well in BP (i.e. normal periods, when you are neither depressed nor manic).


The reason why medical diagnoses are split up is because of treatment. I think so at least.

Yes, I think so too. But the problem is that in one disorder, BP, there is no treatment for executive function issues. Mood stabilisers don't help. I know, that stimulant medication can make you manic, but again, what is the alternative?

Most neurological disorders share similar symptoms. I used to try to find a link between autism and epilepsy. It's fun looking for the links but I don't think just two disorders will share a link. It's all the same disorder that manifests differently and requires different levels of treatment. < theory.

There was a study recently that found a common basis to several disorders, including ADHD and BP. I've forgotten the three others. I think, Autism and Schizophrenia were among them too but I could be wrong.

daveddd
07-22-13, 07:20 AM
High physiological arousal to emotion causing problems in self regulation have been seen in both

Per amygdala activity in brain scans


I'm curios about the bipolar dx that you get and seems quite common

And it's relation to the stuff I mentioned in the noise in our head thread


The 90% thing is true

I'm guessing the executive function is a precursor that makes us vulnerable to several "comorbids"

daveddd
07-22-13, 07:22 AM
The alternative for stimulant meds is mindfulness


Not speaking from experience


But some if the techniques have helped my social anxiety

That's as far as I got

Fuzzy12
07-22-13, 07:28 AM
These days I tend to think that rather than having one or more distinct disorders, I just have a disordered brain and that results in symptoms that fit the bill for all kinds of disorders.

I wish there was a way to treat the cause of the symptoms rather than the symptoms itself, but that's the holy grail of psychiatry I suppose.

I should really give mindfulness a shot. I don't have social anxiety but I'm sure there's other stuff it can help me with.

I remember your thread about noise in our brain and again it's something I can relate to a lot.

I'm sorry, I forgot, what's your diagnosis again? ADHD and BP?

daveddd
07-22-13, 07:40 AM
I'm like you

A bit of everything. For insurance purposes I'm ADHD and bipolar


The social anxiety issue I'm talking about is emotional dysregulation It causes distress which leads to emotion inhibition. It is caused by executive dysfunction


My judgement issues in social anxiety are different. Although most likely stemming from that

daveddd
07-22-13, 07:44 AM
The posts in that other thread I made recently Is what I think leads to these "fuzzy":). Bipolar spectrum dx

fracturedstory
07-22-13, 08:50 AM
Dave you are so black and white in your statements it's tearing my brain in two. I'm unofficially declaring you AS, although bipolar would make sense too. My sister p***es me off with her black and whiteness too.

My sister's executive dysfunction is nothing compared to mine. It's happening for a different reason. She's rapid cycling too so she barely has a normal mood, like me. I'm always popping back Ritalin just to get certain tasks done, and she can just do it.

So, I'm not buying this theory. Sorry, but someone's going to have to disagree with you. It happens. You cannot convince me. I am closed to all attempts of convincement. That's a real word.

Or maybe I just have something worse than ADHD.

daveddd
07-22-13, 08:55 AM
Point taken

But I was just going off the studies claiming executive dysfunction during periods of euthymic mood. That was the part that gets the additional ADHD dx in 90% of bipolar


But yes I have black and white tendencies. Feel free to call them out


It's part of the reason I come here. My self awareness sucks

Fuzzy12
07-22-13, 10:00 AM
I don't know. I always like your threads Dave, but maybe that's because I can relate so much.

Idiota
07-22-13, 09:26 PM
yeah, I also got shut down by social security on all of my stuff despite having some form of bipolar and other stuff. social anxiety, for instance. i cannot get a job because of it and honestly my brain has never been useful for much. i usually get petered out when push comes to shove. it's amazing how you can coast so much in life and have points where it destroys you

tomlinson
08-14-13, 07:03 PM
Dave, this is something that bothers me a lot. As you know I've been diagnosed with BP II but not ADHD. In fact, I have been diagnosed with NOT having ADHD though I have all the symptoms (except for hyperactivity).

My cognitive function is impaired, no doubt about that. Executive function seems to be non existent. I can relate more to ADHD than to bipolar. Yes, I have mood swings. Yes, I'm depressed but I've only had one or two classic hypomanic episodes. The depression and the ADHD symptoms are what I live with every day.

I can accept that BP II is causing all my executive function problems but where does that leave me? Without an ADHD diagnosis, I can't get stimulant medication. The mood stabilisers don't help with ADHD symptoms. But if I have ADHD symptoms, shouldn't I take ADHD meds? What is the alternative? Do I have to resign myself to be impaired for the rest of my life because I have BP II rather than ADHD? I feel as if I've fallen into a diagnostic gap, a grey area, a limbo, which very few experts bother to fill.

Is the physiological basis for executive function impairment the same in BP as in ADhD?

Is it true that there is a 90% comorbidity between ADHD and BP?


I don't know what the situation is in the UK, but in the States stimulant medicines many times are prescribed in cases of refractory depression.