View Full Version : how the heck do I tell if its bp or ADHD?


USMC
08-31-14, 11:49 PM
I was admitted to the psych ward after a suicide attempt a couple years ago. They took me off all ADHD meds and DX me with bp. Put me on lithium, 30 mg of zyrexa, and 2 mg of haldol 2x day. I gained 60 lbs in 4 months and had pretty much no life for the next year and a half. Finally I got tired of it and took myself off all the meds. I'm really not sure that I'm bipolar. I'm definitely an insomniac but the only time where I feel like I actually don't need sleep is when I'm on my ADHD meds. The only thing that makes me think I could possibly be bp is that I didn't outgrow my hyperactivity until very late. I was 16/17 and still couldn't stay seated in class. This wasn't fixed until I was put on meds. Anyway, I don't know if I should request to be tested for bp or what. I just really don't want to be put on anymore antipsychotic after my last experience of being over drugged.

sarahsweets
09-01-14, 04:58 AM
There are no tests for bipolar. Its diagnosed primarily through an evaluation and sometimes trial and error with meds.

USMC
09-01-14, 06:58 AM
I know they can't do any kind of blood work or brain scan or anything like that. What I'm looking for is maybe some kind of psychological testing or even like the tests they have you fill out about symptoms sometimes when trying to determine if you have ADHD.

Flory
09-01-14, 09:14 AM
It is still possible though not as common to be hyperactive as an adult ...I still struggle with hyperactivity into adulthood

Delta40
09-01-14, 09:24 AM
I guess the symptoms seem so similar that you may need to consider what combination of medications are going to work for you and then think about labels. Diagnosis can be a bit like forcing ourselves into an item of clothing handed to us blindly off the rack.It will never be the perfect fit and look. Quality of life is the priority so don't be afraid to explore formulas with your health professional.

kittyb21
09-01-14, 04:01 PM
I had a manic episode after being over medicated with SSRI's, I had never felt like that before or since...

I do not have a diagnosis of ADHD or BP, I have depression/anxiety..

I suspect I have ADHD, my mind races but the drug induced episode was far more intense and I was acting very out of control as opposed to just feeling it..

fracturedstory
09-01-14, 10:34 PM
I go manic on SSRI's, stimulants, alcohol, lack of sleep, stress etc.

What made me figure out if it was bipolar or ADHD was that my moods cycle and are not in any relation to my environment. Sometimes things happening around me can trigger a mood change, but it's usually normal > hypomanic > manic > depressed > normal for 12 secs > manic. My type of ADHD is inattentive and I've been pretty hyper since going on and coming off of Ritalin. They have me back on anti-depressants now. The fools.

I suppose to get assessed for bipolar you go to a GP, get a referral to a psychiatrist and ask them to evaluate you for bipolar. The best thing to do is become aware of your symptoms when they happen and write them down.

Kitty if you go manic on SSRI's you may have even more intense manic episodes on stimulants. I felt wired all the time on Ritalin. On SSRI's it's more hypomania. I've still not got much control on myself but at least I don't talk like I'm on speed anymore.

apoeticdevice
09-02-14, 07:40 AM
. They have me back on anti-depressants now. The fools. .

:lol::giggle:

someothertime
09-02-14, 07:44 AM
i believe you will find as a generality... bp would present in totality to those around....

where as internally with ADHD the majority manifest a persistent internal tangent ( which can often be more indicative of depression )

so, a primarily "ADHD" person is more prone to isolation... / internalisation.... hence practitioners keen attentiveness to wellbeing indicators.... rather than day to day mannerisms... put simply, a doctor is taking a risk putting anyone prone to low moods on stimulants... no matter the diganosis..... i think in a lot of ways the diagnosis is used to support the treatment modality rather than the underlying root causation.... tho in the majority of cases this modality is that which reflects the persons "current" need...

in other words.... it's very grey.... and the label is not as important as the current life experience... ( tho' as you and i know.... medium term / long term that corners many and styfles potential )...

USMC
09-03-14, 03:42 PM
Thank you everyone for your answers. I have one more question that I haven't been able to really find the answer to researching on the web. I quit taking all my bipolar meds in April and had absolutely no symptoms of mania or depression until I started back on stimulants at the beginning of this month. Is it normal to go 4 months without any mood swings or does that rule out the diagnosis of a mood disorder? I looked up another mood disorder, cyclothymia, which looks to be a less severe form of bipolar, and it said the person cannot be symptom free for more than two consecutive months or else this rules out a diagnosis. Just curious if its the same for other mood disorders.

focus pocus
09-04-14, 09:44 AM
I would love to know the answer too.
I know I have a bipolar disease (due to family history), but how do i find out if my problems with focusing are due to a comorbid ADD-Pi or due to the dis tractability of Bipolar disease itself?

namazu
09-04-14, 09:55 AM
Thank you everyone for your answers. I have one more question that I haven't been able to really find the answer to researching on the web. I quit taking all my bipolar meds in April and had absolutely no symptoms of mania or depression until I started back on stimulants at the beginning of this month. Is it normal to go 4 months without any mood swings or does that rule out the diagnosis of a mood disorder? I looked up another mood disorder, cyclothymia, which looks to be a less severe form of bipolar, and it said the person cannot be symptom free for more than two consecutive months or else this rules out a diagnosis. Just curious if its the same for other mood disorders.

No -- with both bipolar disorder (I and II) and major depressive disorder, it's possible to go for months or years between episodes. Some people have residual symptoms in between, and some people don't get a break, but there's no requirement for continuous symptoms in other mood disorders.

When you take stimulants, what kind of effects do they have on your sleep / mood / functioning?

Also keep in mind that bipolar disorder and ADHD aren't mutually exclusive, and in fact co-occur with some frequency.

USMC
09-04-14, 09:27 PM
Stimulant meds get rid of my restlessness and constant need to be "on the move." They make me very focused and less distracted by outside irrelevant stimuli. But at the same time they can make my insomniac tendencies a lot worse. Even when I take them early in the morning, I can still go that entire next night with no sleep.

fracturedstory
09-06-14, 02:55 AM
For me stimulants turned up the rapid cycling by 1000. Looking back I didn't know how I coped with cycling into a different mood 10 times a day. Then there was the minutes/seconds cycling which began to feel physically painful in my head, while making me feel like I was going insane.

The longest I've gone without a mood is about three weeks.

USMC it sounds like stimulants aren't too bad for you. Sleeplessness can be a side effect and have nothing to do with mania. If your mind is racing at the same time then that's a different story.

USMC
09-08-14, 09:46 PM
Yeah. So far I've had a pretty good experience with stimulants, with the exception of the horrible insomnia. I've tried strattera and gave it a four month trial with no luck. It did absolutely nothing. I'm going switching to concerts tomorrow to see if the insomnia and tics get any better. Really hope they do. Thanks for all the insight.

HADDaball
09-10-14, 04:04 AM
BP is a mood thing - ADD is a cognitive thing.

There would be signs if you were prone to BP if you've been taking stimulants - they would make you more unstable even on a low dose - like Fractured talks about.

You may need less stimulant to find the same balance as before.

focus pocus
09-11-14, 11:37 PM
Right now, I'm using a 2.5mg Ritalin twice a day/lots of caffeine/ 5mg Buspirone twice daily.

No mood stabilizers, No rapid cycling.

Is this sustainable in any way?

Baynyn
02-01-15, 08:58 PM
This is an interesting thread. I find myself in a similar situation. A couple of years after the initial ADD diagnosis I find myself recovering from an ADD treatment program that set off an extended manic episode which led to the discovery and subsequent diagnosis of BPD. I now am wondering whether either of the two diagnosis was absolutely correct and if in fact I'm somewhere along the pendulum and am more of an ADD who needs a less powerful stimulant so as to not induce the manic reaction.

It's a narrow tightrope to walk, but hopefully you have some good support to help you through it. I agree that the labels are less important and the symptoms should be identified correctly and treated.

sarahsweets
02-03-15, 05:47 AM
I've found that for me they cross over.

InvitroCanibal
02-05-15, 03:52 AM
I asked my doc this and he said the short answer was that it is very hard. He is a differential specialist in regards to bipolar and adhd.

He gave me some research on it and the general studies in regards to determining their differences.

One of the main aspects is intensity. Everyone has a bad day, adhd individuals are sensitive as well and can have emotional outbursts from time to time. But thats where the similarity ends with bipolar people. Bipolar individuals can experience an emotion for months. It can be very intense.

The second element is mood incongruency. An example would be this. "Normal person: I just won the lottery...im so happy!!"
"Bipolar Person: I just won the lottery...i'm so depressed"

If the mood doesnt match the situation and is very extreme and lasting versus transient than this is a symptom of bipolar and would typically classify as a hypomanic or depressive state.

Usually with bipolar, you sort of feel like you are on a roller coaster, you can feel the peaks coming but you know what's coming after that will be a crash. The going up takes months or sometimes years and so does the going down sometimes but usually the down happens faster than the up.

Mostly bipolar has unexplained emotions and fixations. Bipolar people describe what sounds like hyperfocus but looks more like addiction or ocd. They can obssess for months or years about one subject and it can be very odd or normal. Then they just abandon it one day.

That last symptom can show up in adhd as well but it's generally about looking as the gestalt or whole picture.

I would caution though that bipolar people tend to over rationalize their symptoms. This is because the trigger may seem apparent for their particular emotional state but their reaction can be overt and extreme.

An example would be "I'm not bipolar, I was just going through a period of depression/agitation because everyone at work was conspiring against me/gossiping/looking down on me, but now im fine and it's clear skies ahead."

This can be classic bipolar denial as it fails to take into account previous cyclical episodes and history. We often look at the small to change our diagnosis and therefore seek treatment only for the things we see. In other words "im depressed and anxious doc, I also find myself obssesing over things." 6 months later and "I'm not depressed anymore, why do you keep pushing meds on me doc? Cant you see im better, I just need meds for my adhd now, its become really hard to focus lately."

So all in all to summarize it, the differences are in the changes over time. One day you are adhd, the next you are ocd the next you are depressed or all of the above. You find yourself agitated or on top of the world and then crashing to a deep low and its usually by the seasons. You find yourself with endless energy in the summer and no energy in the winter. You want to move and often. You change jobs, change houses, states, cities every 3 years often on a whim. You have rash out of place behavior. You make lots of friends for a few months but you know you will lose them all in a few more months. You feel super smart one month or year and then super dumb another month or year.

Anyways hope that helps

InvitroCanibal
02-05-15, 04:12 AM
In regards to meds, I personally found that I just needed to stabilize myself with lithium which took large doses of lithium followed by titrating off and then going on lamotrigine which is an anti seizure maintinance med and lurasidone for the depressive symptoms.

It could have just been me but I think most bipolar symptoms, depending on the type are episodic and happen due to kindling. Which is essentially when the brain has no brakes to calm itself down.

This is usually why when you go to a hospital they overmedicate you. They give what are known as antimanic doses. The unfortunate result is that it scares bipolar people away from all medications in general but once you knock out the mania the only real thing you have to worry about is reducing life stress, triggers, and taking meds that prevent your system from going into another hyperexcitation mode/kindling.

The depressive symptoms used to have no true specific med and it was the hardest to treat as depression can still and often does occur even after one is stable. Luckily there is latuda which seems to work well but the price is insane.

Lamotrigine works very well for me over all at 200mgs and it took a year to get there by going up 25mgs every month. It's not always a first line med because it takes so long to titrate but the studies seemed to show that the slower you go, the more successful the treatment results in regards to maintinance.

Treating mania is the opposite.

It's unfortunate that some doctors simply keep their patients at anti manic doses without first trying the maintinance approach but it is a tricky thing because the more episodes an individual has, the harder they become to treat.

If treated early on, bipolar can be managed rather easily compared to later on. This is because bipolar is theoretically a seizure disorder in the same family as epilepsy. This is also why the seasons and specifically light spectrum changes seem to trigger it. Without treatment bipolar disorder becomes a progressive disease that can reach the levels of catatonia on the lows and psychosis on the highs.

This is why most doctors fear the maintinance approach..but it works for me because I was diagnosed earlier than most.

So in that regards I would suggest for your long term health that if you think you are bipolar, that you do everything possible to find out for sure and get treatment. Whatever it may be. Long term lithium doses are better than the alternatives and it's not easy hearing about these things but I always feel its vital to stress early treatment while it is still manageable.

Whatever you choose, I wish you luck

Delboy31
02-06-15, 08:22 PM
Was told I was manic depressive at 19, now they call me "unipoloar", either way I am not sure myself when I am having an ADD moment or if it me being either depressed, or I am reacting to something in the same way that non-diagnosed people would.

It is a tough battle.

USMC
02-08-15, 01:26 PM
Thank you! That did help a lot.
They finally figured it out and diagnosed me with mood disorder, not otherwise specified. So I do have some symptoms of bipolar but not enough to warrant a diagnosis.

InvitroCanibal
02-09-15, 02:35 AM
Glad to hear you have some answers. Wish you the best.

This might help anyone else who was wondering, it's something my doc wrote.

http://www.additudemag.com/adhd/article/2511.html

BellaVita
02-09-15, 03:25 AM
@ InvitroCanibal:

I think you may be confused about Bipolar and epilepsy being theoretically in the same family.

I found what you were referring to:
http://www.ncbi.nlm.nih.gov/pubmed/20675967

And to my understanding, it's saying that mood disorders are a frequent comorbidity in those who suffer from epilepsy.

Not that they're in the same family.

InvitroCanibal
02-12-15, 02:26 AM
@ InvitroCanibal:

I think you may be confused about Bipolar and epilepsy being theoretically in the same family.

I found what you were referring to:
http://www.ncbi.nlm.nih.gov/pubmed/20675967

And to my understanding, it's saying that mood disorders are a frequent comorbidity in those who suffer from epilepsy.

Not that they're in the same family.

I apologize for not having research, it's just what my doc said his theory was and what he was taught in med school. :scratch:

It's sort of why I wrote in "theoretically"
I typically take his word on most things because he's very good at what he does and his job is his life so he researches quite a bit. He's also one of the top specialists in the country according to psych mag so I sort of just blindly believe most things he says at this point...which is rare for me.

But where or how he got that info I can't say and hearing it second hand, it loses weight I suppose. Irregardless, it is shown that the disorder is harder to treat over time. If you'd like case studies, I can post em but otherwise i'm too lazy atm.

That doesn't make you wrong ofcourse but it was just something to look at.