Bipolar vs ADHD: A Guide for Parents and Caregivers
When it comes to mental health in children and adolescents, two conditions that are often confused with one another are bipolar disorder and attention-deficit hyperactivity disorder (ADHD). Both can share some similar symptoms, which can make it difficult for parents and caregivers to differentiate between the two. In this guide, we will explore the key differences and similarities between bipolar disorder and ADHD, as well as the best ways to identify these conditions and treat them effectively.
What Is Bipolar Disorder?
Bipolar disorder is a mental health condition that causes extreme mood swings. These mood swings can range from manic episodes, where a person feels excessively energetic, elated, or irritable, to depressive episodes, characterized by sadness, hopelessness, and low energy.
In children and adolescents, bipolar disorder can present itself differently than it does in adults. While adults typically experience periods of mania or hypomania, children may show more subtle signs of irritability or mood swings rather than full-blown manic behaviors. Experts suggest that the manic phases in children can involve periods of intense energy, hyperactivity, racing thoughts, and talkativeness, but they may not always exhibit the classic euphoric mood that adults with bipolar disorder often experience.
Bipolar I disorder involves more severe manic episodes, while bipolar II disorder is characterized by hypomanic episodes that are less intense. Both conditions can be debilitating, especially in young individuals, affecting their relationships, academic performance, and overall well-being.
What Is ADHD?
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects a person's ability to focus, control impulses, and regulate activity levels. The primary symptoms include inattention, hyperactivity, and impulsivity, which can cause significant difficulties in school, work, and social settings.
Unlike bipolar disorder, which involves episodic mood changes, ADHD symptoms are chronic and persist across various settings (e.g., home, school, social events). Children with ADHD often have difficulty focusing on tasks, following through with instructions, and sitting still. They may interrupt conversations, engage in risky behaviors, or struggle to stay organized.
While ADHD is primarily related to attention and behavior, bipolar disorder affects mood regulation, which can also manifest in impulsivity, hyperactivity, and emotional instability during manic or depressive episodes.
Bipolar vs ADHD: What Are the Similarities?
Both bipolar disorder and ADHD can involve symptoms such as impulsivity, hyperactivity, irritability, and trouble maintaining attention. For example, a child with either condition might have trouble focusing on tasks, act impulsively without considering consequences, and display emotional outbursts. However, these symptoms occur for different reasons and in different patterns.
Symptoms
While both disorders can cause difficulties with focus, they do so in unique ways. Bipolar disorder is episodic, with manic episodes alternating with depressive episodes. In contrast, ADHD is chronic, with persistent issues related to attention, hyperactivity, and impulsivity that don't fluctuate in the same way.
Depressive Symptoms
In both conditions, there can be overlap with depressive symptoms. Children with ADHD may display irritability, difficulty concentrating, and moodiness, which can resemble the depression seen in bipolar disorder. However, with bipolar disorder, the depressive episodes tend to be more pronounced and persistent, often lasting for weeks or months, compared to the short bursts of irritability seen in ADHD.
Manic Episodes
A key distinction between the two conditions is the manic episodes seen in bipolar disorder. During these phases, children may experience extreme irritability, excessive energy, racing thoughts, and an inability to sleep. These symptoms are generally much more intense than the hyperactivity and impulsivity seen in ADHD.
Bipolar vs ADHD: What Are the Differences
Although both conditions share some common symptoms, there are significant differences in terms of their nature, diagnosis, and impact on a child's development.
What It Affects
Bipolar disorder primarily affects a child’s mood, causing rapid shifts between manic and depressive episodes. These mood swings can have a profound impact on the child’s social life, school performance, and overall mental health, including extreme sadness, low energy levels, loss of pleasure, in addition to hypomania or mania, such as irritability, reduced need for sleep and inflated self-esteem.
On the other hand, ADHD is characterized by persistent issues with attention, focus, and impulse control. Children with ADHD may struggle to organize tasks, remember instructions, or sit still for extended periods. ADHD can lead to difficulties in school and with relationships, but it does not cause the dramatic mood swings seen in bipolar disorder.
When It’s Diagnosed
Bipolar disorder often emerges later in adolescence or early adulthood, although it can manifest in younger children as well. In contrast, ADHD is typically diagnosed earlier, often before the age of 12, as symptoms usually start to appear in early childhood.
The diagnosis of bipolar disorder in children is particularly challenging because moodiness and irritability can be a normal part of adolescence. However, when these symptoms occur in manic phases, they may be indicative of bipolar disorder. ADHD, on the other hand, is characterized by ongoing symptoms of inattention, hyperactivity, and impulsivity that interfere with daily life.
Bipolar vs ADHD: Treatment Options
Both bipolar disorder and ADHD are treatable conditions, but the treatment methods may vary significantly due to the differences in their underlying causes.
Bipolar Disorder Treatment
Treatment for bipolar disorder in children typically involves emotional regulation, skill building, lifestyle modifications and therapies including dialectic behavioral therapy (DBT) and cognitive-behavioral therapy (CBT) to help children develop coping strategies and manage mood swings. Mindfulness and sensory tools are also encouraged in supporting regulation. Lifestyle factors, including consistent sleep patterns, play outside and nutrient dense meals and snacks are also important in supporting body and mind modulation. Medication may also be used in conjunction with these modalities.
ADHD Treatment
ADHD treatment often involves stimulant medications as well as behavioral therapy to help children develop better organizational skills, executive functioning, emotional regulation, and coping mechanisms. Non-stimulant medications may also be commonly prescribed. Sensory tools are also encouraged to support regulation and executive function. Similarly, lifestyle factors including sleep, play outside and nutrient dense meals are all supportive for ADHD.
When Should You Seek Professional Help for Bipolar Disorder or ADHD?
If you notice that your child is showing symptoms of impulsive behaviors, mood swings, or difficulty managing emotions, it’s essential to seek the advice of a mental health professional. An accurate diagnosis is crucial, as the treatments for these conditions differ significantly.
It’s important for the professional to gather comprehensive information, including family history and input from teachers, to assess your child’s symptoms over time. A thorough evaluation will help ensure that your child receives the correct diagnosis and treatment.
Next Steps
If you are concerned about your child's behavior or suspect they may have bipolar disorder or ADHD, it's essential to consult with a licensed mental health professional. A proper evaluation will ensure your child receives the right treatment for their condition.
For more guidance and support, schedule a free consultation with one of our licensed therapists at Handspring Health here.
