Characteristics Of Bipolar Disorder
Bipolar disorder is best known for the shifts in mood it causes. People with bipolar disorder can move from manic or hypomanic highs to depressive lows ranging from a few times a year to as frequently as every couple of weeks.
A manic episode needs to last at least 7 days to meet the diagnostic criteria, but it can be of any duration if the symptoms are severe enough to require hospitalization.
If the person experiences depressive episodes, they must experience symptoms which meet the diagnostic criteria for a major depressive episode, which lasts at least 2 weeks in duration. If the person has a hypomanic episode, the hypomanic symptoms need only last 4 days.
You may feel on top of the world one week and down in the dumps the next. Some people with bipolar I disorder may not have depressive episodes.
People who have bipolar disorder have wide-ranging symptoms. During the depressive state, they might feel hopeless and deeply sad. They may have thoughts of suicide or self-harm.
Mania produces totally opposite symptoms, but can be just as damaging. Individuals experiencing a manic episode might engage in risky financial and sexual behaviors, have feelings of inflated self-esteem, or use drugs and alcohol to excess.
Bipolar disorder in children is called early-onset bipolar disorder. It presents somewhat differently than it does in adults.
Kids may cycle between the extremes more frequently and have more severe symptoms on both ends of the spectrum.
Depressive Symptoms Of Bipolar Disorder
The depressive symptoms of bipolar disorder include:
- Very low mood state
- A loss of interest in things that previously gave pleasure
- Dysregulation of appetite
- Significant weight loss or gain
- Change in sleeping habits
- Altered physical agitation rate
- Feelings of fatigue, worthlessness, or inappropriate guilt
- Difficulty concentrating
- Recurrent thoughts of death or suicide
Adhd Vs Bipolar: Diagnosing The Difference In Kids
Little girl having fun playing on monkey bars
Diagnosing behavioral conditions can be challenging, especially in kids. Consulting a specialist with a trained eye, who follows best practices for sifting through the symptoms, can make all the difference in obtaining a correct diagnosisand treating the condition appropriately: Enter Cristian Zeni, M.D., Ph.D., a pediatric psychiatrist and faculty member at UTHealth Department of Psychiatry and Behavioral Health. Zeni understands the complex factors involved in this overlap between ADHD and bipolar disorder.
Studies estimate that 40-80% of children with bipolar disorder also have Attention-Deficit Hyperactivity Disorder . In contrast, 11-20% of kids with ADHD have bipolar disorder. Among children with a mental or behavioral disorder, different behaviors can indicate very different conditions.
These mental health problems in children seem to surface most at school, when children are with their same-age peers. They can become distressed by school demands, worsening their mood symptoms, explains Zeni. He reminds caregivers: When children cant verbally explain whats happening, they can express themselves in different ways of acting out. For example, a child may experience anxious thoughts and express it nonverbally by displaying excessive agitation, which can be confused for hyperactivity.
For those interested in participating in research on bipolar disorders or learning more about it, please call 713-486-2627.
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Children With Adhd And Bipolar Disorder
Although symptoms of bipolar disorder typically donât emerge until early adulthood, children can receive a diagnosis. A child with both ADHD and bipolar disorder will have behavioral outbursts, experience severe mood swings, and act impulsively. If your child with ADHD exhibits an inflated sense of self, demonstrates risky sexual behavior, engages in self-harm, and has little need for sleep, then he or she also may be experiencing mania associated with bipolar disorder.6 A child psychiatrist can help rule out other diagnoses and suggest treatment options.
Bipolar Disorder Vs Adhd: Whats The Difference
Bipolar disorder and ADHD, or attention deficit hyperactivity disorder, are two conditions that continue to be diagnosed in more individuals throughout the country, ranging from children to adults. However, diagnosing the two can be difficult as they both share several symptoms, yet they are two very distinct disorders.
When a child is diagnosed with ADHD, they are more likely to develop other mental health disorders such as anxiety disorders, major depression, and bipolar disorder. This can make it extremely difficult to accurately diagnose the two conditions. ADHD is most often recognized and diagnosed at a very young age while bipolar disorder becomes more evident in the late teens to early 20s. It is important to know the difference between the two to accurately diagnose and treat them.
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What Is The Treatment For Someone With Both Adhd And Bipolar
It is estimated that as many as half of the people diagnosed with ADHD also suffer from a mood disorder on the bipolar spectrumand correct diagnosis is critical in treating bipolar disorder and ADHD together.
The management of combined bp and ADHD is generally a combined medical and psychological approach and is dependent on accurate observations of family and others close to the individual. Objective assessments of behaviors and moods over time will provide the basis for diagnosis and for evaluation of the effectiveness of the treatment strategies. Both disorders must be systematically, yet cautiously, addressed in treatment.
People with a dual diagnosis of ADHD and bipolar disorder can be treated very effectively. Its important to always diagnose and treat the bp first, as ADHD treatment may precipitate mania or otherwise worsen bp. The key lies in the recognition that both diagnoses are present and that the disorders will respond to independent, but coordinated, treatment.
How Common Is Bipolar Disorder In People With Adhd
In a , researchers sought to examine the prevalence of bipolar disorder in a group of 2.4 million people born in Denmark between 1955 and 1991.
They looked at bipolar disorder in people diagnosed with ADHD, an anxiety disorder, both, or neither.
The researchers found that bipolar disorder was almost 11 times more likely in people with a prior diagnosis of ADHD, compared with people who had no prior diagnosis of ADHD or anxiety.
The incidence rate of bipolar disorder was 30 times higher in people with a prior diagnosis of ADHD and anxiety than people who werent diagnosed with either.
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How Manic Symptoms Resemble Adhd
One hallmark byproduct of ADHD is hyperfocus, or the ability to focus intently on something of great personal interest for an extended period of time, at times mentally drowning out the world around. This may happen on deadline pressure or when wrapped up in a compelling project, book, or video game. Hyperfocus may cause a decreased need for sleep and may look like increased goal-directed activity, however this is short-lived in people with ADHD, who often feel exhausted once the hyperfocus fades. A manic episode, on the other hand, is independent of external circumstances. People with bipolar disorder often want to go to sleep or relax, but describe feeling as if there is electricity going through their bodies that they cannot stop or dampen, no matter how desperate they are for sleep. This inability to settle the mind and body can go on for a week. Going without sleep for long periods of time can trigger psychotic episodes or hallucinations.
People with ADHD often interrupt or talk too much without noticing because they miss social cues or because they lose focus on the threads of a conversation. Patients experiencing a manic bipolar episode are often aware they are changing topics quickly and sometimes randomly, but they feel powerless to stop or understand their quickly moving thoughts. This type of behavior is uncharacteristic and does not reflect how they would typically converse.
How To Treat Bipolar Disorder Or Adhd
When someone is diagnosed with bipolar disorder and ADHD, they are at a much higher risk of abusing substances, have relationship problems, legal problems, and suicidal behavior. It is essential for early intervention and comprehensive treatment that allows healthy functioning. Due to the effects of bipolar disorder and their severity, if left untreated, treatment considerations will involve mood stabilizers before treating your ADHD symptoms.
To treat bipolar disorder, it often requires a variety of medications, education, and therapy. Treatment will also include psychoeducation about healthy coping and how dangerous it can be to abuse substances. Those with ADHD and bipolar are at a greater risk of abusing substances and self-medicating their symptoms.
If you believe you may have an ADHD diagnosis in addition to bipolar disorder, you must schedule an appointment with your primary care physician to discuss your concerns. They will likely refer you to a mental health professional for a thorough assessment. You need to remember that your symptoms are not a failure, and you cant be afraid to speak up about your struggles. The more accurately you report the signs, however, the better chance you have at treating them.
Written by: Christopher Schumacher
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Manic Moods: Adhd Vs Bipolar Disorder
Though elevated energy may be one of the most commonly known symptoms of both ADHD and bipolar disorder, it manifests differently in each. For people with ADHD, something that piques an interest may inspire an intense, laser-like focus and action for a period of time, which subsides after the activity is completed. In general, there is a consistent heightened state of activity and energy for people with ADHD, and symptoms like talkativeness and fidgeting are regularly present.
For those with bipolar disorder, elevated energy is not typically triggered by an external stimulus, but manifests internally as part of the mood cycling characteristic of the disorder. This means that someone with bipolar will experience manic symptoms for a period of time, regardless of what is going on in an outside context, and then shift into another mood that is distinctly different than the manic period.
Adhd Versus Bipolar Disorder
Bipolar disorder and attention deficit hyperactivity disorder are both mental health issues that may be rooted in differences in the brain. They are in separate categories when it comes to mental health disorders, but they share some similarities. Plus, they arent mutually exclusive, and its possible for a person to have both disorders at the same time. How can you tell the difference between these two issues? Learn more about the differences and similarities between ADHD and bipolar disorder.
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How Depressive Symptoms Resemble Adhd
The ADHD brain produces an insufficient amount of dopamine, the neurotransmitter that helps control to brains reward and pleasure centers. As such, it naturally craves more dopamine, which sugar and carbohydrates deliver in spades. Feeding these cravings may result in the appetite changes, weight gain, and sleep problems described above. In addition, people with ADHD report frequent sleep disturbances and problems falling asleep due to a racing brain. Inattentiveness and difficulty concentrating may cause fatigue, especially among students and full-time employees working long days. Distractibility and poor focus can cause people with ADHD to quickly lose interest in activities or objects that once gave them pleasure as well.
The principle difference is that ADHD symptoms are contextual and situational, whereas bipolar symptoms are not triggered by any external factors. In a stimulating and positive environment, people with ADHD remain in a good internal state. If the environment is not stimulating enough, they can become bored or agitated. People with ADHD always experience life in this manner. Their sensibility and orientation toward the world is the same, even when they move through mood states of different intensities. Patients with ADHD can more often control their feelings by changing their environment and stimuli.
Treatment For Bipolar Disorder And Adhd
Having a qualified mental health professional provide an assessment and diagnosis is key to determining the right treatment. In some cases, a person may have overlapping symptoms of bipolar disorder and ADHD yet have only one of the disorders. In other cases, the person could have both as co-occurring disorders. Treatment should be tailored to the specific case.
Because the two disorders have similar symptoms, misdiagnosis happens. Its important for professionals to look at the full picture to distinguish between the two disorders and determine if they are co-occurring, and patients should continue to seek help when symptoms do not improve.
Treatment of either bipolar disorder or ADHD generally includes medication, yet treatment of both disorders together can be complex. Studies in The Journal of Psychiatry and Neuroscience review show that psychostimulant medication and atomoxetine medicationcommon treatments for ADHDhave the potential to trigger psychotic and manic symptoms, complicating the bipolar disorder. However, not all studies confirmed this, and some supported the use of these medications for people with both disorders. A combination of medications is often used when these disorders co-occur.
Comorbid Adhd And Bipolar Disorder In Adults
Comorbid ADHD and bipolar disorder has been the subject of numerous studies and much controversy in children, yet little attention has been paid in adults in spite of apparently high rates of co-occurrence. Some studies suggest that ADHD is overrepresented in individuals with bipolar disorder , and that up to 935% of adults with bipolar disorder are affected . The corollary of this is that comorbid ADHD and bipolar disorder may be underdiagnosed and undertreated .
There are several potential explanations for co-occurrence of ADHD and bipolar disorder in adults, none of which are mutually exclusive and a number of which may operate simultaneously to contribute to comorbidity. One possibility is that this finding is an artefact of symptom overlap, yet comorbid ADHD and bipolar disorder appears to be more common than would be expected by chance even when overlapping DSM-IV criteria are removed . Another possibility is Berksons bias, where treatment-seeking patients tend to present with more comorbidities than the general affected population. It is also plausible that a common diathesis leaves patients vulnerable to both conditions, but the current neurobiological understanding of bipolar disorder and ADHD is insufficient to confirm or deny this possibility .
What Happens With Adhd And Bipolar Disorder
If you have ADHD and bipolar disorder, the symptoms of each condition can make those from the other worse.
For example, if you have mania as part of your bipolar disorder but no treatment for it , then that could exacerbate any attentional deficits you might experience due to having ADHD.
And vice versa ADHD symptoms can worsen bipolar disorder, increasing the risk for a manic or depressive episode.
In other words, ADHD and bipolar disorder have an unfortunate negative effect on each others prognosis .
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When To Speak With Your Doctor
Speak with your doctor or call 911 immediately if you or someone you love has thoughts of self-harm or suicide.
Depression in bipolar disorder is particularly dangerous and difficult to spot if the persons mood is cycling between extremes.
Additionally, if you notice that any of the symptoms above are interfering with work, school, or relationships, its a good idea to tackle the root issues sooner rather than later.
Diagnosing Adhd And Bipolar Disorder
When making the diagnosis of bipolar disorder in a person with ADHD, a clinician will follow guidelines laid out in the most recent edition of the American Psychiatric Associations Diagnostic and Statistical Manual.
ADHD and bipolar disorder can share symptoms such as hyperactivity, distractibility, and reduced inhibition, which makes diagnosis difficult.
Bipolar disorder is generally episodic, meaning periods of mania and depression are often short-lived.
People with ADHD show relatively constant symptoms. A clinician can use this difference as a clue to which disorder you might be experiencing.
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How To Tell Add And Bipolar Disorder Apart
Aron Janssen, MD is board certified in child, adolescent, and adult psychiatry and is the vice chair of child and adolescent psychiatry Northwestern University.
There are some similarities and overlap in the symptoms of ADD/ADHD and bipolar disorder. Both may include hyperactive or restless behaviors, distractibility, poor concentration, impulsivity, and racing thoughts. Both are also thought to have a strong genetic link.
Both can result in sleep disturbances, poor social relationships, feelings of anxiety, depression, frustration, and self-doubt. Both can significantly impact daily functioning. In addition, ADHD and bipolar disorder commonly occur together, making it even more difficult to tease them apart.
Bipolar Vs Adhd In Children
Bipolar disorder does exist in children, though its commonly misdiagnosed as ADHD. Parents of children with ADHD describe their babies as colicky, always crying, difficult sleepers, or always moving around. Children are born with ADHD symptoms bipolar is a condition that develops and even grows in intensity. A teen with bipolar disorder can rage for hours in a destructive, disturbing way that is described as volcanic emotion or limbic rage. The limbic system is the most primitive, emotional part of the brain. With tantrums caused by ADHD, a child may be upset, but will stop if distracted by something else or when he becomes exhausted. The rage goes on much longer in children with bipolar disorder.
Children who develop bipolar disorder are often precocious, gifted, and have night terrors characterized by gore and mutilation. They have an extreme fear of annihilation, and talk about death, murder, and suicide in an obsessive, matter-of-fact way. Some children with bipolar disorder will harm animals, or experience hallucinations and psychotic symptoms of paranoia from a young age. Children diagnosed with conduct disorder or oppositional defiant disorder are at a higher risk of having bipolar disorder.
Most parents seek diagnosis for bipolar disorder when they feel something is taking over their child, who doesnt seem in his or her right mind.
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How Is Misdiagnosis Possible
Because ADHD is a more prevalent condition than bipolar disorder, many doctors are more familiar with its symptoms. There are several overlapping symptoms of bipolar and ADHD, which is why an initial misdiagnosis may occur, or a co-occurring disorder may be missed. These symptoms can include:
- Rapid, prolific speech and a tendency to interrupt others
- Increased, intense energy
- Disturbed sleep
- Fluctuations in weight
In order to assess whether these symptoms are a result of ADHD, bipolar disorder, or a combination of both, other factors must be considered. Fortunately, there are some distinct differences between ADHD and bipolar disorder that can help indicate the root cause of the symptoms.