It’s a story that plays out far too often: someone walks in struggling with mood swings, distractibility, energy fluctuations, and impulsivity. They’re desperate for answers. Instead, they walk out with a diagnosis that might not fit, often unsure whether they’re living with ADHD (Attention-Deficit/Hyperactivity Disorder) or bipolar disorder.
If you’ve been confused, overwhelmed, or doubting your diagnosis, you are not alone—and you are not imagining things. Misdiagnosis between ADHD and bipolar disorder is incredibly common. Both conditions share several overlapping symptoms. However, they require very different treatment strategies. This means getting the right diagnosis is an essential step in your recovery journey.
Overlapping Symptoms
At first glance, ADHD and bipolar disorder look surprisingly similar. Both can involve:
- Trouble concentrating. People with ADHD often find it challenging to stay focused on one task, frequently becoming distracted by their thoughts or the environment around them. In bipolar disorder, concentration can also be impaired. During depressive episodes, mental fog and lack of motivation are common. During manic phases, thoughts can race so quickly that it’s hard to follow through on anything.
- Impulsive behavior. Impulsivity is a core trait of ADHD. It might show up as interrupting others, making snap decisions, or engaging in risky behavior without considering the consequences. In bipolar disorder, impulsive behavior is more likely to occur during a manic or hypomanic episode. It’s often more extreme and tied to an elevated or irritable mood.
- Sleep disturbances. It is common for people with ADHD to often have trouble falling asleep or waking up refreshed, partly due to racing thoughts or difficulty unwinding at night. Those with bipolar disorder also experience sleep disruptions in different ways. During mania, they may go for days with very little sleep and still feel energized. During depression, they might sleep excessively or struggle with insomnia.
- Mood changes. Mood fluctuations can occur in both disorders. However, ADHD-related mood swings are usually short-lived and triggered by environmental factors like boredom and overstimulation. The mood changes seen in bipolar disorder are more extreme and last longer—often for days, weeks, or even months—regardless of external circumstances.
- Difficulty with emotional regulation. A person with ADHD might cry easily, become frustrated quickly, or have a hard time calming down. A person with bipolar disorder may also experience intense emotions, but these are generally tied to their mood episode and not a consistent behavior over time.
Key Differences
ADHD is a neurodevelopmental disorder, meaning it originates in early brain development. Symptoms typically start in childhood, though they may be missed or dismissed until adulthood.
The most important thing to remember here is that the traits of ADHD—such as distractibility, impulsivity, and hyperactivity—tend to be stable and persistent over time. They don’t come and go in cycles, and they are present across school, work, and home.
Bipolar disorder is a mood disorder characterized by clearly defined episodes of depression and mania (or the milder form, hypomania). While ADHD symptoms persist over time, a person with bipolar disorder may feel intensely euphoric and unstoppable for several days or weeks, followed by periods of deep depression. The changes are dramatic, often impair functioning, and may include psychotic symptoms in severe cases.
ADHD and Bipolar Disorder Can Coexist
You might be surprised to learn that about 20% of people with bipolar disorder also meet criteria for ADHD. It’s called a comorbid diagnosis.
When ADHD and bipolar disorder occur together, symptoms can interact in ways that make both conditions harder to manage. For example, the impulsivity from ADHD may amplify risk-taking behaviors during bipolar manic episodes.
For someone with both ADHD and bipolar disorder, a misstep in treatment—like starting a stimulant without mood stabilization—can worsen symptoms or lead to a mental health crisis. That’s why integrated care is key. Therapy focused on emotional regulation, routine-building, and coping skills can be just as important as medication.
Why the Right Diagnosis Matters
A misdiagnosis can mean the wrong treatment—stimulant medications for ADHD, for instance, can worsen symptoms of bipolar disorder by triggering manic episodes. Likewise, treating someone with bipolar disorder using only mood stabilizers may do little to address the chronic inattention or impulsivity caused by ADHD.
That’s why it’s so important for evaluations to be thorough. A diagnosis should be made based on:
- A detailed personal and family mental health history. Genetic and generational patterns can offer crucial clues, as both ADHD and bipolar disorder often run in families.
- Timeline and age of symptom onset. Pinpointing when symptoms first appeared helps distinguish between disorders, since ADHD typically begins in childhood while bipolar disorder often emerges later.
- Functional impairments across life areas. Evaluating how symptoms affect school, work, relationships, and daily routines provides insight into the disorder’s impact and consistency.
- Input from people who know the individual well. Friends and family can offer observations about behavior patterns and mood changes that the person may not fully recognize or remember.
You Deserve Treatment That Sees the Whole You
Whether you’re struggling with focus, mood swings, or just don’t feel quite like yourself, the team at Eagle View Behavioral Health in Bettendorf, Iowa is here to help. With individualized treatment plans and trauma-informed care, we work with you to create a path that fits your needs—not just your diagnosis. Reach out today for a free, confidential assessment.
