The Physician’s Guide for Distinguishing Bipolar Disorder and ADHD

People with ADHD report racing thoughts, which they can grasp and appreciate but can’t necessarily express or record quickly enough. With mania, the patient’s racing thoughts flash by like a flock of birds overtaking them so fast that their color and type is impossible to discern. These distracting and disconcerting racing thoughts are often mistaken for ADHD, though they are quite different in nature.

Speaking of dissociation. Let’s talk about sensory overload. Sensory sensitivity is a key feature of ADHD; it is a lesser-known aspect of bipolar. Recent research found that people with bipolar disorders were more sensitive to noise and other senses, which are correlated to differences in the brain and how it processes sensory information. It was found to be more common during mania (Wang et al., 2014)

There is also a type of bipolar spectrum disorder that doesn’t fit neatly into manic or depressive episodes called NOS (not otherwise specified). In the course of a day, people with NOS might experience both mania and depressive symptoms.

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ADHD is a neurological condition; bipolar is a mood-based disorder. Many people with bipolar disorder may find that even when their mood is stabilized with the right medication and treatment, they still struggle to meet deadlines, keep their focus on a task, and stay organized.

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· Weiss Functional Impairment Rating Scale (WFIRS) (PDF)

Here is some data to get us started:

5) Difficulty organizing tasks,

The Physician’s Guide for Distinguishing Bipolar Disorder and ADHD

Treatment for ADHD includes medications and behavioral therapy. ADHD medications can be psychostimulants, nonstimulants, or antidepressants. These include:

Bipolar disorder is characterized by high, euphoric, or irritable periods called mania and low periods of depression. The mania stage is sometimes mistaken for hyperactivity and the low states manifest themselves as inattention and lack of motivation, which are common in individuals with ADHD.

2 Schiweck C, Arteaga-Henriquez G, Aichholzer M, et al. Comorbidity of ADHD and adult bipolar disorder: a systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews. 2021;124:100-123.

The Connection Between ADHD and Bipolar Disorder

ADHD Vs Bipolar Disorder

People with ADHD do not have innate focus difficulties; they have difficulties regulating focus and can hyper-focus on a project of interest. During the context of mania, a person may also experience hyper-focus.

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Changes in Appetite

What to look for (clinicians): What is the gap between the person’s values/baseline and the behavior? In the context of ADHD, reckless behavior is often due to difficulty thinking through the consequences of actions. In the context of mania, there is a disregard for consequences.

In adults, bipolar disorder is marked by mood changes that go from depression to mania. Adult mania is characterized by less need for sleep, rapid speech, euphoria, grandiosity, irritability, racing thoughts, and frenetic activity.

Bipolar Disorder or ADHD

How Is ADHD Tested and Diagnosed?

9) Interrupts or intrudes on other people/other people’s possessions

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Clinicians working to differentiate between ADHD and bipolar disorder should conduct a comprehensive, clinical interview that aims to determine whether the following unique signs of bipolar disorder are present:

· Wender-Reimherr Adult Attention-Deficit Disorder Scale (WRAADDS),

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