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Mood Swings, Distractibility, or Both? Exploring Bipolar Disorder and ADHD Comorbidity

Bipolar disorder is a serious mental health condition that causes significant changes in mood, energy, activity levels, and decision-making. It can affect every area of life—and when it overlaps with ADHD (Attention-Deficit/Hyperactivity Disorder), it can be especially complex to understand and manage.


Below, we’ll break down the different types of bipolar disorder, how it compares to ADHD, and what treatment approaches can help when both are present.



Two people sit in a modern office. One holds a tissue, appearing thoughtful, while the other takes notes. Wooden slat wall and plants behind.


🧠 What Is Bipolar Disorder?


There are three main types of bipolar disorder, each with different patterns of mood episodes:


Bipolar I Disorder


  • Characterized by manic episodes lasting at least 7 days, or symptoms severe enough to require immediate medical attention.

  • Typically includes depressive episodes lasting at least 2 weeks.

  • May include mixed episodes, where both manic and depressive symptoms occur at the same time.


Bipolar II Disorder


  • Involves a pattern of depressive episodes and hypomanic episodes (less severe than full mania).

  • Does not include the full manic episodes seen in Bipolar I.


Cyclothymic Disorder (Cyclothymia)


  • Includes recurring hypomanic and depressive symptoms that don’t meet the full criteria for a mood episode.

  • Symptoms are more subtle but still disruptive over time.



How Are Bipolar Disorder and ADHD Related?


ADHD and bipolar disorder share overlapping symptoms, making diagnosis and treatment more complex—especially when both conditions are present. Studies estimate that up to 20% of people with ADHD may also be diagnosed with bipolar disorder.


Here’s how they differ and where they intersect:


Presence of Symptoms


  • ADHD is chronic and consistent. The symptoms are always present, though they may vary in intensity depending on context.

  • Bipolar disorder is episodic. A person may feel stable for weeks or months, then experience intense depressive or manic episodes.


Age of Onset & Family History


  • ADHD develops in childhood and often persists into adulthood. Many adults receive a diagnosis later in life that helps explain lifelong challenges.

  • Bipolar disorder typically appears in the mid-20s.

  • Both disorders can run in families, but bipolar disorder often has a more direct family history.


How Depression Manifests


  • In ADHD, depression and anxiety are often secondary, developing in response to long-term struggles with executive function, relationships, or performance.

  • In bipolar disorder, depression is a core feature of the condition—not usually caused by external frustrations.


Mood Shift Patterns


  • ADHD mood shifts are:


    • Triggered by external events

    • Sudden and intense (often described as “crashes” or “snaps”)

    • Short-lived (usually hours)


  • Bipolar mood shifts are:


    • Often untriggered

    • Slower in onset (hours or days)

    • Longer-lasting (days to weeks)



Comparison of ADHD and BD, highlighting shared symptoms. Green for ADHD, blue for BD. Includes onset and mood differences. Agave Health logo.


Treatment Considerations for ADHD and Bipolar Disorder


Treating both ADHD and bipolar disorder at the same time requires a careful, individualized approach.


Medication


  • ADHD medications like stimulants can improve focus—but may trigger mania in those with bipolar disorder.

  • Bipolar disorder medications, such as mood stabilizers and antipsychotics, may help with mood regulation but can complicate ADHD symptoms.


Because of this, finding the right balance often involves:


  • Close psychiatric supervision

  • Adjustments over time

  • Trial and error with medications


Therapy


  • Cognitive Behavioral Therapy (CBT) is highly effective for both conditions.

  • It helps with:


    • Managing emotional dysregulation

    • Shifting negative thought patterns

    • Building structure and coping strategies



The Bottom Line


Living with ADHD, bipolar disorder, or both can be overwhelming—but with the right support, treatment, and education, you can thrive.


If you’re experiencing overlapping symptoms, don’t hesitate to seek professional guidance. A correct diagnosis is the first step toward relief—and a better quality of life.



Resources & Further Reading




Need Support Managing ADHD and Mood Symptoms?


Agave Health offers ADHD-informed coaching and therapy to help you navigate overlapping symptoms, executive dysfunction, and emotional ups and downs.




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