How Often Does ADHD Co-Occur With Bipolar Disorder?

​As an experienced bipolar disorder psychiatrist, I am often asked how often does ADHD co-occur with bipolar disorder? While this is quite common, many disorders can co-occur with each other, and all of these issues need to be addressed in order for any treatment plan to be successful.
 
According to the National Institutes of Health, nearly 3% of all adults in the United States have some type of bipolar disorder so this mood disorder is much more prevalent than you might think. ADHD (Attention Deficit Hyperactivity Disorder) is even more common, and it is estimated that about 5% of adults have this disorder and perhaps as many as 9% to 10% of children may have ADHD.
 
But, how often does ADHD co-occur with bipolar disorder? This question is difficult to answer definitively, but one thing I’ve found is that many of the symptoms of each disorder are quite similar. As a psychiatrist, my goal is to discover if a patient has bipolar disorder or ADHD or a combination of the two, which certainly could be the case.
 
Both ADHD and bipolar disorder often include symptoms such as irritability, restlessness, hyperactivity, increased energy and impulsivity, but there are some key differences. For instance, with bipolar disorder, a person will experience severe mood swings, ranging from elation to extreme depression and these mood swings can last for days or weeks.
 
People with ADHD may be quick to anger, but these mood changes tend to be more appropriate to the situation and they have less difficulty calming themselves than a person with bipolar disorder. People with bipolar disorder also might actively seek out problems and dangerous situations that might cause them to act out in anger or express rage. With ADHD, these are isolated moments of strong emotion usually reacting to a specific situation rather than episodes of mania or depression that last for a long time and have no identifiable trigger.
 
Additionally, with both ADHD and bipolar disorder, you might see symptoms such as distractibility or inattention. With ADHD, these are symptoms that tend to always be present, while a person with bipolar disorder might only experience these issues during a manic phase.
 
Likewise, both disorders can cause sleep-related issues. With ADHD, a person might be experience discomfort and fatigue due to sleep deprivation. With bipolar disorder, there also might be a lack of sleep during a manic phase, but without fatigue or a lack of energy accompanying this sleep deprivation.
 
While these conditions have many similarities and differences, it is not uncommon for a person to experience both disorders concurrently. Some studies have shown that more than 60% of people with bipolar disorder also have ADHD. Because of this comorbidity, it’s not uncommon for a doctor to miss one of these diagnoses.
 
A proper complete diagnosis is crucial for treatment to be effective. With bipolar disorder, medication is a common treatment option and while many people with ADHD often take medication, as well, we tend to use different medications to treat ADHD than we would for bipolar disorder. Additionally, both patients benefit from other types of therapy, such as cognitive-behavioral therapy and other strategies.
 
Additional Co-Occurring Disorders
When we talk about how often ADHD co-occurs with bipolar disorder, we often forget that many other disorders also can be present. For instance, many people with ADHD or bipolar disorder also have an anxiety disorder or depression. A substance use disorder also can be a common co-occurring disorder with either ADHD or bipolar disorder.
 
Additional co-occurring disorders might include obsessive-compulsive disorder, borderline personality disorder or even an eating disorder or body dysmorphia. It also is important to take into consideration other possible physical diseases that may have an impact on treatment for mental health disorders. For instance, if a person has diabetes, stabilizing insulin levels could have a positive effect on lessening some of the symptoms of a mood disorder.
 
Psychiatrists should, and must, in my opinion, take the time to truly assess each patient’s physical and mental issues. As an example, if a patient came to you with bipolar disorder, a substance use disorder and suffered from chronic pain, you need to address all three, including the chronic pain, as this can be a reason why people turn to alcohol and drugs and chronic pain has a distinct impact on our mental health.
 
Finding A Diagnosis
The first step to finding a diagnosis is a thorough evaluation and for this, you will need to start with a bipolar disorder psychiatrist or ADHD psychiatrist, although most will treat both conditions. A psychiatrist is a medical doctor that specializes in mental health disorders. Not only is a psychiatrist the only mental health professional able to prescribe medication, but they also have the medical expertise necessary to look at all physical and mental issues and arrive at a complete diagnosis.
 
Once we’ve arrived at the diagnosis, the next step is to create a treatment plan, and this often includes medication, but it also typically includes different types of therapy. Psychiatrists don’t typically provide this therapy and you will need to find a therapist or psychologist to help you with this portion of your treatment.  
 
Achieving Long-Term Success
In addition to working with a psychiatrist and therapist/psychologist, I do have some additional advice for those seeking treatment for bipolar disorder, ADHD and other co-occurring disorders. These include:
 
1. Have Patience
It takes time to identify the treatment options and the best medications as well as the ideal dosage. It takes time for medications to work in general, but we often start with a low dose and alter the dose after a few weeks or months. There’s no magic cure that will delete all of your symptoms overnight, so you need to be committed to taking your medication and attending therapy sessions and understand that it takes time to find the best fit for your needs.
 
In some cases, such as with substance-use disorders, we might need to address that issue first and then work toward a solution for the co-occurring mental health disorders. While it takes time, in the end, you can live a much happier, healthier and more fulfilling life, which is always our goal.
 
2. Avoid Online “Experts”
While it can be very helpful to learn all you can about bipolar disorder and ADHD, the internet is full of misinformation. There are hundreds of so-called psychiatric “experts” on social media sites such as YouTube, Reddit, Tik Tok and other sites that will tell you all about bipolar disorder or ADHD and how to “diagnose yourself” or promise all-natural cures. While there is helpful information out there, too often, these postings are filled with half-truths and not with the information that you need.
 
It’s also important to keep in mind that what works for one person might not work for another. Head to any message board about a specific drug and you’ll find 100 people who it helped and another 100 who it did not help. Every human is unique and needs an individualized treatment plan to ensure the best results.
 
When you look for information on the internet, search for sources that include people with degrees in psychiatry and psychology and scientists that have studied ADHD and bipolar disorder in-depth as well as pharmacology. Look for long-standing publications with solid reputations for accuracy.
 
3. Take Care Of Yourself
Medication and therapy are helpful, but they aren’t the only steps that you can take to alleviate the symptoms of bipolar disorder or ADHD. With both of these issues, some studies show that sticking with a healthy diet and a daily exercise routine can be very helpful. Some people often find that activities such as meditation can be beneficial.
 
It can be smart to create a manageable daily schedule for yourself that includes planning healthy meals, time for exercise and maybe some time spent outdoors in the fresh air and sunshine. Create a nightly routine to help yourself relax and more easily transition into sleep. A structured daily plan can make it easier to achieve stability and lower stress levels.
 
For those who need psychiatric help, I specialize in the treatment of bipolar disorder, ADHD and other co-occurring disorders. While I have offices in Thousand Oaks, I also offer telepsychiatry services throughout Southern California, so we can meet securely and virtually from just about anywhere. In fact, many people prefer using the services of an online psychiatrist because you can relax in the privacy of your own home.
 
If you have been wondering how often does ADHD co-occur with bipolar disorder or another psychiatric disorder, I hope this blog has helped you understand a bit about co-occurring disorders and treatment options. If you are suffering from any psychiatric disorder, please give me a call and let’s find a treatment plan that works for you.