Attention deficit hyperactivity disorder (ADHD) and bipolar disorder are two psychiatric disorders that are often misdiagnosed due to similar symptoms. Accessing the onset of symptoms, nature of mood changes, hyperactivity levels and family history can lead to diagnosis of the correct disorder.
Age of Onset
ADHD is usually diagnosed in childhood, as the symptoms of inattention or hyperactivity should be present by age seven. Bipolar disorder can appear in childhood, but is not usually diagnosed until early adulthood.
Mood Changes
Patients with bipolar disorder have manic episodes, during which they can be irritable, talkative and sleep little, and then cycle to depressive episodes, during which they can be unmotivated, lethargic and sad. ADHD sufferers do not suffer from mood disturbances, although frustration with others can lead to anger outbursts.
Attention
ADHD is characterized by short attention span and easy distractibility. Patients with bipolar disorder can also experience distractibility in manic or depressive episodes, and as such, this is one symptom that cannot confirm a specific diagnosis of either ADHD or bipolar disorder.
Hyperactivity and Impulsivity
ADHD is characterized by hyperactivity and impulsivity. Examples include interrupting others, being unable to sit quietly, and running around excessively. Bipolar disorder patients may suffer from hyperactivity and impulsivity, as well, but only during manic episodes, and not during depressive episodes. Thus, constant hyperactivity differentiates ADHD from bipolar disorder.
Impairment in Relationships and Work
ADHD sufferers must have impairment in two or more settings such as school, work, family, or personal relationships for a positive diagnosis. Bipolar disorder sufferers have similar impairments, but also may be capable of hurting themselves, unlike ADHD patients. Misbehavior in ADHD patients stems from carelessness and inattention, while bipolar patients often act out intentionally.
Family History
Bipolar disorder often is seen in multiple family members, while ADHD does not have as strong of a genetic component. Thus, family history of bipolar disorder can be a clear sign that the patient has bipolar disorder and not ADHD.
References
- DSM-IV Diagnostic Criteria of Mental Disorders
- "The Bipolar Child: The Definitive and Reassuring Guide to Childhood's Most Misunderstood Disorder"; Demitri and Janice Papolos; 2006
