No, untreated ADHD doesn't directly turn into bipolar disorder, but they share genetic/biological roots, and having untreated ADHD significantly increases the risk of developing bipolar disorder or being misdiagnosed, as symptoms like impulsivity and mood shifts overlap, making early detection harder and worsening outcomes for both, with research showing higher rates of bipolar diagnosis in ADHD populations and earlier bipolar onset in those with ADHD.
Some 60-70% of those with bipolar disorder also have ADHD, and about 20% of those with ADHD have bipolar disorder. This rate of comorbidity indicates that people suspected to have one or the other condition should be tested for both.
Manic episodes are not a symptom of ADHD, but a person with ADHD may experience some of the symptoms of a hypomanic episode. Although there may be some symptom similarities, the underlying causes of bipolar disorder and ADHD are different.
Other patients may find that their manic episodes are triggered by the chaos of untreated ADHD symptoms and executive dysfunction; for them, a stimulant medication that keeps ADHD in check may lessen the frequency of bipolar mania.
Adults with ADHD: On the other hand, some studies show that around 15% to 25% of adults diagnosed with ADHD may develop bipolar disorder over the course of their lifetime (Wozniak et al., 1995).
(2021) demonstrated that undiagnosed ADHD was significantly associated with lower self-esteem, higher depression, higher emotional symptoms and higher risks of self-harm.
While some symptoms of ADHD and symptoms during the manic phases of bipolar disorder can overlap — such as fast-talking and hyperactivity — the conditions are vastly different. One of the primary differences between ADHD and bipolar symptoms is that symptoms of ADHD are chronic (ongoing).
The 24-hour rule for ADHD is a self-regulation strategy to combat impulsivity by creating a mandatory waiting period (often a full day) before reacting to emotionally charged situations or making significant decisions, allowing time for reflection and reducing regretful snap judgments, especially for things like impulse purchases or arguments. It's a pause button that gives the brain space to process, move from impulse to intention, and evaluate choices more logically, helping manage ADHD's impact on emotional regulation and decision-making.
The first red flag of bipolar disorder often appears as significant changes in sleep patterns, mood instability (irritability/euphoria), increased energy/agitation, and rapid thoughts/speech, frequently mistaken for unipolar depression or normal moodiness, with sleep disruption (insomnia or oversleeping) and heightened irritability being very common early signs, notes Better Mental Health.
CONCLUSION. This study suggests that methylphenidate may increase the risk of treatment-emergent mania in patients suffering from bipolar disorder when it is used without a concomitant mood-stabilizing treatment.
Five key signs of bipolar disorder involve extreme mood shifts, including manic symptoms like inflated energy, reduced need for sleep, racing thoughts, impulsivity (spending, risky behavior), and irritability, alongside depressive symptoms such as profound sadness, loss of interest, fatigue, significant sleep/appetite changes, and suicidal thoughts, all lasting for extended periods and impacting daily life.
An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis.
Key Takeaways. Mania is characterized by elevated mood, increased activity, and impulsive behavior, whereas ADHD involves consistent patterns of inattention and hyperactivity. Manic episodes are episodic, often lasting days to weeks, while ADHD symptoms are chronic and persist over time.
Both conditions share features such as impulsivity, mood instability, and restlessness, making differential diagnosis particularly challenging. These shared characteristics can lead to situations where ADHD is misdiagnosed as bipolar disorder, potentially resulting in years of ineffective treatment.
As mentioned previously, the most common misdiagnosis for bipolar patients is unipolar depression. An incorrect diagnosis of unipolar depression carries the risk of inappropriate treatment with antidepressants, which can result in manic episodes and trigger rapid cycling.
In managing such states a sequential approach is favoured, with the bipolar condition being brought under control first before initiating any stimulant medication for the ADHD.
Factors that may raise the risk of getting bipolar disorder or cause the first episode include: Having a first-degree relative, such as a parent or sibling, with bipolar disorder. Periods of high stress, such as the death of a loved one or another traumatic event. Drug or alcohol misuse.
The Big Five personality comprises independent traits of neuroticism, extraversion, openness to experience, agreeableness and conscientiousness (McCrae and John 1992) and forms the basis of several personality inventories (Costa and McCrae 1992).
Bipolar symptoms during a manic phase may include:
getting much less sleep or no sleep. poor appetite and weight loss. racing thoughts, racing speech, talking over people. highly irritable, impatient or aggressive.
Increase stress relief by exercising outdoors—people with ADHD often benefit from sunshine and green surroundings. Try relaxing forms of exercise, such as mindful walking, yoga, or tai chi. In addition to relieving stress, they can teach you to better control your attention and impulses.
Start by choosing a task — something you've been avoiding, something that feels too big, or just something on your daily to-do list. Set a timer for 10 minutes and work on that task with full focus, knowing that a break is just around the corner. When the timer goes off, take a 3-minute break to reset your brain.
She also recommends encouraging children to go to bed and wake up at the same time every day. Most children require seven to nine hours of sleep every day and teens with ADHD need about eight to 10 hours.
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.
Symptoms of bipolar disorder
Environmental Factors
Stressful life events, trauma and significant life changes can trigger or worsen the symptoms of bipolar disorder. Creating a stable and supportive environment can help manage these triggers.