When bipolar disorder (BD) and ADHD co-occur, they worsen each other, leading to more severe symptoms like emotional instability, impulsivity, and cognitive issues, earlier BD onset, more frequent mood swings, higher rates of substance abuse, and poorer treatment response compared to having just one condition. The ADHD's chronic inattention and hyperactivity blend with BD's episodic mood states, making symptoms harder to distinguish and manage, with mood stabilizers potentially less effective and ADHD meds risking mood destabilization.
Symptoms in Adults with ADHD and Bipolar Disorder
When ADHD and bipolar disorder co-occur in adults, the symptoms can overlap in the following ways: Impulsivity and Hyperactivity: Both disorders share symptoms of impulsivity and poor decision-making.
It's possible to have both ADHD and bipolar disorder. While the cause of ADHD and bipolar disorder remains unknown, risk factors include both genetic and environmental factors. Bipolar disorder is a mood disorder, while ADHD affects behavior and focus, but these two conditions share many of the same symptoms.
7 tips for how to treat ADHD and bipolar disorder together
The mood shifts of bipolar disorder are usually sustained. For instance, to get the designation of “rapid cycling” bipolar disorder the person need only experience four shifts of mood from high to low or low to high in a 12 month period of time. Many people with ADHD experience that many mood shifts in a single day.
The ADHD "30% Rule" is a guideline suggesting that executive functions (like self-regulation, planning, and emotional control) in people with ADHD develop about 30% slower than in neurotypical individuals, meaning a 10-year-old might function more like a 7-year-old in these areas, requiring adjusted expectations for maturity, task management, and behavior. It's a tool for caregivers and adults with ADHD to set realistic goals, not a strict scientific law, helping to reduce frustration by matching demands to the person's actual developmental level (executive age) rather than just their chronological age.
The 20-minute rule for ADHD is a productivity strategy to overcome task paralysis by committing to work on a task for just 20 minutes, leveraging the brain's need for dopamine and short bursts of focus, making it easier to start and build momentum, with the option to stop or continue after the timer goes off, and it's a variation of the Pomodoro Technique, adapted for ADHD's unique challenges like time blindness. It helps by reducing overwhelm, providing a clear starting point, and creating a dopamine-boosting win, even if you only work for that short period.
The Ring of Fire ADHD subtype receives its name due to the “ring of fire” pattern of increased brain activity seen on the SPECT scans. It is characterized by intense emotions and sensory sensitivities — symptoms that may cause it to be mistaken for bipolar disorder or autism.
Manic episodes are episodic, often lasting days to weeks, while ADHD symptoms are chronic and persist over time. Both conditions can coexist, making diagnosis challenging; however, they require different treatment approaches.
Effectiveness of Mood Stabilizers on ADHD and Comorbid BD
Risperidone was shown to improve both mania symptoms in these subjects and ADHD symptoms when comparing baseline to endpoint scores. The ADHD symptoms that showed improvements were hyperactive-impulsive (p <0.05) and inattentive (p <0.05) symptoms.
Around 1 in 7 patients with bipolar disorder and ADHD experienced worsening of mood, irritability, or anxiety on stimulants with mood stabilizers in place, based on results from 6 small clinical trials.
There is significant research that shows mindfulness and meditation improve mood and positive feelings. Moreover, meditation has been demonstrated to improve many symptoms of ADHD including focus, concentration and mood regulation. There are many strategies for increasing mindfulness.
The Takeaway. A poor diet can contribute to bipolar mood episodes, and certain food choices may help manage them. People with bipolar disorder should avoid or limit caffeine, alcohol, sugar, salt, and saturated fats.
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.
How many hours should a bipolar person sleep? People should try to sleep at least 7 hours per night, regardless of whether they have a condition such as bipolar disorder.
As an alternative, non-stimulant medications such as atomoxetine (Strattera) are often considered safer for those with co-occurring bipolar disorder. Studies have indicated that atomoxetine can effectively manage ADHD symptoms without triggering manic episodes (Biederman et al., 2005).
On the other hand, when compared with BD patients without ADHD, BD patients with ADHD displayed a more severe and chronic course of mood disorder, shorter euthymic intervals, a greater number of both (hypo)manic and/or depressive mood episodes, higher rates of mixed depressive and borderline features, greater affective ...
This can result in tantrum-like behaviour that some compare to a metaphorical volcanic eruption. Symptoms of an ADHD meltdown include: Physical reactions like feet stomping, clenching fists, or throwing objects. Making loud noises including yelling and screaming.
Absolutely. ADHD and depression can, and often do, occur together. It's not just coincidence—there's a significant overlap between these conditions, and it's more common than you might think. Studies show that people with ADHD are at a higher risk of developing depression compared to the general population.
The ADHD "2-Minute Rule" suggests doing any task taking under two minutes immediately to build momentum, but it often backfires by derailing focus due to weak working memory, time blindness, and transition difficulties in people with ADHD. A better approach is to write down these quick tasks on a separate "catch-all" list instead of interrupting your main work, then schedule specific times to review and tackle them, or use a slightly longer timeframe like a 5-minute rule to prevent getting lost down "rabbit holes".
Invisible ADHD symptoms
The ADHD "30% Rule" is a guideline suggesting that executive functions (like self-regulation, planning, and emotional control) in people with ADHD develop about 30% slower than in neurotypical individuals, meaning a 10-year-old might function more like a 7-year-old in these areas, requiring adjusted expectations for maturity, task management, and behavior. It's a tool for caregivers and adults with ADHD to set realistic goals, not a strict scientific law, helping to reduce frustration by matching demands to the person's actual developmental level (executive age) rather than just their chronological age.
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.
For adults, 7-8 hours is recommended. Try to avoid napping during the day. Optimise your sleep environment. Make sure your environment is quiet, calm and comfortable.
What is the Five-Second Rule? The Five-Second Rule is a technique to get things done the moment they cross your mind. The rule is once you get an instinct or gut feeling to do something that you know you should be doing, start it immediately.