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Can bipolar disorder mimic ADHD symptoms in children and teens?

Dr. Michael Roizen, MD
Internal Medicine

Oh, yes. This is one of the reasons diagnosing ADHD and bipolar disorder is not as easy as 1, 2, 3. Behaviors such as hyperactivity, distractibility, and irritability are consistent with bipolar disorder and ADHD. The challenge comes about when children are misdiagnosed. Children with bipolar disorder are often diagnosed with ADHD. Such a misdiagnosis can be harmful if medicines for ADHD are given to a child with bipolar mania. That being said, your child’s doctor will do his best to make an accurate diagnosis (always get a second opinion) and will continue to monitor your child. You can help by keeping track of how your child’s behavior and moods change, especially after taking meds.

Many of the symptoms of attention deficit hyperactivity disorder (ADHD), a disorder common in childhood, overlap with the symptoms of bipolar disorder in children and adolescents. Impulsivity, hyperactivity and distractibility, the hallmark symptoms of ADHD, are a subset of the symptoms found in bipolar disorder. Irritability, as well as oppositional and defiant behaviors, is commonly present in children with ADHD as well as bipolar disorder. It is helpful to recognize that mood elevation, grandiosity, a decreased need for sleep and an increase in sexual interest or behavior, are features strongly suggestive of bipolar disorder, as they are not generally part of the presentation of ADHD. Another clue is that the symptoms of ADHD are generally always present, while the symptoms of inattention, distractibility, hyperactivity and impulsivity, when present in bipolar disorder tend to fluctuate as the episodes of mania and depression fluctuate. However, since eighty five percent of children and adolescents with bipolar disorder are likely to also suffer from ADHD, this distinction is not always helpful.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.