Differential Diagnosis of Bipolar and ADHD: Taking a Phenomenological Approach
Accuracy of diagnosis is critical before treating bipolar disorder, ADHD, or the two together. However, high rates of comorbidity and a constellation of overlapping symptoms make the task of distinguishing between bipolar disorder and ADHD especially challenging.According to a recent meta-analysis of 71 studies in 18 countries published in Neuroscience and Biobehavioral Reviews, 1 out of 13 people with ADHD also had bipolar disorder.
Among patients with bipolar, 1 out of 6 also had ADHD.1 The co-existence is clearly present. So, if you run a mood disorders clinic and you tell me you don’t have ADHD patients, I’ll say maybe you don’t see patients for their ADHD, but you certainly have ADHD patients.In terms of differentiating the two disorders, there’s much talk about executive function subsumed under ADHD, and about emotional dysregulation subsumed under mood disorders, including major depression and bipolar disorder.
However, we know that cognitive symptoms and executive dysfunction exist in patients with bipolar disorder. We also know that emotional dysregulation is a component of ADHD; the more severe the ADHD, the more severe the emotional dysregulation.This connection is borne out by a recent study conducted with 150 ADHD patients, 335 adult bipolar patients, and 48 controls, in which subjects used two self-report scales.
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