Many mental health conditions have symptoms that overlap, which can make diagnosis tricky. ​If you are living with bipolar 1 disorder (also written as “bipolar I disorder”) or attention-deficit/hyperactivity disorder (ADHD), learning about the similarities and differences between them can help you better understand what you’re experiencing.

ADHD and bipolar 1 share some symptoms, which can make it hard even for experienced clinicians to tell them apart. It’s also possible to have both bipolar 1 and ADHD. You may have heard the term “attention-deficit disorder” (ADD), but that name is outdated.

Knowing which symptoms are unique to each condition can help you get the right diagnosis — an essential first step in finding the most effective treatment. Here are four important ways to tell whether your symptoms may be related to bipolar 1 or ADHD.

1. ADHD Symptoms Are Usually Stable, While Bipolar 1 Symptoms Change Over Time

A key difference between bipolar 1 and ADHD is how symptoms show up. ADHD symptoms tend to be steady, while symptoms of bipolar disorder often come and go in cycles.

What Are the Symptoms of ADHD?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ADHD includes a variety of symptoms, including difficulty focusing and frequent movements (like fidgeting). These symptoms can make it harder to succeed at work, in school, or in social situations.

ADHD is most often diagnosed during childhood, but adults can have it as well. Symptoms of adult ADHD can include:

• Impulsivity
• Disorganized thinking
• Restlessness
• Difficulty managing time, staying focused, or following through on tasks

​Several conditions can co-occur with ADHD, especially mood and personality disorders. In particular, bipolar disorder has some symptoms that overlap with ADHD. This can lead to missed or delayed diagnoses for bipolar.

What Are the Symptoms of Bipolar 1 Disorder?

People living with bipolar 1 disorder experience intense mood shifts or “mood swings.” Manic episodes — or “emotional highs” — are broken up by periods of depression or feeling emotionally balanced.

Manic symptoms may include:

• Increased energy or agitation
• Less need or desire for sleep
• Rapid or nonstop speech
• Racing thoughts or jumping quickly between topics
• Acting on impulses, such as spending a lot of money or taking unusual risks

Some people also experience hypomania, a milder version of mania. Hypomanic episodes are generally less extreme than full-blown manic episodes. During hypomania, a person may feel excited, unusually happy, or easily irritated. They often have more energy and creativity than usual — but not to the extreme levels seen in full mania.

These mood changes can make everyday tasks hard. It might be tough to concentrate at work or school, have good relationships, or keep to a regular schedule due to your changing moods.

Overlapping Symptoms

Distinguishing between bipolar 1 and ADHD can be difficult because these conditions share similar symptoms, including:

• Inattention
• Impulsive behavior
• Distractibility
• Irritable mood
• Sleep disturbances

Bipolar 1 disorder and ADHD have some overlapping symptoms like impulsivity, an irritable mood, and problems with sleeping.

2. ADHD Symptoms Usually Start Earlier Than Bipolar 1 Symptoms

ADHD symptoms often appear in early childhood, with age of onset usually before age 12. In contrast, bipolar 1 is often diagnosed in a person’s early twenties or occasionally at a younger age. That said, it’s possible to experience symptoms — and get diagnosed — with either condition earlier or later in life.

3. An Early ADHD Diagnosis Can Change as You Get Older

According to Cleveland Clinic, around 15 percent to 20 percent of kids diagnosed with ADHD still meet the full criteria as adults. Another 40 percent to 60 percent continue to experience some symptoms, even if they no longer meet all the criteria for a diagnosis.

This means that while many people continue to feel the effects of ADHD into adulthood, symptoms can shift over time. In some cases, your doctor might update or add another diagnosis — especially if new symptoms appear.

A bipolar 1 diagnosis tends to be more stable over time compared to many other mental health conditions — especially after the early stages. A review of research found that around 60 percent of people who are initially diagnosed with bipolar disorder continue to meet that diagnosis over time.

A diagnosis of major depressive disorder or a series of depressive episodes can be changed to a diagnosis of bipolar disorder in early adulthood if new symptoms arise.

A diagnosis of major depression might be changed to a diagnosis of bipolar 1 disorder in adulthood if new symptoms arise.

It’s important to keep in mind that nothing is set in stone. Symptoms of several mental health conditions can change throughout early life and adulthood. Always let your doctor know about any symptom changes.

4. Different Medications Are Used To Treat Bipolar 1 and ADHD

ADHD treatment manages symptoms like difficulty with concentration and memory. Treatment plans typically include a combination of medications and behavior therapy.

ADHD medications include:

• Stimulants, such as methylphenidate
• Nonstimulants, such as atomoxetine
• Sometimes, antidepressants

Treatment options for bipolar include psychotherapy, like cognitive behavioral therapy (CBT), and medications. Through CBT — a form of talk therapy — a person works with a mental health professional to identify and shift negative thought patterns, improve coping strategies, and manage mood episodes.

Some common medications for treating bipolar 1 include:

• Mood stabilizers
• Antipsychotics
• Antidepressants
• Anti-anxiety medications

Antidepressants are used less often than mood stabilizers and antipsychotics in the treatment of bipolar disorder. This is because antidepressants may trigger a manic episode. When antidepressants are prescribed for bipolar disorder, they’re usually given along with a mood stabilizer or antipsychotic.

For people living with bipolar disorder and ADHD, mood stabilization is an important treatment goal. Research on using stimulant medications alongside mood stabilizers — particularly in people with both bipolar 1 and ADHD — is still limited.

Stimulant medications used for ADHD can sometimes trigger a manic episode in someone with bipolar disorder. This is more likely if someone isn’t consistently taking their mood-stabilizing medication.

It’s important to always tell your healthcare provider about all the medications you’re taking and whether you’re taking them as prescribed.

It’s Possible To Have Both Bipolar 1 and ADHD

Many studies show that a person can have ADHD and bipolar disorder at the same time. The National Comorbidity Survey Replication — considered to be the largest mental health survey available in the United States — estimated that about 21 percent of people with an ADHD diagnosis also had bipolar disorder.

A study from the journal Medicina estimated that 10 percent to 20 percent of adults with bipolar disorder also have ADHD. A younger age at the diagnosis of bipolar disorder was linked to a higher likelihood of having both conditions.

Somewhere between 10 percent and 20 percent of adults with bipolar disorder also have ADHD.

Is It Bipolar 1 or ADHD? Getting the Right Diagnosis

If you’re unsure about your diagnosis or treatment, talk to your primary care doctor. They can help you and make sure you’re getting the right care. Ask specific questions about how your doctor came to a diagnosis of bipolar disorder or ADHD. Before deciding on treatment, you may want to get a second opinion.

Once you’ve found a psychiatry provider you trust, it’s important to do your best to follow up with them regularly. Being consistent with your treatment allows doctors to better track your mood changes and progress with medications. Be sure to ask questions about your condition, and always take your medication as prescribed.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression or bipolar 1 disorder and their loved ones. On MyDepressionTeam, more than 150,000 members come together to ask questions, give advice, and share their stories with others who understand life with mental health conditions.

Are you diagnosed with bipolar 1, ADHD, or both? Do you have questions about the differences between the two conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.