Is it an ADHD or Bipolar Disorder Symptom in Your Child,
Adolescent or Teen?
ADHD and bipolar disorder in the child, adolescent and teen share
many symptom similarities. While ADHD is over-diagnosed, there is
concern that bipolar disorder is under-diagnosed in the child and
adolescent population.
Effective treatment depends on appropriate diagnosis of bipolar
disorder in the child and teen. Using stimulant medications to
treat Attention Deficit Disorder or ADHD in a child with bipolar
disorder may worsen manic symptoms. Parents should consult their
doctor immediately if manic symptoms develop or worsen while using
stimulant medication.
A child or adolescent with bipolar disorder can be misdiagnosed
with ADHD because both bipolar disorder and ADHD share symptom
characteristics of inattention, behavioral and emotional problems,
impulsivity and even hyperactivity. Studies have reported that
more than 80 percent of children who develop bipolar disorder have
five or more of the primary symptoms of ADHD.
The differences between bipolar symptom and an ADHD symptom are
often found not in the actual symptom but in the intent behind the
symptom. These symptom differences can be very subtle or blatantly
obvious.
Destructiveness may be seen in both bipolar disorder and ADHD but
differ in origin. Children who are ADHD often break things through
oblivious carelessness, whereas the destructiveness is more often
intentional for the bipolar kid.
The bipolar child or teen will exhibit temper tantrums and angry
outbursts just as an ADHD child will but the "trigger" for temper
tantrums also differ. The ADHD child’s tantrums are typically
triggered by sensory or emotional over-stimulation. The bipolar
child or adolescent’s tantrum is typically a reaction to
limit-setting and conflict with authority figures. Oppositional
and bossy behavior, risk-taking and disobedience to authority
figures are often finely honed skills with the bipolar kid.
The duration and intensity of temper and anger outbursts differ
greatly between the ADHD and the bipolar disorder child or
adolescent. The ADHD child will usually calm down within 20 to 30
minutes. The bipolar child can continue to act angry for hours.
The ADHD child will throw a temper tantrum. The bipolar kid will
throw a rage that expends a tremendous amount of physical energy.
The bipolar child or teen will actively seek
conflict with authority whereas the misbehavior of a child with
ADHD is often accidental. Both ADHD and bipolar child will both
engage in risky behavior but the ADHD child typically do so
because they do not think ahead to the possible consequences of
their actions. For the bipolar kid, danger-seeking grandiosity is
an art form.
Sleep problems are also common in both the bipolar and ADHD child
but again, looking at the finer differences is needed. The ADHD
child typically has trouble falling asleep. The bipolar child or
teen is more apt to wake up at multiple times during the night or
fear falling asleep due to the higher frequency of nightmares.
The ADHD and bipolar kid often differ greatly in how they wake up
in the morning. A child or adolescent who is bipolar tends to be
irritable, groggy and fuzzy in the morning. Children with ADHD
tend to wake up quickly and maintain alertness within minutes of
waking up.
Mood swings are common in both ADHD and bipolar disorder but the
child with ADHD generally does not show depression as a
predominate symptom. Depression is frequent with bipolar disorder.
Any child or adolescent who appears depressed, exhibits excessive
temper outbursts and mood changes or exhibits severe ADHD-like
symptoms should be evaluated by a psychiatrist or psychologist
with experience in bipolar disorder. This is especially important
if there is a family history of the illness.
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