Manic ADHD: Can ADHD Cause Mania?
While attention-deficit hyperactivity disorder (ADHD) cannot cause mania on its own, individuals living with ADHD and bipolar disorder simultaneously may experience manic episodes. “Manic ADHD” is not a clinical term. However, symptoms of ADHD and bipolar disorder can share similarities. In addition, some symptoms may be difficult to distinguish from one another, such as emotional dysregulation and hypomania. Understanding these differences can be a way to differentiate between disorders and find the proper support from a mental health professional.
What is attention-deficit hyperactivity disorder or ADHD?
ADHD is a neurodevelopmental disorder and form of neurodivergence that is present from birth and persists throughout one’s life. Individuals living with ADHD may have a difficult time paying attention, staying on-task, retaining information, sitting still, or avoiding impulsive behavior.
There are three subtypes of ADHD listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), including predominantly hyperactive-impulsive, predominantly inattentive, or a combined type.
Predominantly hyperactive-impulsive
Those with hyperactive-impulsive ADHD may be prone to constant movement, fidgeting, or excessive talking. In school, these individuals may struggle to stay in their seats, interrupt others while talking, or shout out comments during class. This behavior may negatively impact their academic career and relationships with teachers or classmates.
Predominantly inattentive
Individuals experiencing inattentive ADHD may struggle to remember important details, finish tasks, or avoid becoming distracted. People with inattentive ADHD may also find organization and time management challenging, which may affect their performance at work or school.
Combined type
Combined type ADHD often meets the criteria for both predominantly inattentive and predominantly hyperactive-impulsive. These individuals may have difficulties focusing and paying attention while also struggling with impulsive behavior and a frequent desire for movement.
What is bipolar disorder?
Bipolar disorder is a mental health condition commonly associated with episodes of mania and depression, originally nicknamed “manic depression,” which is no longer a clinical term.
There are several types of bipolar disorder, including bipolar I disorder, bipolar II disorder, cyclothymic disorder, and unspecified bipolar disorder. The significant difference between these types tends to be the severity of symptoms, which may be best characterized by the appearance of mania or hypomania, as defined below.
Mania
Mania is a state present in individuals with bipolar I disorder that involves high levels of energy, rapid changes in mood, and new changes in behavior. Individuals experiencing a manic episode may struggle with logical thinking or feel euphoric. This euphoria could lead them to make decisions or engage in risky behavior that could negatively impact their lives. Often, manic episodes last a week or more.
Hypomania
Hypomania is a less severe version of mania that lasts for a shorter duration—in some cases, only a few days. A hypomanic episode may not impact an individual's work, school, or home life severely, whereas a manic episode often can. Individuals experiencing hypomania may have similar symptoms to those experiencing mania, such as excess energy, extreme mood swings, and unusual behavior.
Understanding bipolar disorder
Manic episodes only occur in those living with bipolar I disorder, while hypomanic episodes can occur in those living with any subtype of bipolar disorder. Both disorder types can experience depressive episodes, which may have symptoms such as the following:
- Thoughts of hopelessness or worthlessness
- Prolonged sadness or irritability
- Fatigue
- Difficulty concentrating
- A lack of interest in previously enjoyed activities
- Self-doubt or guilt
- Difficulty sleeping
Certain manic and depressive symptoms may make bipolar disorder challenging to discern from ADHD. Identifying these shared or similar symptoms may help individuals understand which disorder they may be living with.
Do ADHD and bipolar disorder share symptoms?
Several symptoms may be shared by ADHD and bipolar disorder, including the following:
- Unstable mood
- Sudden bursts of energy
- Excessive talkativeness
- Impatience
- Low frustration tolerance
- Restlessness
- Difficulty concentrating or making decisions
For those experiencing bipolar disorder, these symptoms may be related to hypomania, the milder and shorter-lasting version of mania. According to Dr. Kelly Ryan of Michigan Medicine, there may be a significant number of similarities between hypomania and specific ADHD symptoms, specifically emotional dysregulation, distractibility, and hyperactivity.
Emotional dysregulation in manic ADHD and bipolar disorder
Hypomania can result in emotional regulation difficulties or fast shifts in mood, which are common symptoms for those living with ADHD. This shift may result in difficulty tolerating frustration, as well as emotional outbursts, irritability, and aggressive behavior. In some cases, these behaviors may affect an individual’s relationships or ability to perform at work or school. In both manic ADHD and bipolar disorder, managing emotional dysregulation can be crucial for maintaining stability in daily life.
Distractibility and attention-deficit symptoms in ADHD and bipolar disorder
Inattention can be one of the core symptoms of ADHD, which may make it difficult for individuals to focus on tasks or conversations. Those with bipolar II disorder may also become distracted, though this symptom might not be present for everyone.
Hyperactivity
Hypomania may cause an individual to experience bursts of energy that can disrupt sleep and increase hyperactivity. Similarly, ADHD can cause individuals to become hyperactive or have a desire for constant movement. This symptom can make it difficult to stay still or cause someone to fidget.
However, there are several ways that ADHD and bipolar disorder are distinct. Understanding these differences may be beneficial in determining whether someone is experiencing mania, hypomania, or the symptoms of ADHD.
What sets ADHD and bipolar disorder apart?
While ADHD and bipolar disorder may share similarities, there are several symptoms that set them apart. For example, ADHD is a neurodevelopmental condition that persists into adulthood and does not have a cure. However, bipolar disorder can develop later, with research indicating that the peak onset is between 20 and 40 years old.
In addition to onset, one potential way to tell ADHD and bipolar disorder apart is the frequency with which symptoms occur. ADHD is persistent, meaning that symptoms are ongoing, while bipolar disorder is often episodic, which indicates that it occurs at irregular intervals. These intervals usually consist of periods of elevated mood, known as manic (or hypomanic) episodes, and periods of low mood, known as depressive episodes.
Understanding psychosis in mental health: Comparing ADHD and bipolar disorder
Another distinguishing factor may be the potential to experience psychosis, which can be more common for those living with bipolar disorder. According to the National Institute of Mental Health (NIMH), psychosis can encompass symptoms like the following:
- Paranoia
- Uneasiness with others
- Suspiciousness
- Difficulty communicating
- Delusions
- Non-conventional feelings
- Emotional numbness
- Social withdrawal
- Difficulty distinguishing reality from fantasy
- Hallucinations
While it may be possible for someone with ADHD to experience psychosis, it may not be as closely connected as it is with bipolar disorder. However, some ADHD medications may increase the risk of psychosis, specifically prescription stimulants.
One study reviewed data from 337,919 young adults and adolescents who received a stimulant prescription for ADHD. Half of the group (110,923) was prescribed methylphenidate, and the remaining half was prescribed amphetamines. Researchers found that 1 in 660 patients experienced psychosis, with amphetamine use accounting for a greater risk of psychosis than methylphenidate.
Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.
How can you treat manic ADHD and bipolar disorder?
When considering treatment, it may be helpful to seek a diagnosis from a medical doctor or mental health practitioner. These professionals may help you determine whether you are experiencing ADHD, bipolar disorder, or a combination of both and find a potentially viable treatment plan.
Some professionals may recommend medications such as stimulants, antidepressants, or mood stabilizers. In addition, certain therapeutic approaches may be beneficial for both ADHD and bipolar disorder, including cognitive-behavioral therapy (CBT). Research suggests that CBT can be effective at reducing the symptoms of ADHD, while further studies indicate that CBT can alleviate symptoms of bipolar disorder.
Whether a therapist specializes in ADHD, bipolar disorder, or the use of CBT, it may be helpful to speak with a professional. Individuals with and without mental disorders may get numerous benefits from therapy, such as the opportunity to find support, build valuable coping skills, and discuss their experiences in a safe environment. However, in-person therapy may not be accessible to everyone.
In some cases, a provider that specializes in ADHD or bipolar disorder may not be available in your area. Mental health providers may also have limited scheduling availability, which could increase the time it takes to get an appointment. In addition, individuals may wish to use other forms of communication for their therapy sessions, such as texting, calling, or video chats. In these cases, it may be beneficial to try different options, such as online therapy through a platform like BetterHelp.
Research indicates that online therapy can be an effective alternative to in-person therapy. In one meta-analysis of 12 randomized controlled trials, researchers reviewed data from 931 patients administered telehealth therapy and face-to-face therapy. Their research indicated no significant differences between in-person and online therapy in function, working alliance, client satisfaction, and overall improvement. These results were seen immediately after treatment and at three, six, and 12 months.
Takeaway
Bipolar disorder and ADHD can also be distinct in many ways, including in their age of onset, symptom frequency, and the presence of symptoms like psychosis. Managing ADHD and bipolar disorder may be accomplished with certain medications and psychotherapeutic techniques like cognitive-behavioral therapy.
How does attention deficit hyperactivity disorder (ADHD) impact mental health?
ADHD can affect mental health by contributing to challenges like anxiety, depression, and low self-esteem, often due to difficulties with focus, impulsivity, and managing daily tasks.
What are effective mental health strategies for managing attention-deficit hyperactivity disorder (ADHD) symptoms?
Practical strategies for managing ADHD symptoms include behavioral therapy, medication, creating structured routines, and practicing mindfulness techniques to improve focus and emotional regulation.
Do ADHD people have manic episodes?
People with ADHD who take stimulant medications may be more likely to experience symptoms of mania, but ADHD itself is not linked to manic episodes. In some cases, mania may be a symptom of another disorder, particularly bipolar disorder.
What are the 4 stages of mania?
The four types of mania include hypomania, acute mania, delusional mania, and delirious mania.
In addition to manic or hypomanic episodes, people with bipolar disorder may experience periods of depression—which is characterized by sadness, inappropriate guilt, difficulty concentrating, or little interest in activities once enjoyed.
Is ADHD mistaken for bipolar?
Yes, according to BMC Psychiatry, ADHD and bipolar disorder share several symptoms, which can increase the risk of misdiagnosis.
Am I manic or just happy?
It can be difficult to differentiate between mania and extreme happiness, but they are distinct. Mania tends to lead to disruption of sleep, racing thoughts, irritability, and impulsive decisions. Furthermore, mania can be a key feature of disorders like bipolar disorder, in which someone fluctuates between episodes of feeling depressed and manic.
Conversely, happiness does not usually interfere with decision-making skills, cause impulsiveness, or interfere with daily functioning. It’s also not a symptom of a disorder.
How to tell if you're manic?
According to the American Psychiatric Association, these are some of the most common signs and symptoms of mania to look out for:
Irritable mood
Reduced need for sleep
Racing thoughts
Talking quickly
Distractible
Restlessness
Impulsive behavior
Symptoms of mania can present differently in childhood, late teens, early adulthood, and later adulthood. For teens and adults, symptoms of bipolar mania may present similarly to hyperactivity found in ADHD.
What is manic but not bipolar?
Mania or hypomania may occur outside of bipolar disorder due to other psychiatric disorders, some medical conditions or medications, or substance use. Some things that may trigger mood changes and symptoms of mania include:
Schizoaffective disorder
Alcohol, cocaine, or other substances
Antidepressant, corticosteroid, or stimulant medication use (commonly used to treat attention deficit disorder)
Some infections
Hyperthyroidism
Brain tumors
Multiple sclerosis
Stroke
Signs of mania include:
Becoming extremely irritable
Racing, recurrent thoughts
Impulsivity
Grandiosity
Family members and loved ones may notice rapid speech patterns or dominating conversations
Severe changes in sleeping habits, particularly needing less sleep
The way that mania is managed will vary based on the underlying cause. For example, healthcare providers may treat bipolar disorder with mood stabilizers or antipsychotics, whereas it usually makes sense to manage medication-induced mania with a medication change.
Do you realize when you're manic?
Some people may recognize that they’re experiencing a manic episode, whereas others may not. People with pediatric bipolar disorder may be less likely to recognize the symptoms of mood fluctuations like bipolar depression or maniac episodes because they may not have experienced enough episodes to recognize their symptoms.
Do people tell the truth when manic?
In some cases, manic symptoms may cause a reduced filter, leading them to share racing thoughts more honestly (though not necessarily accurately) than they might share otherwise. However, people’s experience with adult bipolar disorder can vary widely, and a bipolar mania isn’t correlated with a higher likelihood of lying or of telling the truth.
Thanks for the feedback!
- Previous Article
- Next Article