Question: What is the difference between bipolar disorder and attention deficit hyperactivity disorder and can a child have both bipolar disorder and ADHD?
Answer: Well bipolar disorder is primarily a disorder of mood regulation, so you have problems regulating your mood from going into either depressive periods, or going into manic periods, which can be very high periods or very irritable periods.
ADHD is more a diagnosis that has to do with disorder of attention or kinetic motion, so that you are either hyperactive -- unable to sit still, and/or you're having problems focusing and paying attention.
Now there is a big overlap between the two, there are some symptoms that overlap between the two -- for example, impulsivity. During a manic episode, you can be extremely impulsive and hyperactive with high levels of energy, and you can't tell the difference between that and a child who has those symptoms from ADHD. Where you can tell the difference in is in the mood symptoms. Things like grandiosity, things like not needing as much sleep, things like extreme irritability or extreme euphoria. Things like inappropriate sexual nature. So those things differentiate kids with the two disorders.
However, many children with bipolar disorder also have ADHD. In fact adolescents, that happens in about 60 percent of adolescents with bipolar disorder, and kids under the age of 12 -- about 90 percent of them will qualify for both disorders. Now does it mean they actually have two separate disorders? Well I think because there's so many children who have both together, probably represents really one disorder and the fact that you see bipolar disorder in someone that young, it just happens to encompass the symptoms of ADHD as well. And you're really talking about one disorder.
Now in the interest of treatment, sometimes you do need a separate mood stabilizer treatment for children with bipolar disorder and a separate ADHD treatment. So it is important to make these two separate diagnoses even if it's really one underlying disorder.