How Can Clinicians Differentiate Between ADHD and Bipolar Disorder? 

Clinicians often face the challenge of distinguishing between ADHD vs bipolar disorder, as both conditions can share overlapping symptoms such as impulsivity, emotional dysregulation, and hyperactivity. However, understanding the clinical differences between ADHD and bipolar disorder is crucial for accurate diagnosis and effective treatment. 

ADHD vs Bipolar Disorder: Key Clinical Differences 

The primary distinction between ADHD and bipolar disorder lies in the nature and duration of symptoms. ADHD is a lifelong neurodevelopmental disorder characterised by inattention, impulsivity, and hyperactivity that occur consistently across different settings, such as at school, home, or in social interactions. Symptoms typically emerge before the age of 12 and remain persistent, without extreme mood shifts. 

In contrast, bipolar disorder involves extreme mood swings, including manic episodes (elevated mood, increased energy, impulsive behaviour) and depressive episodes (low mood, lack of energy, withdrawal). These mood changes are often episodic, lasting days, weeks, or even months, and are not consistent over time like ADHD symptoms. Bipolar disorder is primarily characterised by mood instability, rather than the chronic inattention or hyperactivity seen in ADHD. 

Diagnosis: Understanding the Symptoms 

Clinicians differentiate between ADHD and bipolar disorder by assessing the patterns of symptoms. Bipolar disorder symptoms are typically episodic, with clear periods of mood elevation and depression. In contrast, ADHD symptoms tend to be present consistently, with a focus on difficulties with attention, concentration, and impulse control, without extreme mood shifts. 

Although ADHD vs bipolar disorder can be challenging to differentiate, understanding the clinical differences particularly the episodic nature of bipolar disorder versus the persistent symptoms of ADHD helps clinicians make an accurate diagnosis.  

Visit providers like ADHD Certify for personal consultations and expert guidance tailored to your unique situation. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Differential Diagnosis of ADHD.

Avery Lombardi, MSc

Author

Avery Lombardi is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Psychology. She has professional experience in psychological assessment, evidence-based therapy, and research, working with both child and adult populations. Avery has provided clinical services in hospital, educational, and community settings, delivering interventions such as CBT, DBT, and tailored treatment plans for conditions including anxiety, depression, and developmental disorders. She has also contributed to research on self-stigma, self-esteem, and medication adherence in psychotic patients, and has created educational content on ADHD, treatment options, and daily coping strategies.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.