Bipolar disorder and ADHD, or attention deficit hyperactivity disorder, are two conditions that are diagnosed more and more in American children and teens — often at the same time.
We’re learning more about bipolar disorder in children and teens. But the condition is still difficult to diagnose. That’s especially true for teenagers in whom irritability and moodiness commonly co-exist as part of a normal adolescence. A preteen or teen with mood swings may be going through a difficult but normal developmental stage. Or, they may have bipolar disorder with periodic mood changes that shift from depression to mania.
Symptoms of ADHD can have some overlap with symptoms of bipolar disorder. With ADHD, a child or teen may have:
- Rapid or impulsive speech
- Physical restlessness
- Trouble focusing
- Irritability
- Defiant or oppositional behavior
Today’s children and teens are 40 times more likely to be diagnosed with bipolar disorder than they were 10 years ago, according to one study. But the reason isn’t entirely clear. The higher rate could be the result of more awareness on the part of healthcare professionals. We need more research to know for sure.
Some studies have shown that children and teens diagnosed with bipolar disorder are more likely than adults to also be diagnosed with ADHD.
Childhood Bipolar Disorder
Bipolar disorder is a persistent mental illness that comes with challenges. When it happens in childhood or adolescence, it can completely disrupt life as they know it. Undiagnosed bipolar disorder, misdiagnosed bipolar, or poorly treated bipolar is linked to:
- Higher rates of suicide and suicide attempts
- Poorer academic performance
- Difficulty keeping relationships
- Higher rates of substance abuse
- Multiple hospitalizations
In adults, bipolar disorder is marked by mood changes that go from depression to mania. Adult mania is characterized by:
- Feeling like you have less need for sleep
- Rapid speech
- Euphoria, like you’re on top of the world
- Grandiosity, including overconfidence or feeling invincible
- Irritability
- Racing thoughts
Warning Signs in Children and Teens
With bipolar disorder, there are both manic symptoms and depressive symptoms. If your child or teenager has five or more symptoms that last for at least a week, call your doctor to get help. With medications and psychotherapy, mental health professionals can help stabilize your child’s moods. Treatment can also lessen or get rid of the depressed or manic thoughts and behaviors.
Manic symptoms include:
- Severe changes in mood, either extremely irritable or overly silly and elated
- Having an overly-inflated self-esteem (grandiosity)
- Going with very little or no sleep for days, seemingly without tiring
- Talking very fast and changing topics quickly
- Being distracted (attention moves constantly from one thing to the next)
- Not care about risk and taking on risky behaviors or activities
Depressive symptoms include:
- Having a sad or irritable mood that doesn’t go away
- Feeling very angry or hostile
- Complaining about pain (like headaches or stomaches)
- Losing interest in activities they once enjoyed
- A big change in appetite or body weight
- Difficulty sleeping or oversleeping
- Loss of energy
- Feelings of worthlessness or guilt
- Difficulty concentrating
- Thinking about death or suicide
How Is ADHD Different?
Bipolar disorder is primarily a mood disorder. ADHD causes symptoms of inattention, hyperactivity, and impulsivity.
While ADHD is chronic or ongoing, bipolar disorder — while it is a chronic condition — is often episodic, with periods of normal mood interspersed with depression, mania, or hypomania.
Bipolar Disorder Treatment
Doctors usually treat bipolar disorder in young people the same way they treat it in adults. They use medications called mood stabilizers, which include anticonvulsants, such as:
- Carbamazepine (Tegretol)
- Lamotrigine (Lamictal)
- Lithium (Eskalith, Lithobod)
- Oxcarbazepine (Trileptal)
- Valproate (Depakote)
Atypical antipsychotic medications can also stabilize mood. They include:
- Aripiprazole (Abilify)
- Asenapine (Saphris)
- Cariprazine (Vraylar)
- lumateperone (Caplyta)
- Lurasidone (Latuda)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
Sometimes, doctors prescribe a combination of drugs, such as a mood stabilizer and an antidepressant.
ADHD Treatment
Treatment for ADHD includes medications and behavioral therapy. ADHD medications can be psychostimulants, nonstimulants, or antidepressants. These include:
- Amphetamine and dextroamphetamine (Adderall, Adderall XR)
- Atomoxetine (Strattera)
- Bupropion (Wellbutrin)
- Dexmethylphenidate (Focalin, Focalin XR)
- Guanfacine (Intuniv)
- Lisdexamfetamine dimesylate (Vyvanse)
- Methylphenidate (Concerta, Ritalin)
- Mixed salts of a single-entity amphetamine product (Mydayis)
- Viloxazine (Qelbree)
In 2026, the FDA approved centanafadine (Simtriyo), a once-daily, extended-release stimulant for adults and children ages 6 and older who weigh at least 44 pounds (20 kilograms). It is the first ADHD medication that increases the levels of three brain chemicals: norepinephrine, dopamine, and serotonin. Simtriyo is expected to become available after the Drug Enforcement Administration decides how it will be classified as a controlled substance.
Get the Right Diagnosis and Treatment
If your doctor suspects your child has bipolar disorder or ADHD, ask how the diagnosis was made and review all of the information that went into it. Have the doctor evaluate your child over a period of time, not during just one visit. Make sure they talk with teachers or got written reports from them. Before you decide on treatment, get a second opinion from an expert in child and adolescent psychiatry.
See your doctor often to check how the medication is working and for side effects.
