The Differences between ADHD and Bipolar Disorder in Teens

Attention Deficit/Hyperactivity Disorder, also known as ADHD, is easy to confuse with Bipolar Disorder. Add to that the chaos of adolescence and the new behaviors your teen might be exhibiting, it could be difficult to know what to share with a mental health professional who is preparing to diagnose your child.

The adolescent brain is still developing. Neurons are still firing, making new connections, and their emotional landscape is still maturing. It’s no different than the infant who needs to babble before talking in full sentences. Teens need to have immature emotional experiences – like having angry outbursts, tantrums, or lonely wandering – before growing into mature ones.

Despite this recognition, many teens in recent years are being diagnosed with teen bipolar disorder. Some clinicians say that there is an excessive amount of diagnosing bipolar among adolescents, while others believe that it is appropriate because the age of onset for this psychological disorder is late adolescence.

What is ADHD?

ADHD is a disorder that is commonly co-diagnosed with Bipolar Disorder. However, its symptoms are distinctly different than those of Bipolar, and nonetheless, they are easy to mix up. For this reason, the list below is for illustrating their differences.

First, let us explore ADHD in more detail. It’s a disorder that is characterized by difficulty in paying attention to details, impulsivity, hyperactivity, making careless mistakes, trouble listening to others, problems with organization, and distractibility. It typically shows up in children much earlier than Bipolar Disorder. ADHD will begin to show its signs at around age 7 or 8, while Bipolar Disorder will become evident around ages 15-19. Although both disorders might reveal their symptoms earlier or later in childhood, these are the typical age ranges in which they begin to emerge.

You might already be able to detect the similarities in symptoms between the two. If your child has already been diagnosed with Bipolar Disorder, you know that during his or her manic episode, there are symptoms that are similar to those described above for ADHD. However, let us explore those differences now.

Differences between Bipolar and ADHD:

ADHD: Hyperactivity, impulsivity, but not usually accompanied by elation or grandiosity

Bipolar: Manic episodes are distinct periods of an elated mood, grandiosity, along with a decreased need for sleep

ADHD: Problems with distractibility, attention, organization, and memory are consistent.

Bipolar: Problems with attention, distractibility, and impulsivity are usually signs of a manic episode.

ADHD: Moods do not fluctuate widely.

Bipolar: There is a rapid cycling of moods, ranging from one extreme to the other.

ADHD: The age of onset is usually under 10 years old.

Bipolar: The age of onset is typically during mid to late adolescence.

ADHD: More common in boys

Bipolar: Common between both boys and girls equally

ADHD: Irritability, fast speech, and increase levels of energy are symptoms that are stable.

Bipolar: Irritability, fast speech, and increase levels of energy are the result of mood swings.

Depressed Teens

The symptoms of depressed teens include persistent changes in their functioning at school or home, possible self harm behavior, withdrawal, or shifts in energy or sleep. If a teen is experiencing these symptoms, it’s possible to begin to wonder whether he or she will eventually have a manic episode, which will eventually lead to a diagnosis of bipolar disorder. Research indicates that those who develop depression earlier in life have a higher risk of developing bipolar disorder. Some of the risk factors that would turn a diagnosis of depression into bipolar include: repeated episodes of depression, family history of bipolar disorder, how a teen responds to anti-depressants (such as medication being ineffective or effective at the start and later stop working), and among those who have a very high energy personality, sometimes referred to as hyperthymic.

Angry Teens

If a child is angry, he or she might have behavioral explosions, mood swings, and perhaps an inability to meet the demands of life. However, this may or may not be the reason to diagnose a teen with bipolar disorder. There are other possible diagnoses such as depression, anxiety, learning difficulties, sleep disturbances, stress, or medical issues. A depressed teens, for example, might not have the skills for managing unbearable sadness. As a result, they might appear angry instead. Their anger might also be a symptom of an unrecognized medical concern or a teen’s inability to manage stress.


Although, ADHD is diagnosed along with Bipolar Disorder in about 60-90% of teens, this list is meant to point out the clear differences between these two disorders. As a parent, you’re likely searching for information to help you understand the behavior of your child. This article is to know the differences between teen ADHD and Teen Bipolar disorder.

Regardless of the above distinctions, what is clear among clinicians is that an episode of mania or hypomania must be present in order to diagnose a teen with bipolar disorder. The above list points out that just because a teen throws a fit or is hyperactive in some way, doesn’t mean that he or she has bipolar disorder. Instead, a thorough psychological examination is required in order to make an accurate diagnosis. Of course, with an accurate diagnosis the appropriate treatment – therapy and/or medication – can follow.