ADHD vs Bipolar Disorder: How to Tell the Difference

Short answer: ADHD and bipolar disorder can look alike, because both can involve restlessness or agitation and impulsive or risky behaviour.¹² The key difference is the pattern over time. ADHD begins in early childhood³ and is a long-running pattern, while bipolar disorder comes in episodes of extreme highs and lows — changes in mood, energy and sleep that disrupt everyday life.² You can also have both: about 1 in 13 adults with ADHD also has bipolar disorder.⁴

What is bipolar disorder?

Bipolar disorder is an ongoing mood disorder with extreme highs (mania or hypomania) and lows (depression) that disrupt everyday life. Around 1 in 50 Australians has it.²

During a high, a person may:

• feel euphoric, or irritable and agitated
• have more energy and be more active, with a reduced need for sleep
• act on impulse or take risks, for example with spending, business or sex.²

During a depressive episode, a person may have low mood, little motivation and a loss of interest in things, and may feel worthless or guilty, sometimes with thoughts of suicide.² If low mood without highs is your main concern, see ADHD and depression.

ADHD is a different kind of condition. It’s a neurodevelopmental condition that begins in early childhood, and around 1 in 20 people in Australia has it.³

Is it ADHD or bipolar? Why they can look alike

Overlapping symptoms make adult ADHD and the conditions that come with it harder to diagnose,⁵ and several features of ADHD can resemble a bipolar high:

• Restlessness and energy. Adults with ADHD can feel restless and unable to relax,¹ and talking too much and interrupting others are listed ADHD symptoms.⁶ During a high, people with bipolar disorder have more energy and activity and may feel agitated.²
• Impulsive or risky behaviour. In adults, ADHD impulsivity can look like excessive spending and risk-taking.¹ Impulsive or risky behaviour with spending, business or sex is also a feature of mania and hypomania.²
• Changeable moods. Quick shifts in mood are much more common in adults with ADHD than in adults without it,⁷ and a bipolar high can involve feeling irritable rather than euphoric.²

If hyperactive and impulsive symptoms are a big part of your experience, our guide to combined-type ADHD may help.

ADHD vs bipolar: the key difference is the pattern

A helpful question is not just what the symptoms are, but when they happen. ADHD symptoms start in childhood — they must be present before age 12⁶ — and for most people they continue into adulthood.⁸ They form a long-running pattern rather than coming in distinct episodes. Bipolar disorder is different: it comes in episodes of mania, hypomania or depression, with changes in mood, energy and sleep.²

	ADHD	Bipolar disorder
Pattern	Starts in childhood and usually persists38	Episodes of highs and lows that disrupt everyday life2
Mood	Quick, reactive shifts79	Distinct episodes of mania, hypomania or depression2
Energy and sleep	Restlessness; insomnia is common110	During a high: more energy and a reduced need for sleep2
Impulsivity	Part of the ongoing pattern, such as impulsive spending1	Impulsive or risky behaviour during highs2

Sleep shows how a similarity can hide a difference. Studies report insomnia in 43–80% of adults with ADHD,¹⁰ whereas a bipolar high brings a reduced need for sleep alongside increased energy and activity.² Sleeping less because you can’t get to sleep is not the same as sleeping less because you don’t feel you need it.

ADHD mood swings vs bipolar mood episodes

Emotion dysregulation is common in ADHD across the lifespan and is a major contributor to the difficulties it causes.⁹ A 2020 meta-analysis of 13 studies including 2,535 adults found much more emotion dysregulation in adults with ADHD than in adults without it, with the biggest difference in emotional lability — moods that shift quickly, often in reaction to what’s going on.⁷

Bipolar mood episodes are different: they are periods of extreme highs or lows, rather than moment-to-moment reactions, and they disrupt everyday life.²

For more on the ADHD side, see ADHD and emotional dysregulation and ADHD rage and anger. Unstable moods are also a feature of borderline personality disorder,¹¹ which is compared with ADHD in ADHD vs BPD.

Can you have ADHD and bipolar disorder?

Yes. The Australian ADHD Guideline says up to 80% of adults with ADHD have at least one other mental health condition, and it names bipolar disorders as one example.⁸

A 2021 meta-analysis, which combined results from multiple studies, found that about 1 in 13 adults with ADHD (7.95%) also had bipolar disorder, and about 1 in 6 adults with bipolar disorder (17.1%) also had ADHD.⁴

A 2022 systematic review found a wide spread of estimates: in general-population studies, between 4.48% and 35.3% of adults with ADHD had some form of bipolar disorder, compared with 0.2% to 3.6% of adults without ADHD.¹² The figures vary partly because studies used different diagnostic tools, but bipolar disorder was more common in adults with ADHD.¹²

So if you have one of these conditions, it’s worth your doctor considering the other.

Why misdiagnosis happens, and how to get the right diagnosis

Why it happens

The Australian ADHD Guideline warns clinicians that a co-occurring condition can lead to ADHD being missed, and that the co-occurring condition can itself be missed when ADHD symptoms are present.¹³ Both mistakes matter, because each condition needs its own best-practice treatment.¹⁴

Australia’s 2023 Senate inquiry into ADHD heard that girls and women are commonly misdiagnosed with other mental health conditions first.¹⁵ One submitter told the inquiry that women in their 30s and 40s have been through a difficult process of misdiagnosis with conditions such as bipolar disorder and borderline personality disorder.¹⁵ That’s one person’s view rather than a finding of the committee. Bipolar disorder is a real condition, and missing it matters just as much, so the aim is an accurate diagnosis either way.

Getting the right diagnosis

Start with your GP. A doctor diagnoses bipolar disorder by carefully assessing symptoms and ruling out other causes,² and an adult ADHD diagnosis needs evidence that symptoms began in childhood.³ Some things that can help:

• A mood and sleep diary. Note your mood, energy and sleep each day for a few weeks. It can show whether changes come in distinct episodes or follow a steadier pattern.
• Clues from childhood. Old school reports, or memories from a parent or sibling, can help show whether attention problems started early.
• A list of your medicines. Include any medicines and supplements you take.

Your GP may refer you to a psychiatrist, a medical doctor who can prescribe medicines.¹⁶

Treatment when you have both

Bipolar disorder is treatable: treatment includes medicines such as mood stabilisers, psychological therapy and lifestyle changes.² For ADHD, the Australian ADHD Guideline recommends medication as the most effective treatment for core symptoms, with non-medication treatments adding support.¹⁴ When conditions occur together, guidelines generally advise treating the most impairing one first.⁵

How the two are treated together is something to work out with your doctor. Make sure everyone involved in your care knows about both conditions and every medicine you take, and don’t start, stop or change a medicine without talking to your doctor or pharmacist.

Getting support

If your mood is very low, you’re having thoughts of suicide, or someone close to you seems to be taking serious risks during a high, reach out for help. Call Lifeline on 13 11 14, 24 hours a day, or Beyond Blue on 1300 22 4636 (24/7). In an emergency, or if someone needs help right now, call 000.¹⁷

Frequently asked questions

Can you have ADHD and bipolar disorder at the same time?

Yes. Research combining several studies suggests roughly 1 in 13 adults with ADHD has bipolar disorder too, and about 1 in 6 adults with bipolar disorder also has ADHD.

What’s the main difference between ADHD and bipolar disorder?

The pattern over time. ADHD symptoms begin in childhood and form a long-running pattern, while bipolar disorder comes in episodes of high and low mood that disrupt everyday life.

Can ADHD be mistaken for bipolar disorder?

It can. Restlessness, impulsive or risky behaviour and changeable moods can occur in both, and Australian guidelines warn that one condition can lead to the other being missed. A careful assessment helps tell them apart.

Are ADHD mood swings the same as bipolar mood swings?

No. In ADHD, moods tend to shift quickly in reaction to what’s happening. In bipolar disorder, mood changes come as sustained episodes of mania, hypomania or depression that disrupt everyday life.

How is bipolar disorder treated?

Bipolar disorder can be treated with medicines, such as mood stabilisers, along with psychological therapy and lifestyle changes. If you also have ADHD, both conditions need proper treatment, and your doctor can help decide what to focus on first.

Next steps

Read how to get an ADHD assessment in Australia and whether ADHD is a mental illness, or start with the free ADHD self-assessment.

This article is general information only and is not medical advice. Only a qualified health professional can diagnose ADHD. ADHD GP is a private telehealth clinic staffed by AHPRA-registered Australian GPs.

Book your ADHD assessment

References

1. Healthy Male (funded by the Australian Government). Adult ADHD diagnosis in Australia: What you need to know. 2026. healthymale.org.au — In adults, impulsivity can look like excessive spending, risk-taking, conflict with others, interrupting and talking excessively; managing finances and meeting work deadlines can be difficult; some adults ‘hyperfocus’ for hours on activities that interest them, and hyperactivity can show as feeling restless and unable to relax.
2. healthdirect (Australian Government). Bipolar disorder. 2024. www.healthdirect.gov.au — Bipolar disorder is an ongoing mood disorder with episodes of mania or hypomania and depression; around 1 in 50 Australians has it; treatment includes medicines, psychological therapy and lifestyle changes.
3. healthdirect (Australian Government). Attention deficit hyperactivity disorder (ADHD). 2025. www.healthdirect.gov.au — ADHD is a neurodevelopmental condition that begins in early childhood; around 1 in 20 people in Australia has ADHD; it is partly genetic; an adult diagnosis requires evidence that symptoms began in childhood; learning difficulties can occur alongside it.
4. Schiweck C, Arteaga-Henriquez G, Aichholzer M, et al. Comorbidity of ADHD and adult bipolar disorder: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. 2021. PubMed PMID 33515607 — Pooled data: about 1 in 6 adults with bipolar disorder had ADHD (17.1%), and about 1 in 13 adults with ADHD also had bipolar disorder (7.95%).
5. Katzman MA, Bilkey TS, Chokka PR, et al. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017. PubMed PMID 28830387 — Adult ADHD often co-occurs with mood and anxiety disorders, with strong familial and neurobiological links; overlapping symptoms complicate diagnosis; guidelines advise treating the most impairing condition first.
6. American Psychiatric Association. What is ADHD?. 2025. www.psychiatry.org — ADHD is one of the most common mental disorders affecting children; symptoms must be present before age 12; an estimated 8.4% of children and 2.5% of adults have ADHD; listed symptoms include fidgeting, feeling restless (in adults), talking too much and forgetting daily tasks.
7. Beheshti A, Chavanon ML, Christiansen H. Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC Psychiatry. 2020. PubMed PMID 32164655 — Meta-analysis of 13 studies (2,535 participants): adults with ADHD had much greater emotion dysregulation than controls (Hedges’ g 1.17), with emotional lability the largest effect (g 1.20).
8. Australian ADHD Professionals Association. About ADHD (Australian ADHD Guideline). 2022. adhdguideline.aadpa.com.au — ADHD affects 6–10% of Australian children and 2–6% of adults; heritability 70–80%; symptoms begin before 12 though diagnosis may come later; 60–86% persist into adulthood; inattentive presentation most prevalent; up to 80% of adults have another mental health condition, such as depressive, bipolar, anxiety or substance use disorders, and cluster B and C personality disorders are more common; describes executive-function difficulties (working memory, planning, sustained attention, inhibitory control), brain-maturation and dopamine differences.
9. Shaw P, Stringaris A, Nigg J, Leibenluft E. Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry. 2014. PubMed PMID 24480998 — Emotion dysregulation is prevalent in ADHD throughout the lifespan and a major contributor to impairment.
10. Wynchank D, Bijlenga D, Beekman AT, Kooij JJS, Penninx BW. Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature. Current Psychiatry Reports. 2017. PubMed PMID 29086065 — Studies report insomnia in 43–80% of adults with ADHD.
11. healthdirect (Australian Government). Borderline personality disorder (BPD). 2024. www.healthdirect.gov.au — BPD is a treatable condition affecting about 1 in 100 adults; features include overwhelming emotions, unstable mood, fear of abandonment, impulsivity and self-harm; psychological therapy such as DBT is the main treatment.
12. Choi WS, Woo YS, Wang SM, et al. The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review. PLoS One. 2022. PubMed PMID 36331985 — Review of 32 studies: substance use, mood, anxiety and personality disorders were more common in adults with ADHD; in general-population studies depression affected 8.6–55% with ADHD vs 1.2–12.5% without, bipolar disorder 4.5–35.3% vs 0.2–3.6%, and personality disorders 0.3–33.8% vs 0–3.9%.
13. Australian ADHD Professionals Association. Australian ADHD Guideline — Chapter 2: diagnosis. 2022. adhdguideline.aadpa.com.au — Clinicians should know which conditions commonly co-occur with ADHD, as a co-occurring condition may result in a missed ADHD diagnosis, or a missed co-occurring condition when ADHD symptoms are present.
14. Australian ADHD Professionals Association. Australian ADHD Guideline — summary of recommendations. 2022. adhdguideline.aadpa.com.au — Medication is the most effective treatment for core symptoms, with non-medication treatments adding support (3.1.1); diagnosing clinicians should be registered and trained in ADHD assessment (2.1.1); the diagnosis must be confirmed before starting medication (5.1.2); CBT should be offered to adults (4.2.11); stimulants are first-line for impairing adult ADHD, with heart rate, blood pressure, weight, sleep, mood and anxiety monitored during titration; co-occurring conditions get best-practice treatment.
15. Parliament of Australia — Senate Community Affairs References Committee. Assessment and support services for people with ADHD — Chapter 3: barriers to assessment and diagnosis. 2023. www.aph.gov.au — Almost all adult ADHD assessment and diagnosis in Australia is done through the private sector, and cost is a barrier to diagnosis. The committee heard that gender bias has led to under- and misdiagnosis of ADHD in girls and women, who are commonly misdiagnosed with other mental health conditions first and often learn to mask their symptoms; a survey cited by the committee found 86% of more than 570 respondents had tried to mask or hide their ADHD at school or work.
16. healthdirect (Australian Government). Psychiatrists and psychologists. 2024. www.healthdirect.gov.au — A psychologist is not a medical doctor and can’t prescribe medicines; a psychiatrist is a medical doctor who can; psychologists focus on psychotherapy; Medicare covers some costs with a referral or mental health treatment plan.
17. healthdirect (Australian Government). Mental health helplines. 2025. www.healthdirect.gov.au — Lifeline (13 11 14) offers 24-hour crisis support and Beyond Blue (1300 22 4636) is available 24/7; if someone is in crisis and needs help now, call triple zero (000).

Sources were last checked on 5 October 2026. See all sources used on this site on our Sources page.