Can I be Diagnosed with ADHD and Bipolar Disorder?
May 9, 2025 | By Carissa Hannum
As a clinician working in the field of eating disorders and trauma, many of my clients come to me seeking to understand the underlying reasons behind their eating disorders and other behaviors related to mood or mental health. Often, they feel that their mental health is “too complicated,” or they’ve been told no one has been able to “figure them out.” One of my roles is to help clients explore the root causes of these struggles.
Through the course of treatment, I often diagnose clients with mood disorders such as depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and bipolar disorder. I also explore neurodevelopmental disorders like ADHD and autism, as these conditions frequently overlap with eating disorders and trauma.
Co-Occurring Diagnoses in Eating Disorder Treatment
According to the National Eating Disorders Collaboration, 55–97% of individuals diagnosed with an eating disorder also have at least one co-occurring psychiatric disorder. The National Eating Disorders Association (NEDA) reports that 22% of women with ADHD develop an eating disorder, and children with ADHD are nearly six times more likely to develop an eating disorder by late adolescence compared to those without ADHD.
Additionally, 39% of children and adolescents being treated for ARFID (Avoidant Restrictive Food Intake Disorder) also meet criteria for ADHD, compared to up to 10% of the general population. These statistics make it clear, if you’re treating eating disorders, you’ll likely encounter both ADHD and mood disorders, often together.
Can You Have Both ADHD and Bipolar Disorder?
Yes, you can. This is a question I hear frequently, especially regarding the coexistence of bipolar disorder and ADHD. There’s still some confusion, even among clinicians with some being taught that individuals can only have one or the other. However, this outdated view can be harmful. As providers, we must be willing to consider all possibilities and conduct thorough assessments.
In my clinical experience, especially within eating disorder treatment, it is not uncommon to work with clients who have both ADHD and bipolar disorder. Understanding the differences, overlap, and how to treat both is essential.
What Is Bipolar Disorder?
Bipolar disorder is a mood disorder characterized by episodes of depression and elevated moods, either mania or hypomania. There are three main types:
Bipolar I Disorder
Marked by full manic episodes and depressive episodes. Mania can impair functioning and may lead to hospitalization. In some cases, psychosis may occur due to biochemical shifts in the brain.
Bipolar II Disorder
Involves recurring depressive episodes and hypomanic episodes. Hypomania is less severe than full mania but still represents a significant shift from a person’s typical mood.
Cyclothymic Disorder
Cyclothymia is a milder form on the bipolar spectrum. Individuals experience chronic fluctuations between hypomanic and depressive symptoms that don’t meet full diagnostic criteria.
Symptoms of Bipolar Disorder
Mania / Hypomania
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Decreased need for sleep
Increased sexual libido
Grandiosity
Flight of ideas
Risky behavior
Distractibility
Pressured speech
Psychosis (in mania)
Hypomania (Milder)
Increased energy
Inflated self-esteem
Racing thoughts
Impulsivity
Sleep disturbance
Pacing or fidgeting
Depression
Sleep or appetite changes
Low self-esteem
Guilt or shame
Suicidal ideation
Loss of interest
Isolation
Fatigue or low energy
Irritability
What Is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects people across the lifespan. Although the known cause isn’t quite understood, it is starting to be recognized as a genetic condition that may run in families (Elmaghbraby & Garayalde, 2022). Due to the struggles with inattention, hyperactivity, and/ or impulsiveness, individuals diagnosed with ADHD can have struggles in several areas of daily life including work, school, basic needs, and social relationships. Due to difficulties in these areas and with executive functioning, individuals diagnosed with ADHD can struggle with rejection, self-esteem issues, depression, and anxiety.
Types and Symptoms of ADHD
Predominantly Inattentive Type
Difficulty focusing
Disorganization
Trouble following directions
Forgetfulness
Daydreaming or seeming "elsewhere"
Starting but not completing tasks
Losing items like keys
Easily distracted
Predominantly Hyperactive-Impulsive Type
Fidgeting
Excessive talking
Difficulty staying seated
Interrupting others
High energy
Impulsivity
Combined Type
Displays symptoms from both inattentive and hyperactive-impulsive types.
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Prevalence: How Common Are Both ADHD and Bipolar Disorder?
Research suggests that up to 20% of individuals diagnosed with ADHD may also meet the criteria for bipolar disorder (Stiehl, 2023). While some clinicians still believe the two cannot coexist, this co-occurrence is more common than previously thought especially in complex mental health presentations like those involving eating disorders and trauma.
Overlap Between ADHD and Bipolar Disorder
Though they are different conditions, ADHD and bipolar disorder share several overlapping symptoms that can cause confusion:
Commonalities
Mood dysregulation, depression, and anxiety
Impulsivity
Hyperactivity and distractibility
The key difference lies in the cause and pattern of these symptoms. ADHD symptoms tend to be chronic and consistent, while bipolar symptoms are episodic and tied to mood shifts.
How Do I Know If I Have Both?
One major distinction is how mood symptoms develop. ADHD-related mood issues often stem from challenges like executive functioning failures, rejection sensitivity, or repeated misunderstandings. In contrast, mood changes in bipolar disorder arise from neurochemical shifts, often without an obvious external trigger.
For example:
Someone with bipolar disorder may experience a depressive or manic episode without a clear cause.
Someone with ADHD may feel depressed because they missed an important deadline or forgot a task, experiences that repeat over time and affect self-esteem.
How Do We Treat ADHD and Bipolar Disorder?
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1. Psychiatric Assessments
A thorough assessment is key to understanding how these conditions interact. I always recommend clients work with a psychiatrist and consider neuropsychological testing.
2. Medication for Bipolar Disorder
Mood stabilizers and antipsychotic medications are commonly used. Antidepressants must be used with caution, as they can trigger mania in some cases. In cases of severe mood episodes or safety concerns, inpatient treatment may be necessary.
3. Mood Tracking & Therapy
Therapy helps individuals recognize patterns and learn skills for emotional regulation. I often use mood tracking tools and incorporate:
Dialectical Behavior Therapy (DBT)
Cognitive Behavioral Therapy (CBT)
Emotional regulation strategies
Self-care planning
4. ADHD Medications: Use With Caution
Stimulants can help with focus and impulse control but may worsen manic symptoms. Non-stimulant options are available and may be a better fit for some clients.
This part of treatment requires collaboration between client, therapist, and psychiatrist or psychiatric nurse practitioner.
5. Sleep Tracking & Routines
Getting enough rest is crucial. Lack of sleep can trigger mood episodes and worsen focus. I recommend:
Morning sunlight exposure
Structured sleep/wake routines
Brief morning exercise
6. Executive Function Coaching
Working with a coach or therapist on executive skills like time management, organization, and planning can make a huge difference for ADHD symptoms. One highly sought after local resource whom we would recommend is Shara Tipton, who spent some time in the Monarch kaleidoscope! (By the way, kaleidoscope means both the cylinder with mirrors that lets you see beautiful shifting colors, and a group of butterflies!)
7. Therapy for ADHD
Therapy can help address:
Emotional responses to ADHD symptoms
Coping strategies
Negative thought patterns
Impulse control
Treatment Is a Balancing Act
Every client is different. That’s why it’s so important to build a team with professionals like a therapist, psychiatrist, and executive function coach who understands both ADHD and bipolar disorder.
Treatment is not one-size-fits-all, and with the right support, healing is possible. You’re not “too complicated,” and you don’t have to navigate this alone.
Reach Out
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