The vast majority of people with bipolar disorder and about 35% of those with major depressive disorder have at least one other psychiatric illness. Some of these illnesses include anxiety disorders, eating disorders, substance use disorders, obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). ADHD can be difficult to diagnose because symptoms can overlap with other disorders. A group of researchers has found that adults with bipolar disorder and unipolar disorder experience ADHD at rates significantly higher than the average population.
ADHD occurs in anywhere from 4-12% of children. Of these, 10-60% will continue to experience the disorder into adulthood. ADHD is present in approximately 4.5% of adults in the general population. There are generally three sub-types of ADHD- inattentive, hyperactive/impulsive and combined.
Recent research, led by Hatice Harmanci and published in Nöropsikiyatri Arşivi Archives of Neuropsychiatry, sought not only to find the frequency with which bipolar and unipolar disorders co-occur with ADHD, but also to find the frequency of each sub-type.
The study involved 100 people in remission with bipolar disorder, 100 people in remission with major depressive disorder and 100 healthy controls. All participants were surveyed on symptoms and also on hyperthymic, aggressive, cyclothymic and anxious temperaments.
The researchers found that 48% of those with bipolar disorder also qualified for a diagnosis of ADHD. For those with depression, that number was 25%. In the bipolar disorder group with ADHD, the most common sub-type was inattentive at 46%, followed by 33% combined and 21% hyperactive/impulsive. For major depressive disorder, the most common sub-type of ADHD was combined at 52%, 28% inattentive and 20% hyperactive/impulsive.
It can sometimes be difficult to distinguish between behaviors and symptoms in bipolar disorder, unipolar disorder and attention deficit hyperactivity disorder. For those with bipolar disorder, the hyperactivity and impulsiveness of ADHD can mimic that of bipolar mania or hypomania. Inattention can mimic that found in depression.
Because of this, it’s important to recognize the individual symptoms of Adult ADHD. According to the Diagnostic and Statistical Manual of Mental Disorders, at least five of the following symptoms must be persistent for at least six months in order to justify a diagnosis.
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
- Often has difficulty sustaining attention in tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
- Often has difficulty organizing tasks and activities.
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
- Often loses things necessary for tasks or activities.
- Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
- Is often forgetful in daily activities.
Individuals will exhibit these symptoms in different ways according to the sub-type of ADHD they experience as well as other personality traits. This is especially true if other psychiatric illnesses are involved. Always rely on a mental health professional for an official diagnosis.
Image credit: Sodanie Chea