Sometimes, it’s tough getting the right diagnosis. An old friend of mine went through a whole slew of incorrect diagnosis, including bipolar disorder, until her doctors finally hit on ADHD.
I also have a personal connection with misdiagnosis of bipolar disorder, as my husband was
|The prevalence of ADHD across the US.
By CDC, [Public domain], via Wikimedia Commons
diagnosed with it a year after we were married. The incredible stress of high level bullying at work broke him, and when we finally found what we thought was a good doctor, he was given a diagnosis of bipolar disorder, but no indication of type. In retrospect, the fact the doctor prescribed him the newest medication on the market after talking to him for a grand total of ten minutes should have raised huge red flags.
Finally leaving the job and taking some time for himself helped him achieve balance. He’s off of all medication, has shown no signs of regression in almost a decade, and works seasonally. However, that diagnosis makes him difficult to insure privately until the full ten years has passed. That struggle with doctors, medication experiments, stigma, money problems as well as unbelievable fear and stress nearly broke both our marriage and me.
For the record, we’re both doing much better, and next month we’ll be celebrating 10 years of marriage.
Differences Between Bipolar Disorder and ADHD
Although it’s always possible to have more than one diagnosis at the same time, there are some distinct differences between these two. Both disorders have high and low points in mood as well as energy, which affects attention, but the patterns tend to be much different.
Uncontrolled ADHD symptoms tend to show themselves on a chronic basis. The individual is restless, can’t focus and may complain of racing thoughts. ADHD reacts positively to behavioral therapy and sometimes changes in the diet. Doctors will often prescribe a variety of psycho stimulants, some antidepressants or non-stimulant medications.
Bipolar disorder, on the other hand, tends to be episodic. A patient experiences extreme highs and extreme lows for a period of time, usually lasting well over 24 hours. When the right combination of medications and therapies is found, the symptoms will vanish for a period of time. This symptom free period is known as remission, but they will almost always come back without medication or if the individual’s body chemistry changes. This disorder is usually treated with anti psychotics, antidepressants and/or mood stabilizers.
Why They’re Hard to Differentiate
The problem with their diagnosis is that both conditions must be monitored for a period of time until a valid diagnosis can be made. All symptoms and environmental concerns must be noted by the patient, so the doctor can have a good base off of which to work.
Unfortunately, in today’s rushed world, my hubby’s story isn’t rare, and when a loved one is suffering, naturally, everyone wants them to feel better ASAP. Unfortunately, in that rush, details are missed.
Because of that, the mood instabilities associated with bipolar disorder can be mistaken for ADHD, especially in kids and teens, while the hyperactive part of ADHD could be mistaken for the mania associated with bipolar disorder. Adults and children alike who have ADHD may suffer from depression associated with social reactions to behavior associated with their attentional issues.
There is also the fact that there are no blood tests, and because fMRI readings of individuals with these disorder are still being study, there are no concrete markers to turn to for diagnosis. This leaves questionnaires and long term observations as the only diagnostic tools available.
Childhood Diagnosis vs Adult Diagnosis
Another complication arises when you take into account the differences between a child’s developing brain, the effect of hormones on a teenager’s body and the effect of these disorders on a full grown adult.
|Children and adults function differently,
thanks to varying phases of development.
By Linda Bartlett (Photographer)
[Public domain], via Wikimedia Commons
For a long time, doctors thought that symptoms of both disorders would be the same in both children and adults. Recently, that idea is being challenged more extensively. Mania, for example presents in adults by things as euphoria, irritability, lack of sleep and frantic activity. In some children, however, it may only show itself as crankiness or an overly negative attitude.
Another difficulty lies in childhood development and the ever more stressful world of school and work. Multitasking has become more prized in both arenas, and unless you’re one of those few who naturally excels in it, that constant shifting of attention may start to come through as the inability to focus that ADHD is so well known for.
The most sinister thing about that is most people can’t recognize when it begins to happen. Tasks tend to build up on each other, adding more stress to our lives, and before we know it, we’re overwhelmed with activity. Is it any wonder that our attention span goes down the drain after a while?
I have no doubt that there are valid sufferers of both ADHD and bipolar disorder, but there is probably quite a bit of mis- and over diagnosis going on.
(If you’d like more info on over diagnosis, I’ve already written about it here.)
So, how can you spot misdiagnosis in your child? WebMD has some great suggestions here. Basically, you need to find out how the diagnosis was made, ensure the doctor has already talked with your child’s teacher, ensure the doctor sees your child regularly before and after diagnosis, and consult someone who specializes in adolescent psychology.
Similar advice should be taken for an adult, because patterns in their lives are vital to a correct course of treatment. I wish I had known this years ago, but hopefully this can help someone in a similar situation today.