The Carlat Psychiatry Podcast cover image

The Carlat Psychiatry Podcast

When Bipolar and ADHD Overlap: Diagnosis

Nov 18, 2024
The podcast explores the intricate overlap between bipolar disorder and ADHD, using a real-life case study to illustrate diagnostic challenges. Listeners learn about the need for precision in identifying these conditions, especially when considering treatment options like stimulant medications. A quiz is introduced to help understand affective temperaments linked to both disorders. The discussion includes a five-step guide for diagnosing ADHD in adults with bipolar symptoms, emphasizing the importance of assessing mood episodes and childhood history.
17:23

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Quick takeaways

  • ADHD and bipolar disorder share overlapping symptoms that complicate diagnosis, particularly due to the episodic nature of bipolar mood symptoms versus continuous ADHD symptoms.
  • Cognitive impairments in bipolar disorder can persist post-mood stabilization, making it essential to carefully assess these issues to avoid misdiagnosis of ADHD.

Deep dives

Differentiating ADHD and Hypomania

ADHD and hypomania exhibit overlapping symptoms such as distraction, impulsivity, and irritability, making diagnosis challenging. While ADHD symptoms are typically continuous, symptoms of bipolar disorder are considered episodic. However, in practice, distinguishing between these conditions can be difficult, as cognitive issues can persist in bipolar patients even after mood symptoms have resolved. Misdiagnosing ADHD in those with bipolar disorder could lead to inappropriate stimulant prescriptions, which may exacerbate mania.

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