ADHD and Bipolar Disorder

Published on 27 September 2023 at 01:33

ADHD and Bipolar Disorder

Studies have found the rate of comorbidity of ADHD and Bipolar Disorder is around 20% (of patients with BD who also have ADHD) – see Altinbas, 2021. This overlap appears strongest in males. I suspect the link may be even stronger in relation to the milder form of bipolar, called Bipolar 2.

ADHD and Bipolar Disorder are related but not quite the same. ADHD may be viewed as a basic neurobiological temperament, disposing a person to have difficulty in regulating emotions, moods, and impulses. Bipolar conditions are thought of predominantly as mood disorders. However, the disturbances of mood may be rooted partly in the more general dysregulation of mind and brain that characterises ADHD.

People with ADHD often have strong emotional reactions to frustration and rejection. Seemingly small interpersonal events can be amplified so that they are experienced as major narcissistic wounds. Melancholic reactions may intensify, accompanied by plunging self-esteem. Or there may be a mounting mood of rage, designed to neutralise or obliterate the source of intolerable shame. Anxiety may also spiral out of control. All these features of ADHD can set the neurobiological and psychological scene for bipolar mood fluctuations.

In some people, the classic bipolar mood fluctuations are cyclical, appearing to follow an endogenous rhythm. By contrast, in some others, the mood shifts, particularly to depression, may be triggered by interpersonal events and circumstances. In these cases, it can be very helpful for the person to develop the capacity to monitor their moods, to observe patterns, and identify triggers. Without this observational stance, he or she may simply feel immersed in the ‘reality’ of whatever mood state they happen to be in. Since each mood state will be accompanied by a particular constellation of thoughts, perceptions, and self-image, the person will feel this is their reality and may have no access to the cognitive constellation of a different mood state.

Energy psychotherapy, including acupoint tapping, can help to sooth interpersonal wounds and cushion the impact of narcissistic shocks - and generally assist in the brain-mind's self-regulation. 

There are dangers inherent in the use of stimulant medications for ADHD where there are also elements of bipolar mood fluctuations. Manic and aggressive states of mind can be triggered – and there are also cases of stimulant-induced aggressive and paranoid states. Medication for ADHD should always be carefully monitored for adverse effects.



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