How to Detect the Difference Between Bipolar Disorder and ADHD in Children

Symptoms of ADHD and bipolar disorder in children are very similar, and it can be difficult to diagnose which condition your child has. Here are suggestions about how to tell ADHD and bipolar disorder apart. Only a trained psychotherapist, psychologist or psychiatrist can make a definitive diagnosis, so be sure to consult a mental health care professional if you suspect that your child may be suffering from bipolar disorder or ADHD.

Things You'll Need

• Paper
• Pencil

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Instructions

Make a List

• 1

  Make a list of the times your child has broken or destroyed things---either his own, or property that belonged to others. On one side of the list, mark an "A" next to the times he destroyed property in anger, during a temper tantrum or while raging against a real or imagined offense against him. Mark a "C" beside the examples where he broke things by being overly rambunctious or careless. Count each group, and write the letter that most represents the cause of your child's destruction at the top of your page. If the letter is an "A," then your child may be demonstrating a symptom of bipolar disorder. If the letter is "C," your child may have ADHD. If there are equal amounts of both letters, your child may have mixed ADHD and bipolar disorder.

• 2

  Make a list of the length and character of your child's most recent tantrums or rages. Were they brief, lasting no more than 20 minutes, or did your child continue to rage or cry for 2 hours or more? If your child's tantrums, crying spells or rages tend to last for a long time without dissipating, she may be suffering from bipolar disorder. Mark "B" on a piece of paper if your child's tantrums last more than an hour or two. If your child displayed disorganized thinking and a lessening of her usual communication skills, or if she forgot the tantrum afterwards, mark "B" on the paper. These are all signs of bipolar disorder during a tantrum. Next to each listed tantrum, mark an "A" next to the tantrums that were triggered by a transition or physical discomfort or injury. Mark a "B" next to the tantrums that were triggered by a "no" from someone in a position of authority. Children with bipolar disorder are much more likely to throw a tantrum when limits are being set on behavior. They may even seek out a "no" in order to have a reason to rage. Add up your list of letters, and if you have marked more "B"s than "A"s, your child may be suffering from bipolar disorder.

• 3

  Write a brief paragraph about the first half-hour of your child's day this morning, and do the same for each of the past five days. Read through your descriptions, and write an "A" next to descriptions that describe alertness after waking. If your child tends to awaken slowly and remains grumpy or muddled in his thinking for an hour or more afterward, mark a "B" next to the description. If you have more "B"s than "A"s, your child may be suffering from bipolar disorder.

• 4

  Make a list of your child's bedtime habits for the past week. On nights when your child showed resistance to going to bed and woke up several times during the night complaining of nightmares, mark a "B." If your child demonstrated difficulty in falling asleep but remained asleep all night and did not complain of bad dreams when he woke up, mark an "A." Children with bipolar disorder may be fearful of sleep because they tend to have nightmares or wake frequently throughout the night. Children with ADHD may have problems winding down to go to sleep, but once they are asleep they generally sleep through the night without nightmares. Add up your letters, and if you have more "B"s than "A"s, your child may be suffering from bipolar disorder.

• 5

  Observe the way your child reacts when speaking to doctors, psychologists or school counselors. If she is openly hostile or unwilling to be interviewed, she may be demonstrating bipolar behavior. If she is friendly and open during the interview, but she still manages to veer off-course and make the interview difficult for the interviewer, she may have ADHD. Bipolar children are much more likely to be resistant to authority or hostile to any situation where they are not in complete control of the conversation. This may make questioning them difficult on purpose. ADHD children, however, may not be able to focus on questions that they find uninteresting. They may stray from the topic at hand and make a coherent interview difficult.

Reflect on your Child's Behavior

• 6

  Think about your child's behavior around authority figures and in social situations. If she is willfully disobedient, tends to seek out conflict or demonstrates "thrill-seeking" behavior often, she may be bipolar. If, however, she often gets into trouble through carelessness, inattention, forgetfulness or because of an inability to monitor her physical closeness to others, she may be suffering from ADHD.

• 7

  Look at your child's report cards or preschool behavior notices. If your child tends to do well academically but has trouble behaving in class or with his peers, he may have bipolar disorder and not ADHD. If he is having problems paying attention, following simple directions, remembering what he has learned or showing up with his homework, he may have ADHD. If your child tends to be gifted in certain areas, while remaining defiantly disinterested in others, he may have bipolar disorder. If he demonstrates learning difficulties, including problems with math, reading or sequential tasks, he may have ADHD.

• 8

  Think about your child's comments and ideas. If he tends to say things that are morbid, psychotic-sounding, paranoid, or if he tends to wallow in self-pity and blame others for his problems frequently, he may have bipolar disorder and not ADHD. If he speaks in a steady stream, without regard to whether or not his conversation has anything to do with what others are interested in or speaking about at the moment, he may be demonstrating an inability to self-censor and could have ADHD.