By Jeff Copper, MBA, PCC, PCAC, CPCC, ACG – September 29, 2025
In this post, I’m tackling a topic that continues to surprise many people, which is the comorbidity of ADHD and bipolar disorder. “Comorbidity” refers to disease or medical conditions that are present at the same time in a patient. To be completely honest, I once believed that ADHD and bipolar disorder couldn’t coexist. But, as I later learned, not only is it possible to have both ADHD and bipolar disorder, it’s actually quite common.
To learn more, I interviewed clinical psychologist Dr. Roberto Olivardia in an episode on Attention Talk Radio. Dr. Olivardia has deep insights and clarity on complex mental health issues. According to research, around 20% of people with ADHD also have bipolar disorder, and between 50% and 90% of individuals with bipolar disorder show signs of ADHD. This is a substantial overlap and is a significant finding.
When both conditions are present, the impact can be severe. Comorbid ADHD and bipolar disorder are associated with:
- Higher overall impairment
- Increased impulsivity
- Greater frequency of depressive and manic episodes
- Higher suicide risk
In fact, bipolar disorder alone has one of the highest suicide rates of any psychiatric condition. About 20% of people with bipolar disorder die by suicide, and roughly 50% attempt it at some point. Add ADHD to the mix, and the stakes get even higher.
One of the most challenging aspects of treating individuals with both ADHD and bipolar disorder is distinguishing between the two. Many symptoms, such as emotional meltdowns, impulsivity, and energy fluctuations, can appear similar on the surface, so it’s important to understand the context of these behaviors. This subtle distinction is crucial for accurate diagnosis and effective treatment.
Given the high rate of overlap, Dr. Olivardia strongly encourages anyone diagnosed with bipolar disorder to be assessed for ADHD, and vice versa. Unfortunately, many clinicians are not trained to spot the nuances, which makes proper diagnosis even more difficult.
So, what can we take away from this? If you or someone you love has been diagnosed with one of these conditions, don’t just accept it and stop there. Seek out a professional who specializes in both ADHD and mood disorders. A deeper evaluation might reveal a more complex and treatable picture.
Please watch my video interview, ADHD and Bipolar Disorder, Diagnosis Individually and Collectively, for more from Dr. Olivardia on this subject. His insights continue to help countless individuals and families better understand the intricacies of living with neurodiverse conditions.
TRANSCRIPT:
Jeff Copper:
Welcome, everybody, to this edition of Attention Talk Video. I’m your host, ADHD and attention coach Jeff Copper. And we’re here today with Dr. Roberto Olivardia.
Dr. Olivardia, welcome to the show.
Dr. Olivardia:
Oh, great being here, as always.
Jeff Copper:
We love having you on the show. I love your stuff. You always make great distinctions that I think are very helpful. And today, we’re talking about having ADHD and bipolar. I have to be honest with you, I actually had thought years ago that you couldn’t have the two together. Now, from you, you actually can have both conditions at the same time, correct?
Dr. Olivardia:
Absolutely. And actually, they’re quite comorbid or you’ll often see them together. So, about 20% of people with ADHD have bipolar disorder. And studies show that anywhere from 50% to 90% of people with bipolar disorder have ADHD, so they’re highly related. And you can have both as two distinct diagnoses. And in fact, when people do have both, it’s associated with higher impairment, with higher rates of suicide, with higher just general depressive and manic episodes and higher impulsivity.
Jeff Copper:
So, 50% to 90%, that’s a big number. And when you combine those two together, it’s a more debilitating condition.
Dr. Olivardia:
Oh, without a doubt, absolutely. Bipolar disorder in general is a significantly serious psychiatric disorder. It has one of the highest suicide rates. About 20% of people with bipolar disorder commit suicide. About 50%, one in two, attempt suicide.
Jeff Copper:
Wow.
Dr. Olivardia:
So when you combine that with ADHD, it can become a very, very serious problem. And unfortunately, oftentimes one of those disorders often don’t get diagnosed when people actually have both.
Jeff Copper:
Which is my next comment, because many times it seems to me very subtly they present very similarly, so I would think making the diagnosis and cutting it out with a Swiss Army knife to determine it is ADHD or bipolar is difficult, or telling that it’s the two combined. Can you speak to that for a second?
Dr. Olivardia:
Oh, without a doubt. It’s very important that somebody really assess for what’s ADHD and what is a mood disorder. And in general, I would say if there’s one thing that people can take away, it’s the idea of how context-specific it is.
So, for ADHD, generally the emotion or the emotion dysregulation will be very context-specific. So, somebody is not getting a toy that they want and they completely have a tantrum. Somebody is very upset that they just got broken up with, so they’re going to be feeling depressed.
With a bipolar disorder, it’s often not context-specific. It could be triggered or it’s triggered by something that really is out of step with the level of intensity of the emotion. So, some of my patients who are depressed or who have manic episodes will say that they wake up sometimes feeling that way, that it’s just this general sense that feels so internal. Whereas with ADHD patients, you’ll often hear it’s more something external that then informs how they feel internally.
Jeff Copper:
It seems to me that if you’re diagnosed, particularly with bipolar, that just bipolar, if it’s 50% to 90%, you should actually seek out and I guess be screened for ADHD. And my gut is there’s not a lot of people around that are schooled in this because it seems to me it’s a subtle art. What do you think?
Dr. Olivardia:
Definitely. I would say that it is important if you are diagnosed with bipolar disorder to be assessed for ADHD, as it is if you’re diagnosed with ADHD, to be assessed for a whole host of other psychiatric disorders. But absolutely, it’s very important because oftentimes the symptoms can mimic each other, so to see someone who’s an expert in ADHD, see someone who’s an expert in mood disorders is very important.
Jeff Copper:
Well, I appreciate that education. It’s always helpful to have you on the show, and so thank you very much.
Dr. Olivardia:
Sure. You’re welcome.
Jeff Copper:
Take care, everybody.