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Is It Bipolar Disorder or Attention Deficit Hyperactivity Disorder (ADHD)?

Sometimes a child might be diagnosed as having ADD or ADHD when in fact he or she has bipolar disorder. In both cases, the teen might be irritable, easily distracted, impulsive, and hyperactive. However, with bipolar disorder teens also often show depression, agitation, rapid mood swings, and problems with affect (doesn’t seem to understand the feelings of others). Because of the similarities in these disorders, some researchers believe that as many as 16% of children with bipolar disorder may be misdiagnosed.

What About Conduct Disorders?

A dual diagnosis might be appropriate if the teen is also showing extreme impulsive behavior, shoplifting, abusing drugs and/or alcohol, or violent outbursts.

How Are Mood Disorders Different in Teens?

Children and teenagers with mood disorders quite often go undiagnosed. Parents and teachers might simply write the child off as “difficult” and “obstinate,” not realizing there is an underlying psychological issue that must be dealt with by a professional.

Did You Know?

As many as 14% of children will experience at least one episode of major depression by their 15th birthday? Girls are significantly more likely to experience depression than boys after the age of 16.


The reasons it can be difficult to diagnose depression in adolescents are:

Teens do not always have the verbal skill or vocabulary to be able to express exactly what or how they are feeling;

The symptoms of depression and bipolar disorder are often different in children / teenagers than they are in adults;

A teen might have a dual diagnosis, with the more “obvious” illness masking an underlying problem with depression;

Physicians often do not expect to see mood disorders in teens so they simply do not look for them.

A depressed adolescent may be disruptive, begin showing academic difficulties, and start to develop problems with peer relationships. They may be irritable and aggressive. Often the only way these teens can express their feelings is by saying they hate themselves and their family. They may threaten suicide, but lack of a suicide threat does not mean they are not at risk.

Bipolar disorder also expresses itself differently in teenagers than in adults. Rather than bouts of euphoric moods, the bipolar teen may express the manic behavior through aggression or temper tantrums. Parents report these teens are very “moody, irritable, and aggressive.” These children may have sudden outbursts of anger or crying jags or might seem to be agitated for prolonged periods of time. Many clinicians describe bipolar disorder in this group as more “chronic” rather than “acute.”