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Lately a connection seems to have been found between ADHD and Bi-Polar disorder,
what are your thoughts on co-morbidity and misdiagnosis?
All right here is the relationship, alright
the relationship between ADHD and bipolar is a one way street
ADHD children carry no elevated risk for bipolar disorder over that of the general population
no longitudinal studies have found that to be the case my own included
not the Canadian Studies not the New York studies
not the Iowa not the Swedish not the Australian
(the bipolar) risk is 2 to 4% which is the population rate
so if a child starts out ADHD that's probably what they're going to stay
bipolar becomes a very remote diagnosis
however, if there is bipolar disorder in the family
the risk goes up 8 times
now the real relationship is from bipolar to ADHD
if a child has bipolar disorder ... already and it started in childhood
the risk is 80 to 97% that they will have ADHD along with it
and that is why the confusion people saw that so many bipolar children had ADHD
they made the leap that the opposite had to be true
that ADHD was a big risk for bipolar and it turned out to be no risk for bipolar disorder
unless the family history of bipolar illness is there
and then the genetic risk for bipolar disorder obviously are what mediate that high risk
so bipolar disorder only if it starts in childhood
carries a very high risk for ADHD along with it
and ADHD is usually the first disorder to start
if the bipolar starts in adolescence the risk is 40 to 45% that ADHD is (co-morbid) with it.
if it starts in adulthood which is the more typical form of bipolar disorder
the risk is only 20 to 25%
so notice it's the early-onset bipolar that brings the risk of ADHD with it
not the other way around
now if there's bipolar there and it started in childhood
it is one of the worst psychiatric disorders a child can have
barring infantile autism or schizophrenia
very difficult to manage it requires multiple medications to try to deal with it
there's obviously an increased risk of not just destructiveness
but violent behavior particularly in males
there's periodic hospitalization for safety as well as for
re-engineering the psychopharmacology that is testing the drugs
many of the drugs used with
bipolar disorder have far more serious side effects than the ADHD drugs do
and so children are often hospitalized,
partly to monitor the side effects as they are titrating them
the bipolar child has a massive increase in risk for suicide and drug abuse
as they enter adolescence
so this is not a fun disorder
but it is 2 to 3% roughly of children
have the bipolar disorder and it is severe
and it is usually lifelong
and it often requires poly-pharmacy and periodic hospitalization
so the news isn't good
but at least we can say ADHD is not a cause of bipolar disorder
most ADHD children are never at risk for it
but if there's a family genetic link to bipolar
then that young child with ADHD may also carry that link and that risk