Expert: Ivan Goldberg, M.D. - 12/7/2008

Question
Hello, I am 16 years old and i was recently diagnosed with bipolar II disorder. My symptoms were of the standard for the disorder and my doctor decided lamotrigine would be a proper treatment. I will say it has helped more than i could imagine. It keeps me from going into those dark phases and keeps me in a balanced happy mood. I noticed however, as my mind became clearer from the absence of depression i became more aware of my inability to focus, stay on task, complete things i had begun to do etc. I had always had these symptoms but had always blamed it on the depression. I did some research and was suprised to learn ADD and ADHD can often share very similar symptoms with bipolar disorder, even depression. I will admit that in the past i have tried Adderall, as do many high schoolers. The funny thing was i did not get the speedy rush i had often heard about. The effect it had on me was an immense increase in focus and i was for once able to achieve progress in my studies that day. I also experienced an uncanny sense of well being and happiness. I brought up this experience, research and recent symptoms i had noticed to my counselor and she seemed somewhat convinced i could have an attention disorder as opposed to bipolar disorder. Even more coincidental my mom has often shared similar symptoms possibly hinting at a genetic link. How likely is it that i have been misdiagnosed?

Answer
Hi Matthew . . .

ADD/ADHD and bipolar disorder often are found in the same person, the fancy word is that they are 'comorbid." You can read a good deal about the comorbidity of ADHD and bipolarity at:
http://www.psycom.net/depression.central.bipolar-ADD.html

When people feel less depressed when taking Lamictal it is likely that they have a mood disorder. If there are also times of irritability and/or mood elevation and/or hyperactivity, bipolar disorder is a good guess. If, when the bipolar symptoms are under good control, there are symptoms of ADD/ADHD an attentional disorder is probably comorbid. I am obviously talking in general as there is no way I can know what is going on with you.

I think you should discuss all of this with a psychiatrist with experience in the diagnosis and treatment of people with mood and attentional disorders.