At The Atypical View, we often explore how different forms of neurodivergence intersect, overlap, and are misunderstood. One diagnosis that is sometimes left out of the neurodiversity conversation is Bipolar Disorder. While bipolar is not a neurodevelopment disorder, but a mood disorder, many clinicians are advocating to include bipolar presentations within broader discussions of neurodiverse experiences, especially given their neurological basis and the overlap in lived challenges related to emotion regulation, executive functioning, and attention.
What is Bipolar Disorder?
Bipolar Disorder is a condition marked by distinct mood shifts that move between emotional highs (mania or hypomania) and lows (depression). These changes affect energy, activity, and the ability to function in daily life.
There are two primary types:
- Bipolar I: Characterized by full manic episodes that may last at least seven days or require hospitalization, often alternating with episodes of major depression.
- Bipolar II: Defined by patterns of hypomania (a less intense form of mania) and depression, without full manic episodes.
While research shows that bipolar disorder involves genetic, neurochemical, and environmental factors, there is still ongoing debate about where it fits in the neurodiversity framework. Some advocates argue that because bipolar is a form of neurological difference that affects perception and behavior, it belongs within the neurodiverse community, while others see it as a psychiatric condition, and have a more narrow lens of neurodiversity. At The Atypical View, we believe this condition falls under the neurodiverse umbrella.
Bipolar Disorder vs. ADHD and Autism
Because of overlapping traits, ADHD and autism are often misdiagnosed as bipolar disorder, especially in late diagnosed adults. While all three can involve shared symptoms of emotional intensity or executive function challenges, their patterns and triggers differ.
Key distinctions include:
- Emotional rhythm: In bipolar disorder, mood changes occur in episodes of either highs or lows, lasting days to weeks, while in ADHD or autism, emotional shifts tend to be more situational or reactive.
- Energy and sleep: Bipolar mania often brings dramatically reduced sleep needs and while still highly energetic and active during the day, which differ from ADHD and autism related sleep issues, which contribute to fatigue.
- Development of symptoms: Bipolar disorder develops in late teens or early adulthood, so symptoms would begin to develop around that time. Where as, both ADHD and autism are considered genetic, meaning their symptoms will likely be present throughout their life.
What can make things more complicated is we do see an overlap in having bipolar disorder along side autism, ADHD, and other disorders. This means it is incredibly important for us clinicians to stress the need for comprehensive assessment to avoid over pathologizing or missing overlapping traits.
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The Neurodiversity Umbrella
Neurodiversity is the concept that neurological differences such as autism, ADHD, bipolar disorder, OCD, dyslexia, and more are simply variations of the human brain. The term invites society to recognize the diverse ways people experience the world. That being said, these conditions also often require support and differing levels of management. After all, most neurodiverse diagnoses are considered disabling.
The benefit of a broad neurodiversity umbrella is that it allows individuals to communicate that their brain works differently without disclosing specific medical details. Saying “I am neurodivergent” can be a gentle and private way of self identifying, especially in professional or social settings where someone may wish to share their differences without revealing a diagnosis. We also know what it feels like to be isolated and judged for our brain, expanding the neurodiversity umbrella allows for making more seats at our table, and not contributing to that isolation or judgment towards someone else.
At The Atypical View, our therapy and coaching work honors this wide spectrum of neurodiversity. We provide space for late diagnosed adults and neurodiverse clients to find support for symptom management while they explore identity, regulation, and authentic expression with compassion and respect.
Research:
Dell’Osso, L., Carpita, B., Bertelloni, C. A., Diadema, E., Barberi, F. M., Gesi, C., & Carmassi, C. (2019). Subthreshold autism spectrum in bipolar disorder: Prevalence and clinical correlates. Psychiatry Research, 281, 112605. https://doi.org/10.1016/j.psychres.2019.112605
Sandstrom, A., Perroud, N., Alda, M., Uher, R., & Pavlova, B. (2021). Prevalence of attention deficit hyperactivity disorder in people with mood disorders. Acta Psychiatrica Scandinavica, 143(4), 380–391. https://doi.org/10.1111/acps.13283
Straszek, S. P. V., Straarup, K. M. N., Hjerrild, S., & Vinberg, M. (2024). Adults with both bipolar disorder and ADHD. Ugeskrift for Laeger, 186(15), V10230620. https://doi.org/10.61409/V10230620
