man in therapy

Bipolar Disorder and ADHD: Co-Occurrence And What It Looks Like

It’s interesting to note how differently physical and mental conditions are perceived. For example, no one thinks twice about co-existing medical conditions. If someone tells you that they have both arthritis and diabetes, you’d wish them well but would likely not bat an eye. These types of co-occurrences also happen with mental health disorders.

For example, attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BPD) can be frequently and confusingly co-morbid. ADHD is a neurological condition while bipolar is a mood-based disorder. On the surface, they sound distinct. In reality, it’s trickier than it first looks to distinguish between the two. But without accurate diagnoses, treatment plans can go awry.

A Brief Review Of Common Co-Occurring Symptoms (ADHD And BPD)

Bipolar Disorder


  • Distractibility
  • Impulsivity
  • Racing thoughts
  • Moving and talking quickly
  • Talking a lot
  • Restlessness
  • Not sleeping
  • Risky behaviors
  • Inflated sense of self


  • Chronic feelings of sadness and hopelessness
  • Sleep disturbances
  • Gaining and/or losing weight
  • Loss of focus
  • No longer want to engage in activities you once enjoyed
  • Thoughts of death, self-harm, or suicide


  • Distractibility
  • Impulsivity
  • Moving and talking quickly
  • Restlessness
  • Sensitivity to stress
  • Inability to focus on tasks
  • Poor time management skills
  • Indecisiveness

As you can see, there is some significant overlap that can further complicate diagnoses.

4 Factors To Consider During The Diagnostic Phase

man in therapy

  1. If the assessment takes place during the manic phase for someone with bipolar, it can be mistaken for ADHD alone. ADHD symptoms do not typically come and go. If this is observed, it might point toward a bipolar manic episode.
  2. Someone with bipolar disorder may display symptoms of ADHD when neither a manic nor depressive episode is happening. This makes it more likely that they also have ADHD.
  3. Both conditions cause mood swings, but the triggers are quite different. For people with bipolar disorder, mood swings are an inherent part of the disorder. For ADHD, the causes of mood swings are as obvious as they’d be for anyone. If they, for example, break something, inattention is probably to blame.
  4. People are born with ADHD and most often are diagnosed at school age. Bipolar disorder most often appears later in life.

How To Help With The Diagnostic Process

To further complicate matters, your doctor will also have to rule out other possible causes for symptoms like those mentioned above. These might include (but are not limited to) depression, medication side effects, anxiety disorders, and substance abuse. Your input will be essential during this assessment.

There is always the chance that both bipolar disorder and ADHD are present — with or without any of the other issues. And further still, many medical conditions can co-exist with BPD and ADHD, causing more profound symptoms for any of the co-existing conditions. Some of the factors that will be taken into account are:

  • Specific stressors in your life
  • Possible triggers you face
  • Medications you take (if any)
  • The age at which symptoms first emerged
  • Whether ADHD-like symptoms present during times of mood stability (not manic or depressive)
  • The impact of symptoms in your day-to-day life
  • Pre-existing conditions
  • Medical history
  • Family history

After such a thorough evaluation is made the next step is to discuss potential treatment ideas and protocols.

Treatment For Bipolar Disorder and ADHD Co-Occurrence

Every person and every case is unique. Therefore, your journey will not be sketched out using a cookie-cutter approach. Working closely with you — and perhaps others in your life — your mental health team will take a fluid approach. All elements will be considered and minds will remain open.

On their own, both ADHD and bipolar disorder are challenging. Together, they can feel daunting. But, with a skilled professional on your side, the obstacles can be overcome as you move forward. Contact us today to discover how mindfulness-based approaches like CBT therapy can effectively treat these conditions and enhance your well-being.

Sam Swafford, MS, LPCC

Sam is a Licensed Professional Clinical Counselor who works with adolescents, young adults, adults, and those who are a part of the LGBTQIA+ community. They specialize in trauma work and those with dissociative abilities. Sam aims to create a safe and comfortable space for all.

Jonathan Guzman, MA, LPCC

Jonathan Guzman is a Licensed Professional Clinical Counselor who specializes in individual, family, and couples counseling. He works with adolescents and adults to explore meaning, cultivate purpose, and envision ways through all of life’s challenges. He believes in person-centered care with a focus on healing and becoming our best selves.

Christine Dudero, MA,

Christine Dudero is a Licensed Marriage and Family Therapist experienced in working with individuals, couples & families across the lifespan. Christine takes a collaborative approach towards empowering you to achieve your therapy goals.

woman of color looking at her reflection in a glass window smiling

How Does CBT Help Depression?

About five percent of the adults on the planet have been diagnosed with depression. It boggles the mind to think how many others have not sought help or are unable to get such help. We’re not talking about having the occasional case of the blues. Depression is a serious mental health disorder with an alarming link to self-harm and suicidal ideation.

Fortunately, a broad range of treatment options exist. For people with mild to moderate depression levels, Cognitive Behavioral Therapy (CBT) has become a frontline choice — sometimes in combination with other approaches and/or medications. Let’s take a closer look at CBT and depression.

How Does CBT Work?

For starters, CBT is known for being a short-term treatment approach. Often, no more than 20 sessions are needed. The founding principles are as such:

  • Distorted thought patterns will result in distorted beliefs and thus, unhealthy behaviors
  • By identifying your counterproductive thinking, you can derail this cycle
  • From there, healthier cognition can replace the original patterns, e.g. positive self-talk and emotional regulation
  • Your CBT therapist will aim to empower you with the skills needed to repeat this corrective approach as needed

The distorted thought patterns mentioned above usually fall into categories like:

  • Overgeneralization
  • Black-and-white thinking
  • Automatically choosing negative reactions while disqualifying the positive
  • Disproportionate response to minor events
  • Predicting a negative future
  • Fixating on one negative detail
  • Taking everything personally

As you might imagine, this approach can be ideal for someone struggling with a mood disorder like depression. It’s also useful if you have friends and family members to help you keep up with therapy appointments, medications, and CBT homework assignments.

How Does CBT Help Depression?

Typically, people diagnosed with depression struggle with a negative view of themselves, their world, and their future. This can get them locked into the thinking traps listed above. CBT, therefore, is tailor-made for such a case.

woman of color looking at her reflection in a glass window smilingSomething must be done to short-circuit the depressive spiral. Left unchecked, it can drag a person down into a dark place. CBT aims to help them recognize the causes and effects. At the same time, CBT homework makes people with depression more aware of how much control they have. This combination has been found effective in:

  • Improving the person’s mood and keeping it consistent
  • Increasing the amount of positive self-belief the client experiences
  • Promising carry-over thanks to the CBT “homework” between sessions

Depression is notorious for giving someone the feeling that they lack agency, e.g., life is bad, and nothing they do can change it. Conversely, CBT demystifies the process of understanding how one’s thoughts can be controlled, which, in turn, controls one’s beliefs, moods, and actions.

CBT is Not Necessarily For All People With Depression

Almost always, CBT is safe and effective. However, some co-existing conditions or circumstances could shift that equation. If you are depressed but also present with any of the below issues, be sure to tell your therapist right away:

  • Substance abuse (including alcohol)
  • Psychotic disorder
  • Mental retardation

In addition, if you’re diagnosed with Major Depressive Disorder with suicide risk, CBT may not be considered until other steps are taken to address the urgent needs of such a diagnosis.

How Do You Know If CBT is Right For You?

First and foremost, you’ll want to consult with an experienced therapist. Every person with depression is unique. When choosing a treatment plan, a qualified therapist knows how to factor in these distinct elements. Hence, we invite you to reach out to talk and learn more about cognitive behavioral therapy. Let’s connect for a free and confidential consultation to discuss the specifics of your situation. From there, we can get you on the road to recovery and healing.

man in a business suit walking down a city street

How Does CBT Help Anxiety?

Anxiety is the most common mental health issue in the world. As a result, there are many available treatment options. Right up there at or near the top of the list is Cognitive Behavioral Therapy (CBT). A short-term treatment, CBT is founded on the concept that thoughts lead to feelings and feelings lead to behavior. Therefore, if distorted thinking can be identified and challenged, it will help unhealthy emotions and actions.

CBT can help teach someone with anxiety how to assess a situation before their embedded thought-feeling-behavior cycle kicks in. You might even choose to see it as pre-emptive fact-checking.

The 3 Steps of CBT For Anxiety

Identify the Distorted Thought

A person with anxiety may feel insecure or self-conscious. These negative thinking patterns can inspire feelings that they are unliked or unwanted. As a result, they avoid social gatherings. Recognizing this root cause is a giant first step toward healing.

Challenge the Distorted Thought

This is where fact-checking comes in. For example, if people don’t want you around, why would they invite you to the events you keep avoiding? It can be transformative to accept that your thoughts, feelings, and actions are not based on reality.

Replace the Distorted Thought

Once you realize that anxiety is lying to you, you can substitute a fact-based perspective. You might start with: Every when I feel uncomfortable or awkward in a crowd, people still like me and want me there. From there, new emotions and new behaviors will follow.

What Techniques Does a CBT Therapist Use to Apply the Above Steps?


In this technique, you’ll be guided to explore the thought patterns in your life. You may, for example, discover that you have a tendency to:

  • Fixate on minor episodes or details
  • Default to the worst-case scenario
  • Use singular events to generalize about all events

Such awareness increases your chances of eventually replacing these patterns.

Challenging Thoughts

Negative thoughts or “cognitive distortions” cannot stand up to real-life evidence. So, once you’ve identified these patterns, it’s time to examine them closely. Thoughts are sensations, not facts. Therefore, when a thought becomes chronic and invasive, it helps immensely to apply facts to it. This positions you to start trying out activities that you’ve been avoiding.

man in a business suit walking down a city streetBehavioral Activation

Speaking of activities that you’ve been avoiding, CBT will help you stop the avoidance. Anxiety is blocking you, not reality. Thus, as you move forward with your treatment, you’ll be encouraged to literally schedule an activity that you previously evaded doing. Write it in your calendar and, when the day comes, move forward — armed with a new awareness of the truth.

A subset of this technique is called “behavioral experiments.” These can be performed whenever you get caught up in worst-case-scenario thinking. You work with your therapist to list everything you feel anxious about. Then, you break down the items on this list — one by one — and basically deconstruct them.


You’ll want to keep a journal of journal of some sort. Keep track of your fears, doubts, and triggers. Monitor your thoughts and organize them into categories, e.g. anxious thoughts vs. thoughts based on facts. Another powerful list would be juxtaposing the negative thinking you experience with the new positive thoughts you are replacing that with.

Relaxation Techniques

CBT guides you to reduce stress by developing specific skills that can be applied whenever you need them. It might be progressive muscle relaxation, meditation, breathing exercises, or whatever else works for you.

Learn More About How CBT Helps With Anxiety

If anxiety is hampering your daily functionality, Cognitive Behavioral Therapy might be the right option for you. I invite you to reach out and learn more by scheduling a free and confidential consultation.

woman smiling at something off camera

What is CBT Used For?

CBT is short for Cognitive Behavioral Therapy. It’s a method of talk therapy that highlights the reality that our thoughts and our behaviors are connected. Once that connection is understood, it’s way easier to recognize how our distorted thought patterns shape our choices. CBT is very effective and is popular for taking place over a relatively few sessions.

It all sounds good, right? But, you’re wondering what is CBT used for. This post will focus on that but first, we’ll go over some basics of the treatment approach. How does it work and what principles and techniques are used?

How Does CBT Work?

To keep things brief, these three steps can help sum up CBT:

  • Assessing and challenging your current thought patterns
  • Replacing thought distortions with productive thought patterns
  • Altering your behavior when triggered

The techniques used to accomplish these goals include:

  • Cognitive reframing: Restructuring your perception in a positive way
  • Guided discovery: With your therapist’s help, you’ll learn how to see situations from multiple perspectives
  • Exposure therapy: Slowly confronting fears and phobias
  • Journaling: Keeping records of your thoughts and behaviors as they evolve
  • Scheduling new behaviors: Learning to not put off actions due to anxiety or fear
  • Behavior experiments: When scheduling those new behaviors, you’ll be asked to predict how it will go and then compare that with the actual outcome.
  • Stress reduction: This will involve visualization, deep breathing, and more.
  • Role-playing: Gain confidence, develop problem-solving tools, improve social and communication skills
  • Successive steps: Breaking big tasks into smaller, more attainable steps

woman smiling at something off cameraWhat is CBT Used For?

1. Anxiety

This goes for all forms of anxiety. CBT helps the client challenge the cognitive distortions that usually heighten anxiety. In other words, they become more skilled at facing up to fears and no longer default to avoiding them.

CBT has a stellar track record in treating two high-profile forms of anxiety, Obsessive-Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder.

2. Depression

CBT was originally developed precisely for the purpose of treating depression. Generally speaking, CBT empowers people who suffer from depression as a mood enhancer. Also, it encourages them to replace negative thought patterns with accurate beliefs and thinking.

3. Eating Disorders

There are different types of disordered eating. Different forms of CBT can address different types of eating disorders. CBT is often combined with other modalities when used for anorexia nervosa. However, with bulimia nervosa and binge eating disorder, CBT is usually the first line of treatment.

4. Schizophrenia

For people with schizophrenia, it is essential to disrupt the cycle of delusions leading to a worsening of all symptoms. CBT is an ideal option for this critical task.

Daily Benefits of Cognitive Behavioral Therapy

Whatever the reason you have sought treatment, the skills learned during CBT offer daily support, e.g.

  • Rational thinking: You now feel as if you are in control of your thoughts and thus, the behaviors they inspire.
  • Self-esteem: This feeling of self-control boosts confidence and self-esteem — two crucial components in the work of reducing symptoms.
  • Relaxation: Feeling confident in your ability to handle stress has a powerful calming effect on your mood.
  • Hope: People who have tried CBT report feeling more optimistic — not just about their condition or issues but about life itself.

Is CBT Right For You?

You’re surely curious about a treatment choice that:

  • Alerts you to distorted thinking and its impact
  • Teaches you how to reframe your negative thought patterns
  • Guides you away from relapse and toward recovery

With that foundation in mind, I suggest you reach out to learn more. CBT is a proven, effective treatment that occurs over a fixed number of sessions. Let’s find out if it’s best for you.