Many people with ADHD receive a diagnosis of cyclothymia, either before their ADHD diagnosis or after. Cyclothymia is a relatively rare mood disorder; it involves frequent mood swings between periods of hypomania and depression. But is cyclothymia a part of ADHD, or is it an entirely separate condition?
ADHD experts have known for decades that ADHD often includes an element of emotional dysregulation. Unfortunately, non-ADHD specialists often do not know this.
Let’s explore this complex interplay, highlighting a study on this topic.
Along the way, I’ll shed light on a larger issue—the widespread misunderstanding of ADHD’s complexity, even among mental health professionals. This lack of understanding has real consequences. ADHD is often misdiagnosed as something else, leading to ineffective or even harmful treatment plans. Yes, ADHD frequently has “traveling companions” such as anxiety, depression, or autism spectrum disorders. But misdiagnoses of mood disorders like bipolar or cyclothymia remain common.
Why do these misdiagnoses seem to happen so often with ADHD? Because ADHD symptoms can look like these conditions—or, over time, create fallout that mimics them. Mostly, it happens because the field of mental health still remains largely unsophisticated in its knowledge of ADHD. Let’s dig deeper into where cyclothymia fits in this puzzle.
ADHD’s Complexity: Traveling Companions vs. Fallout
One of ADHD’s most misunderstood aspects is its variability. It’s not a one-size-fits-all condition. Potentially hundreds of genetic factors contribute in small ways. Symptoms can evolve, overlap, and intertwine with other challenges, making diagnosis tricky.
Partly the problem is that many mental health terms and diagnoses are simply descriptive, some are outdated, and others represent distinct conditions. In the context of ADHD, certain traits may be inherent to its neurobiology, while others result from “ADHD fallout”—the consequences of unrecognized or poorly managed ADHD over the years.
To break it down:
- Some conditions are true co-existing disorders, such as depression or generalized anxiety.
- Others are consequences of unmanaged ADHD, like chronic stress, relationship problems, sleep deficits, or poor self-esteem.
- Then there are traits or temperaments—natural variations in personality or neurobiology that overlap with ADHD. Cyclothymia often falls into this category.
Cyclothymia, marked by mood swings less severe than bipolar disorder, can share symptoms with ADHD, such as emotional variability and impulsivity. The overlap often confuses clinicians who aren’t deeply familiar with ADHD’s full spectrum.
Cyclothymia and ADHD: A Risk Factor?
Recent research helps clarify the link between cyclothymia and ADHD. A study published in the open-access Cureus Journal of Medical Science examined temperament traits—like cyclothymic, irritable, and anxious temperaments—in adults with ADHD. Here’s what they found:
- Adults with ADHD scored significantly higher on cyclothymic, irritable, and anxious temperament scales than a control group.
- These traits were most pronounced in participants with childhood ADHD symptoms, suggesting a strong neurobiological connection.
- The researchers proposed that cyclothymic temperament might be a risk factor for ADHD, meaning it could reflect underlying neurobiological vulnerabilities.
But what exactly is a “risk factor”? It doesn’t mean causation. Instead, it suggests that certain innate traits—like emotional variability—may amplify challenges associated with ADHD.
Why It Matters: Misdiagnosis and Treatment Risks
Again, many clinicians misinterpret these overlaps. They see mood instability and emotional swings and label them as bipolar disorder, cyclothymia, or another mood disorder—missing ADHD altogether. This misdiagnosis can lead to inappropriate treatment. That is no small thing.
For example:
- Treating ADHD emotional dysregulation as bipolar disorder might result in unnecessary mood stabilizers or antipsychotics.
- Avoiding stimulant medications for fear of triggering mania can leave ADHD untreated, worsening emotional and functional difficulties.
- Proper diagnosis starts with understanding ADHD’s complexity, including its interplay with temperament traits like cyclothymia.
- When ADHD is properly managed, many overlapping symptoms—such as mood swings or irritability—often improve dramatically.
What Can You Do About A Potential Mis-diagnosis?
If you or someone you love has been diagnosed with cyclothymia and ADHD—or you suspect this overlap—consider these steps:
- Find an ADHD-savvy clinician: Misdiagnosis often occurs when professionals lack a deep understanding of ADHD’s nuances.
- Advocate for ADHD-first treatment: Properly addressing ADHD is often the key to alleviating co-existing symptoms.
- Stay informed: Knowledge is power. Research ADHD’s dimensional nature to better understand how it intersects with mood and temperament.
- Check out Solving Your Adult ADHD Puzzle Piece: Foundations. Here I take you step by step through the ADHD diagnostic criteria—and help you sort out ADHD symptoms and their lifelong impact from co-existing conditions. But that’s just one step in this comprehensive training, the equivalent of evidence-based therapy for ADHD.
Moving Forward: Better Understanding of ADHD
Understanding how cyclothymia and ADHD intersect is vital—not just for academic curiosity, but for improving real-world outcomes. Misdiagnosis doesn’t just delay treatment; it can derail lives. With clearer knowledge, we can move beyond labels and focus on strategies that truly help.
Curious about ADHD’s overlap with anxiety, depression, and mood disorders? Check out this post: Misdiagnosis: ADHD or Something Else?.
Let’s push for a deeper understanding of ADHD—not just as a diagnosis, but as a unique and multifaceted experience.
To Read the Full Paper on ADHD and Cyclothymia:
“Does Temperament Constitute a Risk Factor for Adult ADHD?” (Cureus Journal of Medical Science)
As always, I welcome your comments.
—Gina Pera
6 thoughts on “Cyclothymia and ADHD: A Risk Factor or Misdiagnosis?”
Bipolar is sometimes mistaken for ADHD too. Such as in my case. I always knew I wasnt ADHD… only had symptoms sometimes… and distinct episodes.
Hi Jamie,
I’d say at least until now, the reverse was more true. That ism ADHD being misdiagnosed as bipolar (and tons of other misdiagnoses).
It’s tricky. The human brain is not neat and orderly. 🙂
Sometimes ADHD resembles bipolar due to perceived “cycles” around poor sleep and dysregulated emotions.
A clear and careful history is so important.
g
Thank you so much Gina. Ive found out about your work today and all of it has been extremely validating. At the start of this journey, I originally thought that I had some form of BPD, specially, Cyclothymia. Hearing that its a genuine misdiagnosis and having such a key experience that aligns with that is other wordly.
Hi John,
Thanks so much for letting me know. Feedback like yours is what keeps me going.
It’s hard for some folks to believe, that they cannot trust the average psychiatrist (or even some of the “best”) to accurately diagnose ADHD.
Yet, there are so many competing fiefdoms, including grandstanding bipolar experts who actually promote the idea that ADHD isn’t real (and who have tenure at university medical schools), Trauma Industrial Complex sellers, and so much more.
I’m glad that my work is helping you find your way.
ADHD *is* tricky. It often requires above-average intelligence and diligence to understand.
There are the symptoms themselves, highly variable. Then there are the common coping responses when ADHD has long gone unrecognized. Too often, those coping responses are viewed by therapists as the problem, and they miss the core symptoms entirely.
I help folks tease out these threads in my online training. Because no one else is doing it!
Always feel free to write via the “contact” form.
take care
Gina
Gina
Thank you Gina, this is the first time I have seen Cyclothymia connected to adhd. I came across this after listening to a podcast from Dr Khurram Sadiq, regarding misdiagnosis, so put a search out. I was diagnosed with Cyclothymia in 2003, previous to that an Anxiety disorder. Then a year ago ADHD was brought to my attention by a Dr as I had felt completely overwhelmed, burnout and that have taking antidepressants on and off over my adult life felt it was not right for me. I struggle daily to manage time, expectations etc I get things done but it’s tiring and has a knock on affect. without and although now on the waiting list for a diagnosis, wonder what and how will help. Obviously putting in place techniques and strategies I have learnt on the way and developmental theories and neuroscience have helped me thrive in areas I may not without understanding trauma and impact.
I have a University Integrative Counselling Degree, nearly 2 decades of working in this field and began my own therapy at 22 years old. Only a couple of times have I heard Cyclothymia known or diagnosed.
As I reach my 60th birthday soon I hold out hope that I will be able to integrate this new information and if there is medication that would enhance and stabilise so I could pull this altogether and thrive in my later years and function well within my work with others and more relaxed in being with loved ones, it starts here embracing who I am with what I have and what I can be with what I know. Thank you for all your research efforts and time that you have put into this, I believe it has brought out an honesty within me and others I’m sure.
Dear Maria,
I’m so appreciative of the time you took to read the post and to write this comment.
My driving motivation, for 25 years, is to ease suffering and elevate lives in my little corner of the world. Which, fortunately, includes the “World Wide Web.”
Can I also say I admire you so much. You kept trying. You kept searching. You learned new things. You applied them. You earned a counseling degree for petesake. And yet you didn’t remain content in the standard orthodoxy. You kept your mind open and kept searching.
I say kudos to that doctor who mentioned ADHD. While ADHD is chronically and horribly misdiagnosed as many other things…. I have not seen many cases of the reverse.
I hope that while you are waiting for an evaluation, you can learn all you can from solid sources. Honestly, I would avoid most of what we find online and really focus on true expertise.
I have created online training to take folks by the hand from A-to-Z. It can jump speed progress an order of magnitude. You might also want to check out the YouTube videos from a person I consider a mentor, Russell Barkley, PhD.
For ADHD in women, in particular, you might want to check out book from my friend, Patricia Quinn, MD, a pioneer in ADHD, but especially in females. Her book is 101 questions about women with ADHD. Something like that! She and two fellow experts in female ADHD wrote a book called Understanding girls with ADHD. I shared an excerpt on this blog. Just look for it in the search box.
Honestly, you don’t need some therapist or psychologist for psychiatrist to tell you that you have ADHD. I believe that if you have a solid education, you will be able to fit these highly variable puzzle pieces to your life, from childhood on. No one knows your life experience, and your inner life, better than you do.
Of course, an evaluation and official diagnosis is needed in order to get stimulant medication. But being fully educated and proactive is the first step. Especially with medication.
Please consider me a resource. Write to me with questions anytime you like. Just hit the contact button on the top of the page.
I am very excited for you and wish you all the best.
Thanks again.
Gina