Like_Your_Spell I think that it's hard to to see the difference especially when you are dealing with new hormones etc. For myself a clear difference can be seen when my mood doesn't match with what's going on around me i.e. week 2 of my hospitalization for major depression I woke up happier than a pig in s***. For children / teens in my opinion a misdiagnosis of ADD often occurs when it's actually BP. Either way if there is a concern a diagnosis should be made by a Psychiatrist who specializes in disorders in teens/children because medication at that young age is even more controversial.