ADHD: implied, equal to or meaningful/valid

Do you think ADHD is a valid/useful diagnosis together with BP, or do you maybe think that ADHD is a prodrome or in some other way, and still, part of BP?

Does it deserve a separate mention?

Maybe it's helpful in answering to take in consideration that about 50% of us, with BP, have a diagnosis of ADHD.

Should it maybe be a specifier, like what "with a seasonal pattern" is?

Yes, it is a valid/useful diagnosis.

When you're depressed, your concentration sucks... but when you're in a better mood, your concentration is usually fine. (That's assuming you don't sit on the ADHD spectrum.)

When you have ADHD, your concentration sucks no matter what mood you're in (although depression certainly exacerbates those concentration issues). Not everyone with BP has concentration problems that exist 100% of the time (and I realize this is why you suggested the "specifier"). Also, there is much more to ADHD than attention & concentration issues. There is emotional dysregulation involved, and often hyperactivity with impulsivity exists. Sure, there are people with ADHD who don't have the hyperactive-impulsive behavior (and therefore qualify for the inattentive ADHD subtype), but their working memory and processing speed is impaired.

Bipolar disorder involves mood instability (hence it is a mood disorder), not attention/concentration problems. Sure, a mood can bring about attention/concentration problems, but if you don't sit on the ADHD spectrum, those problems don't exist when you're in a normal state of mind. I think ADHD is very much separate from BP because it is independent of mood and therefore the "ADHD symptoms" seen in BP patients should not qualify as a BP "specifier".

So, tl;dr -- I don't think it should be a specifier. I think the ADHD-BP combo is just a common comorbidity.

Same thing with BP people who have GAD. There are a lot of people here who also have GAD.

ADHD is a valid and separate diagnosis. It doesn't wax and wane with mood. If it does, then it probably isn't ADHD.

Interesting.

Would you say the distractibility is also of a different nature (not considering the non-episodic nature)? Does the same type of distractibility, attention/concentration problems, get worse with mania or is it a different kind taking centre stage, or both?

For me, distractibility is the same in terms of how it presents itself. It's the intensity that changes. During hypo/mania, the distractibility is significantly worse. I get nothing done.

I would say that distractibility and attention kind of go hand in hand. If you're distracted, you're not really paying attention, right? But, I still think it's a little different. In ADHD, your attention drifts whether you're distracted or not. With hypo/mania, your attention drifts because you're distracted... if that makes sense.

It's the impulsivity that's really different. In mania, impulsivity presents itself as "OMG I LOVE CHOCOLATE. I'M GOING TO INVEST $100,000 IN A CHOCOLATE COMPANY." In ADHD, impulsivity is more along the lines of impatience.

I get that (not as in like that, luckily: I have enough problems)! Makes perfect sense. Interesting. Thanks.