When ADHD Gets Mistaken for BPD, Bipolar, etc: A NYC Therapist's Perspective
If you've ever felt like your ADHD diagnosis doesn't quite fit, or you're wondering whether what you're experiencing is actually ADHD or something else entirely, you're not alone. ADHD is one of the most commonly misunderstood conditions I see in my practice, and honestly, that's what concerns me most.
Here's why: when ADHD gets confused with other diagnoses, people end up pursuing treatment approaches that might not be the right fit. And since each of these conditions requires its own specific approach, getting the right diagnosis from the start really matters.
I'm Matt, a therapist here in New York City, and I run PRGRS Therapy, a group practice specializing in ADHD therapy. Over the past decade, I've worked in a large hospital psychiatry department and in private practice, and I've seen firsthand how often ADHD gets mixed up with other conditions.
I'm not going to bog you down with dense research citations here. Instead, I want to share what I've observed working with real people navigating these questions.
Why ADHD Is So Often Misunderstood
ADHD is complex. It's not just about being unable to focus or sitting still. It shows up in memory challenges, emotion regulation struggles, difficulty handling rejection, and so many other ways that people don't typically associate with ADHD.
Because ADHD manifests differently from person to person, it often gets mistaken for other mental health conditions. Now, here's an important caveat: these disorders can absolutely occur together. This is exactly why getting a thorough assessment from a qualified professional is so crucial.
Five Conditions That Get Confused with ADHD
1. Bipolar Disorder (Type 1 and Type 2)
This is probably one of the more concerning mix-ups I see. Both ADHD and bipolar disorder can involve elevated mood states and seeming “mood swings”. What really trips people up is the concept of "hyperfocus" in ADHD, which can sometimes look like the intense, “hyperfocus” seen during manic or hypomanic episodes. But I'll be honest—teasing these apart requires careful assessment, especially since they can coexist.
2. Borderline Personality Disorder (BPD)
Both ADHD and BPD involve significant emotion regulation difficulties. People with ADHD often experience intense emotional reactions that feel overwhelming and hard to control. This can look a lot like the emotional intensity seen in BPD. Again, these conditions can occur together, which makes professional assessment essential.
3. Post-Traumatic Stress Disorder (PTSD)
Here's another tricky one. PTSD and ADHD can both cause concentration difficulties, emotional reactivity, and that constant feeling of being on edge. Not to mention some research shows that people with ADHD are more likely to experience trauma. Now, sometimes it's both. Sometimes addressing the trauma helps with focus and emotional regulation. Sometimes ADHD was there all along and needs its own attention.
4. Anxiety Disorders
ADHD and anxiety are close companions. They occur together quite frequently. But sometimes what looks like primary anxiety is actually ADHD-driven.
Think about it: if you're constantly forgetting things, running late, losing track of commitments, and feeling like you can't keep up, you're going to feel anxious. Is that anxiety a separate condition, or is it a natural response to living with untreated ADHD? This is something we work through carefully with clients at our practice.
5. Depression
Depression and ADHD share some surprising overlaps—low motivation, difficulty concentrating, feeling overwhelmed by daily tasks.
The exhaustion of trying to function with an ADHD brain in a neurotypical world can absolutely lead to depression. Sometimes treating the ADHD helps lift the depression. Sometimes both need attention. It's rarely simple, though.
What This Means for You
If you're reading this and thinking, "Wait, could I have been misdiagnosed?" or "I'm not sure what I actually have," here's what I want you to know: uncertainty is okay, and seeking clarity is smart.
A thorough assessment with someone who understands ADHD—and these overlapping conditions—can make all the difference. At PRGRS Therapy, we specialize in ADHD treatment for exactly this reason. We understand the nuances, we know what questions to ask, and we've helped many New Yorkers find the clarity they needed to move forward.
Whether you're in Manhattan, Brooklyn, Queens, or anywhere else in New York State, we're here to help you figure out what's actually going on and what will help you feel better.
The right diagnosis isn't about labeling you—it's about opening the door to treatment that actually works.
Book a free call with our practice today
