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From the outside in, Emmy award-winning actress Mariette Hartley appeared to have it all. A successful career acting on stage, film, and television, co-authoring a best-selling memoir, Breaking the Silence, and performing an acclaimed one-woman show. But is the life behind the scenes that is raising public awareness of an entirely different sort of existence – the personal day-by-day struggle of living with mental disorder.

The granddaughter of infamous psychologist John B. Watson, whose studies in child development would have a marked effect on her early life, Hartley witnessed the suicide of her father and her mother’s slow descent into alcoholism. Despite her growing professional success, Hartley struggled throughout her early adult life with depression, alcoholism, an abusive marriage, and promiscuity – things she would later learn were symptoms of undiagnosed bipolar disorder. It was Hartley’s own experience in seeking treatment that has pushed her to become an advocate for others suffering with bipolar disorder, and to act as Honorary Director of the American Suicide Foundation.

In 1994, Hartley was first diagnosed with depression – an occurrence that hinders the doctor’s ability to treat the underlying disease. As most bipolar patients are pushed to seek treatment only when experiencing a profound low, doctors often mistake one for the other, resulting in a course of treatment with anti-depressants that can potentially trigger manic episodes. It was her experience in pursuing an alternative diagnosis that has brought to light a surprising connection between ADHD and bipolar disorder – both the commonalities of how the disorders manifest and the potentially dangerous results of misdiagnosis.

What is Bipolar Disorder?

The difficulty in diagnosis stems from the similar traits witnessed in both those with ADHD and bipolar disorder – among them intense emotional reactions to life events, impulsivity, inattention, and hyperactivity. While ADHD exhibits as a chronic disorder, and one that can often decrease with time, bipolar disorder is episodic and its effects can increase as the patient ages. To properly diagnose either disorder, and to treat the symptoms, there must be a thorough, detailed evaluation of how it manifests – a step that can be hindered if the patient is a child. (Many pediatricians are not fully trained in distinguishing the nuances between each, so if there is a genetic link with either disorder, it is best to seek the consultation of a child psychologist.) Misdiagnosed, it can take years to find the correct medications to address the symptoms.

ADHD and bipolar disorder can co-exist, prompting some researchers to speculate that there may be a third disorder that is not yet known. It is important to note however that in most cases, ADHD is the most likely culprit – occurring in 3-5% of school-age children, while bipolar occurs in less than 1%. But given proper medical attention and treatment – whether through medication or psychotherapy, patients are able to lead full, productive lives.

In sharing her own struggles, Mariette Hartley’s story has been reflected in the challenges faced by others, bringing greater social acceptance and understanding to this community. But it is an endeavor that is not yet finished. It is important to recognize that for those living with either of these disorders; the social stigmas can be as difficult to overcome as the symptoms.