While there are similarities between bipolar I and bipolar II disorders, a few key elements set them apart.
Lately, you seem to have more energy than usual. Your loved ones have noticed that you’re speaking differently, and they’ve pointed out a change in your sleep schedule. Given this, you’re wondering if you may have bipolar disorder. And if that’s the case, which type is it?
Only a mental health professional can provide an accurate diagnosis. In any case, the outlook is hopeful. With supportive treatment, your symptoms of bipolar I or bipolar II can be managed. But a specific diagnosis can make all the difference in your treatment plan.
Bipolar disorder is a mental health condition that impacts about
Bipolar disorder exists on a spectrum, and not everyone experiences it the same way.
There are four types of bipolar disorder:
- bipolar I disorder
- bipolar II disorder
- cyclothymic disorder
- bipolar disorder unspecified
If you live with this condition, you may cycle between moods over a period of days, weeks, or months, according to the American Psychiatric Association (APA).
Symptoms of bipolar disorder vary. They may present as mania (or hypomania), depressive episodes, or a combination of both. You may also have periods where you don’t experience extreme highs or lows.
Mania, or a manic episode, is the main diagnostic criteria for bipolar I disorder.
You may have a manic episode for a week or more, during which you’ll feel unusually high in energy or self-confidence, according to the National Institute of Mental Health (NIMH).
During a manic episode, you may talk quickly and jump from topic to topic. You may have difficulty controlling impulses, leading to behaviors like spending more money than usual or driving at high speed.
Sometimes, people with manic episodes also experience symptoms of psychosis. These symptoms often require urgent medical care and can include:
- disorganized thinking and speech
Psychosis can also occur during depressive episodes, but it’s more common during mania.
Hypomania is one of the diagnostic criteria of bipolar II disorder.
A hypomanic episode is similar to a manic episode but considered milder. While many of the symptoms overlap, they differ in the level of intensity.
During a hypomanic episode, you may feel a sense of euphoria or a general “good mood.” It could arrive as a sudden onset of new ideas or creativity. Perhaps you sleep less or have a hard time turning off your brain from racing thoughts.
You may feel more social than usual or have an increased desire for sex. You may also find that you have more energy to do things that you normally feel too tired to do.
This sudden boost in energy levels is not as extreme as during episodes of mania.
A depressive episode may occur in all types of bipolar disorder. Though, contrary to popular belief, it is not required for a diagnosis of bipolar I disorder.
Some signs of a depressive episode include:
- an overwhelming sense of sadness or despair
- appetite or weight changes
- extreme fatigue or exhaustion
- inability to enjoy your favorite activities
- insomnia or trouble falling asleep
- irritability or angry outbursts
- sensory sensitivities (noise, touch, etc.)
- thoughts of self-harm or suicide
While they’re considered separate diagnoses, there are many overlaps between bipolar I and bipolar II disorders.
For the majority of people, symptoms of bipolar disorder first emerge between the ages of 15 and 24, regardless of the subtype.
In both bipolar I and bipolar II, symptoms may be exacerbated by substance use, history of childhood trauma, death of a loved one, or persistent significant stress.
In order to receive a diagnosis of any type of bipolar disorder, you must experience intense changes in mood that differ from your usual state.
You must also experience at least one episode of mania or hypomania.
General symptoms of these episodes may include:
- elevated energy level
- feeling restless
- needing less sleep
- increased self-confidence
- being more talkative than normal
- having a rush of new plans and ideas
- working on multiple projects at once
- being easily distracted
- having decreased inhibitions
- increased libido
Research suggests that bipolar I disorder is the more prevalent of the two.
There is new
In bipolar II disorder, depression may occur more frequently. It may even be your dominant experience.
There are some crucial differences in how the two types are diagnosed.
|Bipolar I disorder||Bipolar II disorder|
|Symptoms are more intense and frequent.||Symptoms may present as less intense.|
|You have at least one manic episode with symptoms of psychosis that may or may not require hospital care.||You have at least one hypomanic episode, typically without psychosis or hospital care.|
|Mania occurs for at least 7 days or more.||Hypomania occurs for at least 4 days or more.|
|No depressive episode is required to receive a diagnosis.||You have at least one depressive episode lasting 2 weeks or more.|
|Symptoms may lead to hospitalization, but not always.||Symptoms are less likely to lead to hospitalization.|
Everyone’s experience with bipolar disorder is unique.
Treatment of bipolar disorder may include a combination of:
- lifestyle changes
- self-care strategies
You may have additional specifiers in your bipolar disorder diagnosis, like rapid cycling or features of psychosis, that can modulate the type of treatment that’s best for you.
Seeking the help of a mental health professional is highly advisable. They will work with you to create a treatment plan that fits your individual needs and experiences.
In general, treatment for bipolar I disorder may include mood stabilizers, antipsychotics, and sleep aids.
Treatment for bipolar II disorder may include mood stabilizers and antidepressants, as depressive episodes may show up more often.
Some form of therapy is recommended for all types of bipolar disorder.
There are five modalities that may be effective for this condition, according to the National Alliance on Mental Illness (NAMI).
- cognitive behavioral therapy (CBT)
- family-focused therapy (FFP)
- interpersonal and social rhythm therapy (IPSRT)
- dialectical behavioral therapy (DBT)
- group psychoeducation (aka, group therapy)
Those who live with bipolar I disorder may benefit from hospitalization or inpatient treatment, particularly during manic episodes with symptoms of psychosis. However, this is not the rule, and only a health team can recommend what’s best for you at the time you’re presenting symptoms.
If you’ve been living with bipolar disorder for a while, you may have seen your symptoms shift over time. This is natural as you age and try out different treatments.
With that said, researchers don’t yet know if you can experience one type of bipolar disorder first and then another.
In one older study,
Living with bipolar disorder, no matter which type it is, can be a challenge.
If your mood episodes occur frequently, feel intense, and sometimes require hospital care, it may be bipolar I disorder.
If your mania symptoms feel more mild, and you experience depressive episodes more often, it may be bipolar II disorder.
Only a mental health professional can provide the right diagnosis. In any case, symptoms of bipolar disorder can be managed and recovery is possible.
To explore your options for diagnosis and treatment, consider these resources:
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Find a Psychologist tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Psychologist tool
- National Alliance on Mental Illness Helplines and Support Tools
- National Institute of Mental Health’s Helpline Directory
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists