Updated on 8/30/2022
According to the American Psychiatric Association, there are four major categories of bipolar disorder: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder due to another medical or substance abuse disorder.
Bipolar disorder is a mental health condition that causes extreme shifts in an individual’s mood and energy levels. Although everyone experiences ups and downs in their life, there are severe shifts in mood and behavior characteristic to bipolar disorder that can seriously impact a person’s life and daily functioning.
A person with this disorder may experience periods of an extremely elevated or irritable mood defined as manic episodes, as well as episodes of depression. Both the manic and depressive periods can be brief – they might last for just a few hours or days – or the cycles might be longer, lasting up to several weeks or even months.
Different Types of Bipolar Disorder
Each type of bipolar disorder is identified by the pattern of mania and depressive episodes. The treatment that is best for you may differ depending on the type.
Common symptoms of a manic episode include three or more of these symptoms:
- Abnormally upbeat, jumpy or wired
- Increased activity, energy or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Impulsive decision-making
Common symptoms that occur in a major depressive episode include:
- Insomnia or hypersomnia
- Unexplained or uncontrollable crying
- Severe fatigue
- Loss of interest in activities that the person typically enjoys
- Recurring thoughts of death or suicide
Bipolar I disorder
Bipolar I is defined by at least one manic episode that lasts a minimum of seven days, or by manic symptoms that are severe enough to require immediate hospital care. In Bipolar I disorder, depressive episodes might occur as well and typically last at least two weeks. It is also possible for someone struggling with Bipolar I disorder to have manic episodes with some depressive features or depressive episodes with some manic features.
Bipolar II disorder
Bipolar II disorder consists of depressive episodes and hypomanic episodes, but doesn’t include the severe manic episodes that can inhibit functioning that is characteristic of bipolar I disorder. People who have bipolar II disorder have experienced at least one hypomanic episode and one major depressive episode in their lifetime. Bipolar II disorder typically causes individuals to experience multiple major depressive episodes, unlike bipolar I disorder where major depressive episodes aren’t required.
Between experiencing periods of hypomanic and depressive episodes, the individual with bipolar II disorder is typically able to live life normally.
Bipolar I Vs. Bipolar II Disorder
Understanding the similarities and differences between bipolar I and II disorders might be confusing, but the core differences lie in the intensity of manic episodes and the amount of major depressive episodes experienced. In bipolar I disorder, severe mania is experienced for at least one week, but in bipolar II, the less intense hypomania is experienced for at least four days. Both emotional highs of mania and hypomania might consist of abnormally high levels of energy, inflated self esteem, racing thoughts, impulsive behavior, a decreased need for sleep, and excessive talkativeness, among other things. However, while severe mania might come with psychotic features, impairment in functioning, and often requires psychiatric hospitalization, hypomania does not.
Both bipolar I and bipolar II disorders consist of shifts in mood, energy, and concentration. Other signs of these disorders might include: experiencing anxious distress, melancholy emotions, and psychosis. Depending on the timing of these symptoms, a person may be diagnosed with mixed episodes or rapid cycling.
Cyclothymic disorder (also called Cyclothymia)
This type of bipolar disorder is a milder form of bipolar disorder which consists of cyclical periods of hypomanic symptoms as well as periods of depressive symptoms that last for days or even weeks. The highs and lows of cyclothymic disorder, however, are not severe enough to qualify as hypomanic or depressive episodes according to the bipolar test requirements.
Cyclothymic disorder usually develops in adolescence. People with the condition often appear to function normally, although they may seem “moody” or “difficult” to others. Those struggling with this condition will often not seek treatment because their mood swings do not seem severe, but if left untreated, cyclothymia can increase the risk of developing bipolar disorder.
Bipolar disorder due to another medical or substance abuse disorder (unspecified bipolar disorder)
Some bipolar disorders don’t have a specific pattern or don’t match the three categories of disorders listed above and yet, they still align with the criteria for abnormal mood changes. For example, a person may experience mild depressive or hypomanic symptoms that last less than the specified amount for cyclothymia. Additionally, a person might experience depressive episodes, but have symptoms of mood elevation that are too mild or brief to be diagnosed as mania or hypomania.
These instances can be determined to be characteristic of bipolar disorder, but aren’t classified under the aforementioned types of bipolar disorder.
Help is Available for All Types of Bipolar Disorder
Treatment is available for all types of bipolar disorder. The first step to recovery is to seek help from a medical doctor or licensed mental health care provider such as a psychiatrist. The professional will likely provide you with a psychological assessment for bipolar disorder and work with you to create a treatment plan specifically for you. You might also be asked to monitor your daily moods and sleep patterns through a mood chart to help with diagnosis.
Treatment for this disorder usually includes a variety of strategies to manage the condition over the long term such as psychotherapy and medication. Since bipolar disorder is a chronic illness, treatment must be ongoing.
Medications are typically an important part of treatment and might include mood stabilizers, antipsychotic medications, or antidepressants. Such medications usually need to be taken regularly to be effective. If you have been diagnosed with bipolar disorder, you and your doctor will work together to find the right medication or combination of medications for your unique needs. As everyone responds to medication differently, you may have to try several different medications before you find one that relieves your bipolar disorder symptoms.
With treatment and through an individual’s own efforts, people with all types of bipolar disorder can live rich, rewarding lives.