The Different Types Of Bipolar Disorder And How To Treat Them

Bipolar disorder is a lifelong mental health condition that affects the way a person thinks and behaves. People with bipolar disorder experience notable shifts in mood and energy levels that (referred to as mood episodes), when left untreated, can affect a person’s ability to study, work, and maintain healthy relationships.  

Contrary to what many people believe, bipolar disorder is not just one mental illness - in fact, there are a few types of bipolar disorder with distinct characteristics. The type of bipolar disorder a person can get diagnosed with can also influence their course of treatment, which is why it is essential to distinguish between them. In this article, you will learn about the various types of bipolar disorder and how they are treated.

General characteristics of bipolar disorder

Although there are variants of the condition, bipolar disorder, as a general term, has some common traits and symptoms that apply to any type.

Bipolar disorder is an episodic condition defined by mood swings that can last for over a week. Mood swings typically range from “highs” (referred to as manic or hypomanic episodes) to “lows” (referred to as depressive episodes), which is why bipolar disorder is sometimes called manic-depressive disorder or manic depression by some individuals. When someone experiences four or more cycles of mania or depression within one year, this is referred to as “rapid cycling.”

Here are some of the most common symptoms of bipolar disease characterized by the type of mood episode:

Manic symptoms

To meet the criteria for a manic episode, patients must exhibit at least three of the following:

• Increased energy and a sense of euphoria and elation
• Feeling touchy and irritable
• Racing thoughts and speech
• Excessive multi-tasking
• Easily distracted
• Inflated self-esteem and delusional and grandiose thoughts
• An increased desire for pleasurable activities, including risky behaviors

Depressive symptoms

To meet the criteria for a major depressive episode, patients must exhibit a minimum of five of the following:

• Feeling sad, down, and anxious
• Restlessness and difficulty concentrating
• Low energy and forgetfulness
• A loss of interest in activities
• Appetite changes
• A sense of hopelessness and worthlessness
• Preoccupation with death and suicidal ideation

You may have noticed that symptoms of a depressive episode are identical to those of major depression, and you would be correct. Mania, to some degree, will always be present in bipolar disorder; without it, it would just be depression. In some episodes, there might never be depression, but in others, they can be mixed.

Next, you will learn about how these kinds of episodes are essential in helping to determine which of the types of bipolar disorder a person will be diagnosed with.

The three main forms of bipolar disorder

Based on the episodes a person is experiencing, people are primarily grouped into one of three different categories - bipolar I, II, and cyclothymic disorder; on top of these, there are a few additional ones for those with signs that do not fit with the other selections. These are the possible options:

Bipolar I disorder

Bipolar I disorder consists of episodes of mania that last for a minimum of seven days and persist for most of the day. It can also be diagnosed when the symptoms require hospital care. Individuals with bipolar I type can also experience mixed symptoms and depressive episodes. For a mixed episode to be present, symptoms of mania and depression must have persisted for at least one week; however, depressive episodes often last for two weeks or longer.

Bipolar II disorder

Depressive and hypomanic episodes characterize bipolar II disorder but not severe mania, which is present in bipolar I. On the other hand, unlike a manic episode, a depressive episode must have lasted for at least two weeks.

Cyclothymic disorder

Cyclothymic disorder is a unique kind of bipolar disorder in that it has hypomanic and depressive symptoms that are still persistent, but they are not nearly intense enough as standard hypomanic or depressive episodes. In adults, these symptoms can last for at least two years; in younger individuals, they may only last only for one year. Therefore, people with cyclothymic disorder will experience many mood swings reasonably consistently.

Other types of bipolar disorder

Substance/Medication-induced bipolar and related disorders

Various substances, including prescription medication, can cause symptoms of bipolar disorder to develop in some individuals. These people are grouped here because the symptoms do not meet the DSM-5 criteria for regular manic, hypomanic, and depressive episodes, as a substance may contribute to them.

Bipolar and related disorder due to another medical condition

This category is also situational, contingent on something else for a diagnosis. For instance, hypothyroidism can cause manic features in some individuals, and it would qualify them for this niche category. However, some medical conditions might not be apparent right away, which could lead someone to be diagnosed with one of the primary types of bipolar disorder if other testing is not completed.

Other specified and unspecified bipolar and related disorders

If a person has symptoms that do not match the above categories, they can receive this diagnosis. For example, if someone has hypomanic symptoms that have only lasted three days, they can fall into this category. The symptoms are enough to cause clinical distress and impairment in various aspects of life. In some cases, there may not be enough information available, yet the symptoms are present, and thus the condition will be grouped here.

The risk factors for bipolar disorder

Currently, there is no definitive cause for bipolar disorder, but it is believed that multiple factors can play a role in the development of this condition, such as:

• Genetics
• Brain structure and chemistry
• Stress, abuse, and trauma

Bipolar disorder often runs in families, but genetic predisposition is not caused by a single gene. Multiple genes are responsible. Studies involving identical twins have shown that one can develop bipolar disorder while the other will not. While your closest family members, such as siblings and parents, having bipolar disorder can increase the odds of developing the condition, it is important to point out that most people will not develop bipolar disorder, despite a familial connection.

Comorbidity with bipolar disorder

According to the National Institute of Mental Health, many people diagnosed with bipolar disorder commonly experience other comorbid mental health conditions. If someone has a comorbid disorder, they experience two or more conditions at the same time. For example, one study tells us that as many as one in six people diagnosed with bipolar disorder are also diagnosed with attention deficit hyperactivity disorder (ADHD). At times, some of the symptoms of bipolar disorder and attention deficit hyperactivity disorder overlap, and may make it difficult for someone to recognize which symptoms are associated with which diagnosis. 

In order to properly treat and manage symptoms of bipolar disorder, it’s important to receive an accurate diagnosis. If you believe that you’re experiencing symptoms of bipolar disorder or other mental disorders, like attention deficit hyperactivity disorder, make an appointment with your doctor.

How bipolar disorder is treated

Since there are different types of bipolar disorder, there can be some variation in how each is treated; nonetheless, there is still plenty of common ground.

Because all forms of bipolar disorder have manic properties, an antimanic agent and mood stabilizer are almost always used to treat the symptoms of mania. Lithium is one of the most common mood stabilizers for treating bipolar disorder.

For depressive symptoms, an antidepressant may also be prescribed, but not always. Some of the most commonly used antidepressants target serotonin, a neurotransmitter in the brain associated with mood and pleasure.

Treatment is tailored to each person’s specific diagnosis. For example, if someone is diagnosed with bipolar disorder and attention deficit hyperactivity disorder, their treatment plan may look different from someone who only experiences bipolar disorder. 

Other people with this condition may be prescribed an antipsychotic medication if they are also experiencing psychosis, which is a symptom found in various conditions, including substance abuse. Psychosis can make diagnosing bipolar disorder complex at times because it can overlap with manic symptoms, exhibiting as delusional and grandiose behavior. Some people with bipolar disorder have been misdiagnosed with schizophrenia because of this reason.

Outside of medication, people have seen significant improvements by including psychotherapy (also called talk therapy) in their treatment plans. If you have been struggling with the symptoms of bipolar disorder and you have been thinking, "I just need someone to talk to," this may be one of your preferred treatment options.

If you need someone to talk to, a therapist can help address and restructure your thoughts and give you the skills to handle the emotions you are currently experiencing and might again in the future.

Lastly, electroconvulsive therapy (ECT) may be used in severe cases where other treatment methods do not work. Some people might require different medications, but some rare individuals may be unresponsive to all of them. ECT can also be used when an immediate response is needed, such as in a suicide risk situation or when they are unresponsive.

If you or someone you know is experiencing suicidal thoughts, help is available. The National Suicide Prevention Lifeline can be reached by calling or texting 988 and is available 24/7.

Online treatment can help

While there is no cure for bipolar disorder and its different forms, these treatment methods have a high success rate. People with bipolar disorder can manage their symptoms through a combination of medication and therapy.

The condition can worsen without treatment, so it is crucial to get diagnosed by a physician or mental health professional as soon as possible. Although people with bipolar disorder can keep it under control, the condition is incurable, and treatment will need to be ongoing to prevent episodes from reoccurring and produce better long-term outcomes.

Only a medical doctor or psychiatrist can prescribe medication, but psychotherapy never requires a prescription. Having someone to talk to online is always an option. Online therapy is an excellent option for people with bipolar disorder or their loved ones who need help coping. With online treatment, you don’t have to worry about being on a waiting list or commuting to an office some distance away. When you sign up, you’re matched with someone who is available to start helping you right away, and you can attend sessions from anywhere you have an internet connection. Research showed that online treatment is effective, with one review of 14 studies concluding that it is just as effective as in-person therapy. If you’re ready to take the next step, sign up with Regain to get started.

Takeaway

Bipolar disorder can be difficult for all parties to cope with, especially at first, but with the proper support, you can manage it. When friends and families have active involvement in the treatment process, it allows people to overcome bipolar disorder together.