Understanding The Difference In Bipolar Types I And II

Updated December 3, 2024by Regain Editorial Team

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If you or someone you know has been diagnosed with bipolar disorder, you might be curious about what it means. Maybe you've heard about it before but never looked into it. Perhaps you know there are multiple types, and now you're trying to figure out which one applies to you. Either way, you must take a closer look at bipolar types I and II and just what they can mean for you and your life in the future.

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What is bipolar disorder?

Bipolar disorder is a mental health disorder characterized by extreme ups and downs. People with bipolar disorder may feel extremely excited and have a great deal of energy at certain times; at other times, they may feel like they are in a deep depression. What's worse is that the highs and lows can each last for several weeks or even months before switching course. You never know what to expect or how long the good or bad times will last.

There are multiple types of bipolar disorder, but since the most commonly diagnosed bipolar disorders are bipolar I and II, we will focus on those types.

What is bipolar I disorder?

Bipolar I means that you have extreme episodes of mania. In this subtype of the disorder, you must have at least one manic episode to be diagnosed. That manic episode could include risky behavior, poor sleep, trouble concentrating, extreme happiness, extreme energy, and restlessness. This is not the same as simply being in a good mood or being hyper. The extremes will be evident to anyone who sees them, and it will be clear that something is wrong or very different.'

Mania could mean that the individual spends money recklessly, engages in high-risk behavior, is sexually promiscuous, or otherwise acts in ways that are incongruent with their normal behavior or what is considered socially acceptable behavior. Their actions interfere with their daily life, making it difficult to be reasonable or calm. Instead, they will generally be over the top for extended periods. These conditions must not be caused by another health condition, alcohol, or drugs to officially be considered a manic episode consistent with bipolar I disorder. Also, patients with bipolar I may or may not have depressive episodes.

What is bipolar II disorder?

Bipolar II disorder is characterized by major depressive episodes. Someone with bipolar II may not have a full-blown manic period as described with bipolar I. Instead, they will have hypomanic episodes, which are considered less severe. With the major depressive episode, it must last at least two weeks, and there must then be at least one episode of hypomania to receive this diagnosis. Unfortunately, because of how the depressive episode presents, patients may initially be misdiagnosed with major depressive disorder.

Patients with bipolar II disorder will have both hypomanic and depressive symptoms. The hypomanic symptoms may likewise showcase behavior different from typical behavior and will likely interfere with everyday life. 

Still, the hypomanic symptoms will not be as severe as full-blown mania. These are generally still severe enough that an outside observer will recognize that something is different or wrong and point out the behavior. Individuals suffering from hypomania typically engage in risky behavior, be overly excited or energetic, and in many ways similar to the full-blown mania we discussed. Still, they may not be to quite the same extreme. Other health conditions or drugs and alcohol must not induce these symptoms for them to be considered hypomania.

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Likewise, individuals with bipolar II will also suffer from depressive symptoms. These symptoms are very similar to major depressive disorder and include periods of sadness and hopelessness. The individual may experience a lack of interest in things they enjoyed and may be excessively tired or irritable. They may also have difficulty concentrating, sleeping too much or too little, eating too much or too little, or having thoughts of suicide. These symptoms must also not be caused by alcohol, health conditions, or drugs to be considered depression or part of bipolar II disorder.

People who are diagnosed with type II bipolar disorder may be more likely to experience “rapid cycling,” experiencing four or more episodes of either mania or depression in one year. 

How does bipolar disorder happen?

Like many other mental health disorders, we know little about how someone develops bipolar disorder or why others don't. In general, we understand that some physical characteristics or chemical imbalances in the brain can cause this condition. The reasons for these developments are unclear. 

Those with parents or siblings diagnosed with bipolar disorder are also at a higher risk for being diagnosed. There appears to be some genetic aspect, and the more people in your family with this disorder, the higher your risk will be. There is still no research identifying a specific gene that causes bipolar disorder, and there's no clear understanding of how this disorder is genetic. We also know that genetics is not the only way that you could develop bipolar disorder.

Some research suggests that extreme stress, drug, alcohol abuse, and even extreme experiences throughout life could result in bipolar disorder. Losing a loved one, suffering abuse, dependence on mind-altering substances, and more could all impact the brain dramatically, putting someone at a higher risk of developing bipolar disorder. Though not everyone who goes through these experiences will develop bipolar disorder, they most definitely increase the risk. Therefore, patients must seek mental health treatment if they experience severe symptoms, hopefully before developing bipolar disorder.

The diagnosis process

When it comes to diagnosing bipolar disorder, it requires an evaluation of symptoms related to mania, hypomania, and depression. Patients may be asked questions to determine more about their behaviors and experiences. They may also be encouraged to bring a close friend or a family who has witnessed much of the behavior and can speak to the situation even better. These individuals may be able to answer some questions and help the mental health professional get a better picture of just what's going on and how to diagnose it properly.

Treatment for bipolar disorder

Treatment for bipolar disorder may include a combination of medication and talk therapy. Medications used to treat bipolar disorder are commonly called mood stabilizers that aim to prevent episodes of mania or hypomania and depressive episodes. 

Mental health treatment from a licensed professional is recommended. This treatment will enable patients to work with someone to better understand their symptoms, behavior, and what they need to know about living with bipolar disorder.

Getting professional help

When you're ready to get professional help, you must find someone who can work with you effectively. You need someone you feel comfortable talking to who is available to start helping you right away. If you’re thinking about starting treatment, consider online therapy.

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With online treatment, you can find an extensive range of mental health professionals to help you. You don't have to worry about commuting to an office or being on a waiting list for an appointment. Instead, you can easily meet with your mental health professional from the comfort of your home or anywhere you have an internet connection. Online therapy is effective, too. In fact, one analysis of 14 studies concluded that online interventions are just as effective as online treatment. If you’re interested in online therapy, sign up with Regain to get started.

Takeaway

Bipolar types I and II have some similarities, but there are differences that distinguish one from the other. Regardless of the type, treatment is usually the same and centers on talk therapy. If you or someone you know needs help, consider talking to an online therapist.

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