The Surprising Differences Between Bipolar I and Bipolar II

Bipolar disorder has been making headlines recently as a growing number of celebrities and influencers—including singers Halsey and Bebe Rexha—reveal their diagnoses with the condition that affects nearly 6 million Americans. Despite the increased awareness of the disorder, the condition that used to be called manic-depressive disorder remains shrouded in myths and misinformation. Most people think bipolar disorder is a singular condition with a fixed set of symptoms—manic episodes that alternate with depressive episodes in a cyclical pattern. While that may be true for many people with the disorder, it isn’t so for everyone who has bipolar disorder. In fact, there are multiple types of bipolar disorder and the symptoms experienced depend on which type you have. The most common and most serious forms of the condition are bipolar I and bipolar I. What are the differences between these subtypes of bipolar disorder? To clear up the confusion, this blog will outline the main characteristics of each type.

WHAT IS BIPOLAR I?

Bipolar I is characterized by the presence of mania and may or may not include depressive episodes. During manic episodes, people feel abnormally energized, euphoric, and full of confidence. It is common for people in the throes of a manic episode to come up with lots of grandiose ideas, start several big projects, and skimp on sleep. Common signs of mania include:

• Unusually elevated mood
• Inflated self-esteem
• Decreased need for sleep
• Increase in goal-oriented activity
• Grandiose notions, ideas, or plans
• Increased talking or pressured speech
• Racing thoughts
• Inability to “turn off the mind”
• Poor judgment that leads to risk-taking behavior
• Hypersexuality or hyper-religiosity
• Excessive appetite
• Inappropriate social behavior
• Irritability or aggression
• Delusions or hallucinations

With mania, behaviors can be so exaggerated that they disrupt daily life. People with bipolar I may impulsively buy expensive items they can’t afford, have sex with a colleague in the office during working hours, or engage in criminal activities. In some instances, mania may be so severe that a person requires hospitalization or suffers severe consequences, such as being injured, attempting suicide, getting arrested, being fired, being suspended from school, and more.

WHAT IS BIPOLAR II?

People with bipolar II typically experience both emotional highs and low moods that can occur in a cyclical pattern. However, the biggest difference between bipolar I and bipolar II is that episodes of elevated moods in bipolar II aren’t as intense as those in bipolar I and don’t reach the level of mania. Mental health experts call these episodes in bipolar II “hypomanic.” The biggest difference between bipolar I and bipolar II is that episodes of elevated moods in bipolar II aren’t as intense as those in bipolar I and don’t reach the level of mania.

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During hypomanic episodes, you may feel a surge of energy, self-esteem, and productivity, but it usually doesn’t prevent you from handling everyday tasks and it isn’t likely to land you in trouble at work, at school, or with the law. People who are experiencing a hypomanic episode may seem like the life of the party—full of ideas, confidence, and high energy.

DEPRESSIVE EPISODES IN BIPOLAR DISORDER

There can be a downside to the manic or hypomanic episodes seen in bipolar I and bipolar II, respectively. These emotional highs may be followed by periods of depression that can last weeks or months. Symptoms of depressive episodes in bipolar disorder include:

• Sad or negative mood
• Low energy
• Fatigue or feeling “slowed down”
• Feelings of hopelessness and helplessness
• Feelings of worthlessness
• Difficulty concentrating
• Insomnia, hypersomnia (sleeping too much), or early awakening
• Suicidal thoughts and behaviors

In both bipolar I and bipolar II, depressive episodes occur more often, are longer in duration, and are more debilitating than manic or hypomanic episodes. Results from a study in the journal Bipolar Disorders show that people with bipolar I spend 3 times as much time in depressive episodes compared with manic periods. For those with bipolar II, nearly 4 times as much time is spent in a depressed mood compared with hypomanic episodes.

GETTING DIAGNOSED WITH BIPOLAR I OR BIPOLAR II

To be diagnosed with bipolar I, a person must have experienced at least I manic episode with or without a depressive episode. For a bipolar II diagnosis, there must be at least one hypomanic episode and one depressive episode. However, because the symptoms of hypomania are more subtle, it can be more challenging to get a definitive diagnosis of bipolar II. What may complicate diagnosis even further is the fact that people struggling with both forms of bipolar disorder typically seek help related to the depression they experience. As a result, people with this condition may be misdiagnosed with major depressive disorder. In fact, research shows that 12% of people with hypomania initially received a diagnosis of depression. People with bipolar disorder may also be misdiagnosed with ADHD or schizophrenia since there is some overlap in symptoms with these conditions. Brain SPECT imaging can be beneficial in getting an accurate diagnosis because it is helpful in identifying brain activity patterns associated with various conditions. SPECT, when included as part of a comprehensive evaluation, can help rule out other possible conditions or causes for symptoms, such as substance abuse.

TREATMENT FOR BIPOLAR DISORDER

There is hope for people who are struggling with either bipolar I or bipolar II. With a clear diagnosis, a targeted treatment plan can put you on a path to manage your condition. The most effective treatment plans for bipolar disorder take a multi-pronged approach and may include psychotherapy, nutritional supplements and medication, lifestyle changes, and more. Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.