When we look at bipolar disorder, we tend to think of someone with an alternating personality. However, this condition is actually much more complicated. Bipolar disorders are made up of different types, each of which has their own unique set of symptoms.
Throughout this article, we’re going to explore the differences between bipolar 1 vs bipolar 2, along with other types of this disorder. At the end, we invite you to ask further questions.
The Four Types of Bipolar Disorders
Bipolar disorder is actually a set of four different distinct disorders that range in severity as well as in their symptoms. ¹
The four disorders are:
- Bipolar 1
- Bipolar 2
- Cyclothymic disorder
- Mixed Features
Bipolar 1 is classified as a mental disorder that typically includes mood shifts from highs to lows. These high mood swings are called periods of mania or manic episodes as they usually only last for a short period of time, from handful of days to a couple of weeks. ²
It is likely for those struggling with bipolar 1 to have depressive symptoms as well. However, they are more commonly affected by manic or hypomanic episodes that vary in duration and in effects.
Bipolar 2 is fairly similar to bipolar 1. Still, it does have differences that requires distinction in diagnosis. Bipolar 2 is marked by mood shifts involving emotion altercations from a normal state to a depressive one.
Bipolar 2 involves major depressive episodes that usually last from a handful of days to a couple of weeks at a time. It is common for those suffering from bipolar 2 disorder to go from a depressive state that last for several days to a week to a manic one.
Cyclothymic disorder is described by the Mayo Clinic as a “rare mood disorder that causes emotional ups and downs, but they’re not as extreme as those in bipolar I or II disorder”. Cyclothymic disorder causes the patient to have shifts from high to low on a rhythmical cycle.
Mixed features refers to the coexistence of depressive and manic symptoms. This often complicates diagnosing as these symptoms closely resemble those of manic-depressive disorders.
They key difference of mixed features from bipolar 1 and 2 is that instead of just having one manic/depressive episode, these sufferers present a mixture in their mood states. Oftentimes experiencing two or more complex mood states at once.
Those that experience mixed features often develop the disorder with these complications at a younger age than those that have been diagnosed with either bipolar 1 or 2. However, there are those that develop mixed featured bipolar disorder at older ages as well.
Due to the complexity of those that have mixed feature episodes with their bipolar or manic depressive states, it is often noticed that patients have longer recovery periods from these volatile mood shifts as well as heightened states of paranoia, depression and manic-like tendencies or behaviors.
Those that struggle from mixed featured bipolar disorder are also more at risk of suicidal thoughts or actions as well as abuse to addictive substances.
What are the Symptoms of Bipolar Disorder
In order to identify the signs and symptoms of bipolar disorder, it’s important to categorize symptoms by three separate classes.
Mania is a common class of symptoms for bipolar disorders and it’s marked by periods of great excitement, euphoria, delusions, or overactivity that is heightened compared to how the patient usually functions.
Those experiencing mania or a manic-related episode might have the following sub-symptoms to their overlying mania:
- Increase in energy
- Feeling wired or naturally high
- Interrupting, racing or intrusive thoughts
- Fast in speech and movements
- Dabbling in behavior(s) deemed usually risky
- Distracted easily
- Heightened sensations, especially in smell and touch
Hypomania is a subset to mania but it’s less severe than regular mania or manic episodes. Those that experience hypomania might actually feel good or even better than they usually do, and they feel that their mania isn’t out of control.
However it is always best to air on the side of caution if you or someone you love is suffering from hypomania as hypomania, if gone unchecked, can spiral into full blown mania and cause interruptions or complications in a patient’s day-to-day life.
Depression or depressive-related symptoms are common in those that suffer from bipolar disorders. They often develop in cycles, much like mania or hypomania, and often make it difficult for the patient to function normally.
Its also common for those suffering from bipolar disorders to experience depression with large amounts of energy and to have deep depressive episodes a couple of times a year.
Those that are suffering from depression or a depressive-related episode might experience one or more of the following symptoms:
- Experiencing little to no energy
- Over or under-eating
- Hard time getting up and out of bed in the morning or during the day
- Complications in paying attention, concentration and decision making
- Little to no joy, wonder or excitement in what one is usually interested in
- Suicidal thoughts or tendencies
The Differences Between These Diagnoses
The major difference between all of these different diagnoses is essentially the severity of the mood shifts and the duration of said mood swings. However, due note that while these diagnoses might seem similar to one another, they are distinctively different disorder types that have their own symptoms and methods of diagnosis and treatment.
- Bipolar 1 is marked by a shift from a relatively normal state of functionality to a manic one that commonly lasts for anywhere to a handful of days to a couple of weeks.
- Bipolar 2 is similar to Bipolar 1, however, the shifts are usually towards a depressive state rather than a period of mania.
- Cyclothymic disorder is a kind of bipolar disorder that resembles bipolar 2 but is less severe in its symptoms.
- Mixed features is a subset of bipolar disorder in which the person who struggles experiences both high and low effects within the same episode.
Difficulties in Diagnosis: Searching for a Needle in a Haystack
The problem in diagnosing bipolar disorder and its different types is that its actually quite difficult to diagnose bipolar disorder in the first place. Due to its constantly shifting mood sets and the fact that the symptom set is similar to other mental disorders, bipolar disorder has created a real issue in finding clear and concise diagnosing methods.
To add to this predicament is the fact that there isn’t any one no specific tests to diagnose bipolar disorder (i.e. blood tests or brain scans). That being said, that isn’t to say there aren’t any measures that can be done to try and diagnose bipolar disorder.
The testing methods are more through longterm care and consultation when it comes to charting and recording developments of symptoms as well as physical and mental exams by medical professionals. These help to rule out other possible conflicting disorders or diseases and to confirm that the real culprit is bipolar disorder.
How Does A Doctor Diagnose Bipolar 1 From Bipolar 2?
The only real way to discern whether or not a particular case of bipolar disorder falls into either bipolar 1 or 2 or one of the other disorder subsets is by closely following the progression of the disorder and the development of symptoms. It’s also important to recognize patterns of symptoms over a given time to try and place the patient in a bipolar disorder subgroup.
Remember the biggest difference between the different kinds of bipolar disorder is the way in which the symptoms develop and how often the swings or episodes develop and last. It’s not an exact science, but it’s also not a guessing game either. Rather, it’s a careful consideration for the symptoms, their severity, and how they develop.
In order to diagnose bipolar 1, for example, a doctor would look at the overarching symptoms. They’ll then observe if these symptoms develop into a pattern that best resembles bipolar 1.
For bipolar 2 disorder, doctors will take into consideration the fact that their particular patient has more depressive episodes as the condition is known to have less severe hypomanic episodes with depressive features.
Bipolar 1 vs Bipolar 2: Which is Worse?
When we try and compare and contrast the effects of bipolar disorders, we often times think that one set of mood swings might be more tolerable than the other. However, every case is different and the severity of the symptoms range with each individual.
A study published in the Annals of General Psychiatry found that patients with “bipolar I and bipolar II depression were similar in demographics, baseline rating scale scores (depression, anxiety, mania, and quality of life), and mood episode histories.” meaning that the two subsets of bipolar disorder are more common with each other than initially understood and therefore the argument of which is better or worse to have is essentially null and void. ³
Any type of bipolar disorder is a complicated circumstance to try and deal with. However, they can be managed with the proper treatment through a close advisement of medical professionals. Whatever classification of bipolar you might fall under, it is always advised that you consult with a physician or a mental health professional to try and manage your symptoms.
Bipolar 1 and Bipolar 2 Treatment
In order to treat bipolar disorder, a medical professional will recommend psychotherapy (talk therapy), medication therapy, and close follow ups by a physician and a mental health team. However, depending on the type of bipolar disorder you struggle with, you may be given a different treatment plan geared towards your specific symptoms.
For bipolar 1, it’s often advised to have a mental health professional monitor the disorder and the onset of symptoms. Also, it is common for those diagnosed with bipolar 1 to be prescribed medications that range from mood stabilizers and antidepressants to antipsychotics and benzodiazepines. These can help decrease the severity of symptoms. Some have also noted that electroconvulsive therapies can help treat symptoms of bipolar 1. ⁴
For bipolar 2, the same set of therapies are often advised. However, the medications are geared towards treating the common complications of hypomania in bipolar 2 disorder.
Mood stabilizers like lithium can help in controlling mood swings in both forms of bipolar disorder and are often prescribed for adults suffering from bipolar disorders. Anti-seizure meds like carbamazepine have been prescribed to level out mania since the mid-1970s and researchers have found that it might have value in treating bipolar depression but it still needs further research and certification by specialists.
In closing bipolar disorders are complex mood disorders that still needs to be better understood and we hope that we have shed some light on these disorders as well as how to manage the symptoms. It’s understandable to try to compare and contrast the symptoms and to figure out which type you struggle with.
However, we need to be mindful that each and every one of these disorders are serious and often complex mental illness that should be followed up closely by a medical professional.
There isn’t one type of bipolar disorder that’s easier to manage. Each of them come with their own unique set of challenges and all of the disorder types should be treated with respect and care.
Still have questions concerning bipolar disorders and their differences?
We invite you to ask them in the comment’s section below. If you have any further advice to offer – whether personal or professional – we’d also love to hear from you.
¹ Mayo Clinic: Bipolar Disorder – A Definition
² National Institute for Mental Health: Bipolar Disorder Symptoms
³ National Center for Biotechnology Information – Ann Gen Psychiatry: Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response
⁴ National Alliance on Mental Health: Treating Bipolar Disorder