Bipolar I vs Bipolar II: Analyzing the Key Differences
Most of us know common mental health conditions, like depression and anxiety. Many have even heard of bipolar disorder, obsessive-compulsive disorder, and others. However, those same people probably aren’t familiar with the various types of these mental health conditions. How does that impact the person? Wouldn’t they all be treated the same way?
In the United States, 1 in 20 adults experience a serious mental health condition each year. Chances are, you know 19 other people, but could you recognize if one of them was managing a serious mental health condition such as bipolar disorder?
At Clean Recovery Centers, we understand the importance of talking about mental health. Many serious conditions have types, making recognizing the similarities and differences more challenging. Let’s talk about bipolar I vs. bipolar II, the key symptoms of each, and how to tell them apart.
Bipolar Disorder Defined
Bipolar disorder is a type of mood disorder that causes mania and depression with symptoms usually occurring for set periods known as “episodes”. While mood fluctuation is normal, those with bipolar I and II disorder will experience extreme highs and lows. There are four types of bipolar disorder, with I and II being the most common. Let’s compare how the two conditions are similar and different and what makes each unique.
What Are the Characteristics of Bipolar I
The main characteristic of bipolar I disorder is manic episodes. During this time, the person will feel like they have endless energy, leading to increased productivity, rapid thoughts and ideas, restlessness, and a decreased need for sleep. With manic episodes, mood swings can range from extreme happiness to irritability and frustration.
One side effect that can occur during manic episodes is psychosis. This is where the person loses the concept of reality and may experience hallucinations, delusions, and paranoia. Experiencing psychosis can be dangerous and requires medical attention immediately.
Those living with bipolar I disorder will primarily experience manic episodes lasting at least one week, but can also experience depressive episodes that last at least two weeks. A person with bipolar I may also experience shortened but intense manic episodes that require hospitalization. It is possible to experience symptoms of both mania and depression at the same time, which are known as mixed episodes.
What Marks Bipolar II Disorder
Those living with bipolar II disorder will experience depressive episodes. These episodes can still last two weeks at a time but are often more debilitating than in those with bipolar I disorder. Because of this, bipolar II is sometimes misdiagnosed as a major depressive disorder.
The key to distinguishing bipolar II disorder from depression is tied to hypomanic episodes. Hypomania, experienced by those with bipolar II, is not as intense as mania seen in bipolar I. Though the person will still have a boost in energy and productivity, the episode only lasts around 4 days. Hypomanic episodes also do not result in psychosis – experiencing a psychotic event is only a characteristic of mania.
Bipolar Depression: The Low Episodes
When referring to bipolar depression, specifically we are looking at depressive episodes that occur with both bipolar I and II disorder. As we mentioned above, bipolar II disorder is more likely to experience depressive episodes that cause moderate to severe interference with the person’s life and well-being. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the person must meet at least 5 of the following criteria to be determined a major depressive episode:
- Loss of interest most or all of the day (anhedonia)
- Significant weight changes such as dramatic weight loss or gain or changes in appetite
- Sleep pattern interruptions such as sleeping too much or not enough
- Reporting feelings of sadness, emptiness, or hopelessness, or having someone else point these symptoms out in yourself
- Feeling either restless or as if you are moving too slow
- Experiencing fatigue or a loss of energy
- Difficulties concentrating or making decisions
- Feeling excessive and/or unnecessary guilt
- Having thoughts of suicide, including planning, ideation, and attempting
Bipolar I vs Bipolar II: What They Have in Common
As bipolar disorder affects mood, both I and II will experience mood swings and highs and lows. These mood swings can vary from mild to severe and cause disruptions in day-to-day life. This can also affect relationships, jobs, and finances. On top of this, energy level variations can also interfere with these areas.
During manic and hypomanic episodes, those living with bipolar I and II will experience similar symptoms. These can include increased talkativeness, less need for sleep, increased production, impulsivity, and coming up with ideas rapidly. These episodes can cause an increase in distractibility as well.
Bipolar disorder also can involve rapid cycling, which can occur in both types I and II. Rapid cycling involves experiencing 4 or more episodes of mania, hypomania, or depression during a 12-month period. There is no pattern to rapid cycling and there is no way to predict when it will happen. The shifts in mood can occur as fast as a few hours to a few days apart.
Lastly, both types of bipolar disorder involve similar treatment options. Cognitive behavioral therapy (CBT) is an effective method in treating bipolar I and II. This specific therapy works to change negative thought patterns and behaviors by recognizing and addressing their unhealthy nature. CBT also works to develop coping skills for stress management. Another component of treating bipolar disorder is medications. Antidepressants, antipsychotics, and mood stabilizers can be utilized to treat both manic and depressive symptoms of bipolar I and II. Bipolar disorder is a life-long condition, and both types can benefit from seeking treatment to manage their symptoms.
Key Differences Between Bipolar I and II
The biggest difference between bipolar I and II disorder is mania vs. hypomania. Though hypomania can happen in both, only those with bipolar I will experience manic episodes. The key to understanding a manic episode is the possibility of psychosis. Also, manic episodes last longer than hypomanic. Those with bipolar I disorder may require more specialized treatment for mania than bipolar II disorder and hypomania.
In bipolar II disorder, depression is likely to be more prominent, causing chronic symptoms when left untreated. Though depressive episodes occur in bipolar I, they are typically not as long-lived. Treating bipolar II disorder often requires an increased focus on addressing depressive symptoms and working to manage them.
It is important to note that because of these differences, the diagnosis of bipolar I disorder compared to bipolar II disorder equates to two separate conditions. Both conditions fall under the bipolar disorder umbrella, but being diagnosed with bipolar II is not a lesser form of bipolar I. Each condition poses its own presentation of symptoms and management techniques, even though some do overlap.
Treatment for Bipolar Disorder in Hillsborough County, Florida
Even though a bipolar I or II disorder diagnosis is for life, there are many options to manage the condition and get you back to enjoying the things you love. Treatment for bipolar disorder will begin with a full evaluation, including a physical exam and a mental health evaluation. This gives your care team the best course of action to address your specific goals and needs. Your plan will entail tailored therapies, coping skill development, and in some cases medications. Bipolar disorder doesn’t have to hold you back, taking the first step into treatment will give you the hope you need for a bright future.
If you or someone you love is looking for treatment for bipolar disorder, Clean Recovery Centers is here to help. Our unique, three-phase approach addresses all aspects of mental health, offering trauma resolution therapy, identity reconstruction therapy, cognitive self-management techniques, and personal growth development strategies. Our compassionate staff will always treat you as a whole person and is able to diagnose co-occurring conditions alongside bipolar disorder. Call us today at (888) 330-2532 to learn more about our bipolar disorder program.
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