3 Types of Bipolar Disorder

The National Institute of Mental Health estimates that 4.4 percent of adults in the United States will live with bipolar disorder at some point in their lives. Despite its prevalence, bipolar disorder is still widely misunderstood. Perhaps one of the most pervasive myths about bipolar disorder is that there is only one type. In reality, “bipolar disorder” is an umbrella term used to describe five different disorders.

The primary types of bipolar disorder are:

  • Bipolar 1
  • Bipolar 2
  • Cyclothymic disorder

People with these disorders and their loved ones can benefit from learning about the differences between the disorders, Spreading awareness about the types of bipolar disorder can help break the stigma and lead people to get the help they need.

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What is Bipolar Disorder? 

All types of bipolar disorder are characterized by periods of mania and major depressive episodes. For that reason, some people know bipolar disorder as “manic depression.” Manic episodes include symptoms such as taking risky behaviors and not sleeping. Depressive episodes include the symptoms of depression, such as low mood and fatigue.

The difference between the types of bipolar disorder is the intensity and length of these episodes. Some types of bipolar disorder are marked by long episodes of both mania and depression with full symptoms of each. Others may include less intense manic episodes or shorter depressive episodes.

What is Bipolar 1?

Also known as “bipolar I,” bipolar 1 includes the most severe manic and depressive symptoms for the longest periods of time.

Diagnostic criteria for bipolar 1 includes:

  • At least one major depressive episode that lasts at least one week
  • At least one manic episode that lasts at least one week
  • Or depressive and manic episodes of any length that require hospitalization
  • Manic symptoms not better explained by other disorders, such as schizoaffective disorder

Even within the category of bipolar 1, there are additional subtypes of bipolar disorder. Providers take a look at the symptoms of the most recent depressive and manic episodes to determine if any other specifiers may fit the person’s diagnosis.

Someone with bipolar 1 may have bipolar 1 with:

  • Anxious distress
  • Seasonal patterns
  • Mixed features
  • Peripartum onset
  • Rapid cycling
  • Catatonia
  • Melancholic features
  • Mood-incongruent psychotic features
  • Mood-congruent psychotic features
  • Atypical features

These distinctions show that no two people with bipolar 1 experience the exact same thing. Most importantly, an accurate and specific diagnosis can help mental health care providers give patients care that is tailored to their unique needs.

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What is Bipolar 2?

Bipolar 2, or “bipolar II,” is a type of bipolar characterized by major depressive and hypomanic episodes. Unlike with bipolar 1, people who live with bipolar 2 do not have fully manic episodes. Instead, they experience hypomania.

Bipolar 2 also has several specifications, such as with atypical features, catatonia, or peripartum onset.

Bipolar 1 vs. Bipolar 2

The primary difference between bipolar 1 and bipolar two lies in the difference between mania and hypomania. Hypomania is a less-severe form of mania that may last only a few days, rather than a week or more.

Symptoms of both mania and hypomania include:

  • Above-normal energy levels
  • Restlessness
  • Racing thoughts
  • Being extremely talkative
  • Low impulse control
  • Engaging in risky behaviors regarding sex, substance use, gambling, or money
  • Having a sense of grandiosity
  • Being unusually irritable

The difference is in the severity of these symptoms. Someone in a manic episode may go on a spending spree that depletes their entire savings. On the other hand, someone in a hypomanic episode may spend more money than they reasonably should, but not jeopardize their future.

Someone with bipolar 2 has never had a full manic episode. However, someone with bipolar 1 may have both manic and hypomanic episodes.

What is Cyclothymic Disorder?

Cyclothymic disorder is the diagnosis given to people who nearly meet the criteria of either bipolar 1 or bipolar 2, but don’t quite. Because the other types of bipolar disorder have such stringent diagnostic criteria, some people with serious mental health concerns were left in need of care before researchers identified cyclothymic disorder.

To determine if someone lives with cyclothymic disorder, mental health care providers look at symptoms over the previous two years.

Someone with cyclothymic disorder:

  • Has had numerous periods with hypomanic symptoms over the previous two years that did not fully meet the criteria for a hypomanic episode
  • Has had numerous periods with depressive symptoms over the previous two years that did not meet the criteria for a major depressive episode
  • Have not met the criteria for major depressive, manic, or hypomanic episodes at any point
  • Have severe enough symptoms to impair their life

Some people with cyclothymic disorder have it with anxious distress, and this is the only specifier for the disorder.

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Authored By 

LifeStance Health

LifeStance is a mental healthcare company focused on providing evidence-based, medically driven treatment services for children, adolescents, and adults.