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When people think about bipolar disorder, they’re usually thinking about bipolar 1 disorder or bipolar 2 disorder. The main difference is the type of elevated mood episode a person has.
Bipolar 1 includes at least one manic episode. Bipolar 2 includes at least one hypomanic episode and at least one major depressive episode. There are also several similarities between the two conditions.
If you or someone you love has been diagnosed with bipolar 1 or bipolar 2, it’s important to understand what that does and doesn’t mean. Here’s what you need to know about how these two conditions are different.
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According to the National Institute of Mental Health (NIMH), bipolar disorder is “a mental illness that causes clear shifts in a person’s mood, energy, activity levels, and concentration.” People with the mood disorders bipolar 1 and bipolar 2 may have similar symptoms but also a few differences. The length, type, and severity of symptoms may differ the most.
While depression can be common in both bipolar 1 and bipolar 2, a major depressive episode of at least two weeks is required for diagnosing bipolar 2. This doesn’t mean that people with bipolar 1 don’t experience depression. In fact, it’s common, just not necessary for a diagnosis.
For some people, the depression experienced in bipolar 2 lasts longer or interferes with daily life more than that in bipolar 1. This isn’t true in every case, as severe and significant depression can occur in people diagnosed with bipolar 1 too.
Symptoms of depression in bipolar 1 or bipolar 2 may include:
People with bipolar 1 have experienced at least one manic episode, while people with bipolar 2 do not experience manic episodes. A manic episode usually lasts at least one week. However, it can last for less time and still count as mania if symptoms are severe enough that the person needs to be hospitalized.
People experiencing mania usually have much more energy than usual. Their mood may be elevated, euphoric, overly excited, or extremely irritable. They may experience symptoms like:
Sometimes, people experiencing mania will experience a break from reality, called psychosis. They may see or hear things that aren’t there (hallucinations) or believe things that aren’t true (delusions). All of these symptoms can make a manic state dangerous, which is why people are sometimes hospitalized when it occurs.
Hypomania is similar to mania, but not as severe. People with hypomania may feel elevated, excited, or energized. They may take risks or make rash decisions, but not to the extent that people with mania will.
To meet the definition of a hypomanic episode, symptoms must last for at least four days in a row. It doesn’t require hospitalization and, overall, doesn’t interfere with daily life or functioning the way mania can.
Examples of hypomania include:
Hypomania also doesn’t have psychotic symptoms. If psychosis is present during an elevated mood state, the person is considered to be experiencing mania, not hypomania.
People with both bipolar 1 and bipolar 2 can experience hypomania, but it’s only a requirement for someone diagnosed with bipolar 2. While people with bipolar 1 must have experienced at least one manic episode in their lives in order to be diagnosed with the condition, they can also experience episodes of hypomania.
Bipolar 1 and bipolar 2 disorders also share some similarities. Healthcare providers often treat these two disorders with similar treatments. Certain shared triggers can lead to these mood episodes as well.
Although bipolar 1 and bipolar 2 cause different symptoms, they have similar treatments. Your exact treatment plan depends on the type of bipolar disorder and how severe it is.
For example, mood stabilizers help manage manic or hypomanic episodes. You may be prescribed these medications if you have either bipolar 1 or 2 disorder.
Antidepressants may sometimes be used to treat depressive symptoms in bipolar disorder. For bipolar 1, antidepressants should not be used alone because they may trigger mania or increase mood instability.
Doctors usually combine them with a mood-stabilizing treatment when they are used. In bipolar 2, doctors also decide carefully whether an antidepressant is appropriate.
Antidepressants may also trigger rapid cycling in some people. This occurs when they have four or more episodes that qualify as manic, depressive, or hypomanic in one year. This can happen in any type of bipolar disorder.
Antipsychotic medications may help manage delusions and hallucinations during manic episodes. Some antipsychotic medications can also be used to treat bipolar depression or help prevent future mood episodes. Their effects and approved uses vary based on the specific medication and may be used to treat mania, bipolar depression, or to maintain a stable mood.
Psychotherapy or talk therapy is a vital part of bipolar disorder treatment. A mental health professional will help you identify negative thoughts, behaviors, and beliefs.
You’ll work on replacing them with more positive thoughts. This is known as cognitive behavioral therapy.
Joining a support group can also be beneficial. You’ll learn tips and hear stories from others living with bipolar disorder.
Everyone’s bipolar disorder is unique, but certain triggers can set off mood episodes. Your brain and body need sleep to rest and recover.
Changes in sleep can be linked with mood episodes in people with bipolar disorder. Too little sleep may sometimes come before or contribute to mania, hypomania, or depression. Sleeping too much is also common during depressive episodes.
Stressful life events can also trigger mood episodes in both disorders. Divorce, the death of a loved one, and illness all take a toll on mental health.
Issues with finances or work create worry and stress too. All these events may contribute to mood episodes, including depression, mania, or hypomania.
If you’re dealing with new stress or a life-changing event, don’t be afraid to reach out for help. Talk to your doctor or therapist about ways to manage stress.
If you think you’re experiencing symptoms of bipolar disorder or you’re not sure if you’ve been misdiagnosed, talk to a healthcare provider. They can help you find the solutions you need, including the right diagnosis and treatment options. Bipolar disorder can interfere with your daily life and functioning, so getting help right away is key to staying well.
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I was not aware that individuals with bipolar one may be having hallucinations or hearing voices. I thought this was only with people who were showing positive symptoms with schizophrenia. I have a… read more
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