Key Differences Between Bipolar 1 and Bipolar 2 Disorder

Key Differences Between Bipolar 1 and Bipolar 2 Disorder Bipolar Disorder Print An Overview of Bipolar Disorder Explore key differences between the types By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Medically reviewed by Medically reviewed by Steven Gans, MD on May 28, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on September 12, 2019 Bipolar Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Your Rights In This Article Table of Contents Expand Symptoms Causes Diagnosis Treatment Coping In Kids View All Bipolar disorder is a mental health condition defined by periods (better known as episodes) of extreme mood disturbances. Bipolar affects a persons mood, thoughts, and behavior.   There are two main types of bipolar disorders: bipolar I and bipolar II. According to the  Diagnostic and Statistical Manual of Mental Disorders, bipolar I disorder involves episodes of severe mania and often depression. Bipolar II disorder involves  a less severe form of mania called hypomania. Illustration by Hugo Lin. © Verywell, 2018. Symptoms Despite the major difference when it comes to mania in the two types of bipolar disorder, there are quite a few similarities in symptoms.?? Depressive Episodes In bipolar I disorder, a major depressive episode (one or more)  usually  occurs, but it is not required.  Bipolar II disorder involves one or more major depressive episodes.  Common symptoms that occur in a major depressive episode include:?? Insomnia or hypersomniaUnexplained or uncontrollable cryingSevere fatigueLoss of interest in things the patient enjoys during euthymiaRecurring thoughts of death or  suicide Both disorders may include periods of  euthymiaâ€"symptom-free or normal states. Mania Manic  episodes last at least seven days. An individual experiencing a manic episode may experience:?? Feelings of euphoriaLess need for sleepIncreased sexual desireHallucinations or delusionsMarked  increase in energy During a manic episode, individuals may engage in  risky  or reckless behavior. For example, someone may indulge in risky sexual behavior, spend excessive amounts of money, or make impulsive decisions. Its important to note that experiencing mania does not automatically mean a person will become violent or dangerous. Sometimes people assume a manic episode means someone turns into a maniac. Thats not true. Hypomania   An  individual experiencing a hypomanic episode may experience similar symptoms but their functioning wont be markedly impaired. Many individuals who experience hypomania associated with bipolar II enjoy the increased energy and decreased need for sleep. An episode of hypomania does not escalate to a point that  a person needs hospitalization, which may happen with a person experiencing maniaâ€"especially if he or she is becoming a danger to others and/or themselves. Symptoms of Bipolar Disorder Causes While the exact cause of bipolar I disorder remains unclear, genetics is believed to play a major role. This is evidenced, in part, by studies of twins in which one or both had a bipolar I diagnosis. In 40% of identical twins (those with identical gene sets), both twins were found to be bipolar compared to less than 10% of fraternal twins (who dont share all the same genes).?? Other contributing factors include abnormalities in a person’s brain circuitry, irregularities in neurotransmitters, and environmental factors such as  childhood trauma  or abuse. Theories About the Causes of Bipolar Disorder Diagnosis When diagnosing bipolar disorder (regardless of the type), a physician or clinician must rule out other illnesses such as  schizoaffective disorder,  schizophrenia, delusional disorder, or schizophreniform disorder.?? Bipolar disorder cannot be diagnosed like other illnesses where a blood test, X-ray, or physical exam can provide a definitive diagnosis. The diagnosis is based on a set of criteria that a person must meet in order to be considered bipolar. An informed diagnosis would likely include specific tests to exclude other physical causes. This may involve a drug screen, imaging tests (CT scan or MRI of the brain),  electroencephalogram (EEG), and a full battery of diagnostic blood tests. Your doctor will also ask you questions, and you should do your best to work closely with your healthcare team to confirm a diagnosis and find the right treatment plan for you. Bipolar Disorder Discussion Guide Get our printable guide to help you ask the right questions at your next doctors appointment. Download PDF Treatment Treatment of bipolar I disorder is highly individualized and based on the  types and severity of symptoms  a person may be experiencing. Mood stabilizers are the core of the treatment process, and other agents are often used, such as:?? A  mood stabilizer, such as  lithiumAnticonvulsants  to stabilize mood swingsAntipsychotics  to control psychotic symptoms such as  delusions  ?and  hallucinations, as well as the newer atypical antipsychotics which have mood-stabilizing properties of their ownAntidepressants  (less commonly prescribed as they can trigger a manic episode) In more severe cases,  electroconvulsive therapy (ECT)  may be used to help relieve mania or severe depression.?? Both Types Should Be Properly Treated Since hypomania is less severe than the mania that occurs in bipolar I disorder,  bipolar II  is often described as milder than bipolar Iâ€"but this is not completely accurate.  Certainly, people with bipolar I can have more serious symptoms during mania, but hypomania is still a serious condition that can have life-changing consequences and so should be properly addressed. In addition, research suggests that bipolar II disorder is dominated by longer and more severe episodes of depression. In fact, over time, people with bipolar II become less likely to return to fully normal functioning between episodes.?? One  study  specifically concluded that bipolar type II was linked to a poorer health-related quality of life compared to type I. This remained true even during long periods of euthymia. Thus, experts tend to believe that bipolar II disorder is equally (if not more)  disabling than bipolar I disorder because it can lead to more lifetime days spent depressed and not doing as well overall between episodes.?? Proper treatment should be pursued for all types of bipolar disorders, and you should work closely with your healthcare team to figure out the best treatment for you. Understanding Your Bipolar Treatment Plan Coping As with many mental health conditions, bipolar disorder is associated with a certain stigma in society, which may make coping with the condition more difficult for you or a loved one.?? Know that stigma very often develops because of lack of knowledgeâ€"those who make comments or discriminate are usually ignorant or have fear based on what they think they know about the disorder. Whether or not someone with bipolar faces stigma directly, know that the best way to cope with the condition is to connect with others who are experiencing it and get professional help. You can also fight stigma to help you cope better, and read up on your rights. Living Well With Bipolar Disorder In Kids Bipolar disorder can occur in kids of any age.?? Its important for parents and caregivers to be aware of the unique signsâ€"they should pay attention to a childs functioning, feelings, and any family history of the disorder. With a timely diagnosis, a treatment plan for symptom management can be better established. Could Your Child Have Bipolar Disorder? A Word From Verywell Bipolar disorder is a complex mood disorder. If you are worried that you or a loved one has symptoms of a bipolar episode, seek medical attention for a proper evaluation. Although bipolar is not curable, it is treatable. With the right medication and support, symptoms can be managed to the point where quality of life isnt drastically affected. These Are the Most Common Symptoms of Bipolar Disorder