Differences Between Bipolar I and Bipolar II

There are a number of questions that arise after a diagnosis of bipolar disorder has been made. One of the first questions to ponder is what type of bipolar disorder is being faced, because some treatments may be different. Personally, the decision that I am bipolar I rather than bipolar II, bipolar NOS (not otherwise specified), or Cyclothymia came after very thorough talks with psychiatrists and general practitioners. Bipolar I and bipolar II are closely related, but there are some differences. Here are the facts.

One of the unifying factors behind bipolar I and bipolar II is the extreme and intense changes in mood, known as "mood episodes."(2) Depression is the best understood of the mood episodes, and depression also occurs with both bipolar I and Bipolar II. Symptoms of depression include extreme lethargy and fatigue, excessive feelings of guilt, inability to concentrate, lack of self-esteem, extreme changes in appetite and weight, feelings of sadness and hopelessness, social withdrawal, lack of interest in activities, and dark thoughts (1).

Unfortunately, since most patients seek help during the depressive phase of bipolar I and bipolar II, many patients are misdiagnosed with Major Depressive Disorder or some other ailment (1).

Bipolar I is characterized by severe symptoms, and those symptoms are best characterized during the manic phase of bipolar I. Symptoms of mania include agitation, irritability, grandiose feelings and impaired judgment, loss of inhibition, inability to focus, delusions and/or hallucinations, euphoria, increased energy, decreased need for sleep, extreme anger, racing thoughts, pressured speech, and reckless behavior (1).

Bipolar II is characterized by hypomania, which is basically a less extreme form of mania (1). However, that does not mean that bipolar II is any less severe than bipolar I. In fact, with bipolar II, the depression is just as severe as the depressive episodes in bipolar I. Only the mania (or hypomania) provides a true distinction between the two types (3).

The type of bipolar disorder can only be determined by a psychiatrist or other licensed professional. Accuracy is key since medication is usually a key part of the treatment for bipolar disorder (1).

Bipolar I and bipolar II are two intense mood disorders that essentially differ only in the area of mania. Both illnesses can be difficult to deal with if left untreated, but there is hope for treatment if a patient is correctly diagnosed.

Sources

1. Bipolar Central. 2004-2009. http://www.bipolarcentral.com/

2. National Institute of Mental Health. 2009. http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml

3. WebMD: Bipolar Disorder Health Center. 2005-2009. http://www.webmd.com/bipolar-disorder/default.htm