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Bipolar I and II: Understanding the Differences

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Bipolar disorder is a medical condition in which a person experiences alternating mood swings from high manic to low depression for a specific time frame. Mania is a state of elation characterized by heightened energy levels, whereas the depressive stage is a state of feeling very sad, low, and hopeless. There are different types of Bipolar disorders,  and all of them have better outcomes when treated early. The two main types are Bipolar I and Bipolar II. 

Types of Bipolar Disorder: Bipolar I and II

Bipolar disorder is classified by the type, duration, and severity of the symptoms. The categories are Bipolar I disorder, bipolar II disorder, Cyclothymic disorder, and other bipolar-related disorders. Bipolar disorder I is also called manic-depression or manic-depressive disorder. The individual affected by bipolar I disorder encounters manic episodes. The person with Bipolar II has one or more than one major depressive episode and at least one episode of hypomania. A person with bipolar 2 disorder experiences more depressive episodes than episodes of hypomania.

Understanding Bipolar I Disorder

Bipolar disorder I is also called manic-depression or manic-depressive disorder. The individual affected by Bipolar I disorder encounters manic episodes. To be classified, the person would have at least seven days of manic episodes or manic symptoms.

Symptoms of Bipolar-I include:

  • Abnormally inflated self-image
  • Rapid and loud speech
  • Random speech without any link to each other
  • Increased energy, with hyperactivity
  • Too much or too little sleep
  • Hypersexuality
  • Substance abuse

Depression in Bipolar I

In this phase, the person may experience a low mood state. They might lose interest in activities that they liked previously and feel worthless over a longer period of time, sometimes days and weeks. Research suggests that this phase often lasts longer than the manic stage in Bipolar I. Depressive states in Bipolar I need to be taken care of with the right medical attention. 

Mania in Bipolar I

In this phase, the person may experience a high mood state. They might feel euphoric, irritable, and impulsive and partake in risk-taking behaviors such as driving recklessly, gambling, and substance abuse. They sometimes also experience an episode of psychosis and appear delusional. Manic symptoms can be dangerous, even life-threatening. 

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Understanding Bipolar II Disorder

The person with Bipolar II has one or more than one major depressive episode and at least one episode of hypomania. These depressive episodes may occur soon after episodes of hypomania subside or after a period.

The symptoms of hypomania include

  • Inflated self-esteem.
  • Decreased sleep
  • Talking more than usual
  • Racing thoughts
  • Inattention
  • Engaging in risk-taking or reckless activities

Symptoms of depressive episodes include:

  • Feelings of sadness, hopelessness, worthlessness, guilt, or emptiness, as well as a lack of energy
  • Decreased interest in previously enjoyable activities
  • Decrease or increase in appetite and sleep
  • Inability or decreased ability to think or concentrate
  • Having recurrent thoughts of death or attempts of suicide

Depression in bipolar II

Most people with Bipolar II experience a state of depression that lasts at least two weeks. In some cases, the extent of the symptoms felt in this depression is more chronic and debilitating than the symptoms of Bipolar I. 

Hypomania in bipolar II

Hypomania is similar to mania (in Bipolar I0, but they are not as extreme. The person may feel abnormally energetic, excited, or happy. They generally don't have delusions or hallucinations, but they might take risks and make hasty decisions. 

Key Differences Between Bipolar I and II

Both Bipolar I and II have similar symptoms, but they are not the same. The symptoms also depend on what mood state one is experiencing. The main difference is that individuals with Bipolar I usually have at least one manic episode, which isn’t the case with Bipolar II. The latter will not usually have a manic episode usually it is restricted to hypomania. 

Manic episodes are more intense when compared to hypomanic ones. During the manic state, the symptoms are usually severe enough to impact regular functioning, whereas a hypomanic episode isn’t as severe. 

Mania can also include psychosis, i.e., a detachment from the reality one lives in, which isn’t in the case of hypomanic episodes. 

Effective Treatment Strategies for Bipolar I and II Disorders

The most effective treatment strategies for both Bipolar I and II are in the form of medication and therapy. 

Understanding Bipolar Disorder Treatment

A combination of medication as well as therapy is usually prescribed as a treatment for most cases of Bipolar disorder. 

The Challenge of Treatment Adherence

It is difficult to stick to the treatment, especially when the person is in a manic state or even a hypomanic one. One may feel ‘invisible in a sense and may think at the moment, due to their inflated mood, that they're feeling better—however, that is rarely the case. 

The Risks of Discontinuing Medication

The treatment for Bipolar is a lifelong commitment, and even though it is easy to be tempted to stop one’s medication and go for therapy, it is not advisable to do so. One may relapse into a worse state if the medicines stop, unadvised by a doctor, that is.

Suicidal Ideation and Bipolar Disorder

In a depressive state, one may go to a point where suicidal thoughts can occur. This is a point where intervention is needed, and hospitalization should be considered to get better. Loved ones around the person should also be kept in the loop, and communication is key to cases as serious as these. 

Emergency Situations and Immediate Care

One should, in cases of suicidal thoughts or ideation, seek emergency care. This is also applicable if one has psychotic episodes or has hallucinations, or delusions. The loved ones around should also be informed by the doctor to keep a look out for symptoms such as these because immediate intervention is key. 

The Role of Support in Treatment Adherence

A good support system in the form of friends, family and loved ones is oftentimes essential in recovering from Bipolar. Having others around can keep you grounded and in check when oftentimes one is not able to do so themselves. 

Experience Comprehensive and Personalized Care for Bipolar Disorder at Cadabam's

Cadabams offers an intensive level of care for individuals suffering from bipolar disorder to help them learn to manage their illness and get back to stability within their school or work environments. Our team of clinical experts and mental health care professionals specialize in treating all sorts of mood disorders and offer comprehensive Bipolar treatment programs, including family therapy and medication management.

If you are searching for a solution to your problem, Cadabam’s Rehabilitation Centre can help you with its team of specialized experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively manage their Bipolar. Get in touch with us today. You can call us at +91 96111 94949

Book screening with our director of triage,  Kamlesh Verma
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FAQs

1. What is the difference between Bipolar I and Bipolar II?

Bipolar disorder I is also called manic-depression or manic-depressive disorder. The individual affected by bipolar I disorder encounters manic episodes. The person with Bipolar II has one or more than one major depressive episode and at least one episode of hypomania. A person with bipolar 2 disorder experiences more depressive episodes than episodes of hypomania. 

2. Why is diagnosing bipolar I and II so difficult?

There is a large prevalence of misdiagnosis when it comes to Bipolar, as there are several types within, as well as other disorders that can appear in a similar manner. Major depressive disorder is a common one, as the individual talks about their depressive episodes while not actively knowing or acknowledging a manic episode they might have had. Substances also alter one’s mood state, so sometimes it can be charted down to that as well. Also, bipolar disorder may be misdiagnosed as schizophrenia because many symptoms are included in the diagnostic criteria for both disorders.

3. Is bipolar 2 the worst?

Not really. Bipolar II is not a higher degree or level of Bipolar or something harsher than Bipolar I—it simply suggests a different form of Bipolar. Both Bipolar I and II have their fair share of issues, but that is not to say that either is significantly worse than the other.

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