Bipolar I vs Bipolar II: What's the Difference?

Bipolar disorder is a complex condition, and it can sometimes be challenging to understand the differences between Bipolar I and Bipolar II, or how they relate to other mood disorders. At Next Step Psychiatry in Lilburn, Georgia, we help patients understand their diagnosis and develop personalized treatment plans.

What Is Bipolar Disorder?

Bipolar disorder is a mental health condition characterized by extreme mood swings. People with bipolar disorder experience episodes of mania (elevated moods and emotional highs) and depressive episodes (emotional lows and depressed moods).

The Mayo Clinic describes these swings: "When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy, or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly."

Some people experience these swings only occasionally, while others may have mood episodes multiple times a year.

Symptoms of Manic Episodes

• Decreased need for sleep
• Feeling jumpy or wired
• Feeling unusually important or powerful
• Feeling like you can do multiple things at once
• Increased irritability
• Loss of appetite
• Poor judgment or taking unnecessary risks
• Racing thoughts
• Talking fast about many different things

Symptoms of Depressive Episodes

• Difficulty concentrating
• Eating more than usual
• Fatigue and low energy
• Feeling bad about yourself
• Feeling hopeless, worthless, or helpless
• Little interest in activities you usually enjoy
• Restlessness
• Sleeping too much or too little
• Suicidal thoughts or ideas of self-harm

Types of Bipolar Disorder

Bipolar I Disorder

Bipolar I is a condition in which an individual has experienced at least one full manic episode and typically one or more major depressive episodes.

The National Institute of Mental Health defines Bipolar I as "manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible."

Of all bipolar disorder types, Bipolar I tends to be the most severe, with full-blown manic episodes that can require hospitalization.

Bipolar II Disorder

Bipolar II features the same major depressive episodes as Bipolar I, but without full manic episodes. Instead, those with Bipolar II experience hypomanic episodes—which are shorter and less disruptive than full mania.

It's important to note that Bipolar II isn't simply a "milder" version of Bipolar I. Both disorders can significantly disrupt quality of life, and Bipolar II often involves more frequent and prolonged depressive episodes.

Cyclothymic Disorder

Individuals who experience symptoms of bipolar disorder over an extended period of years may be diagnosed with cyclothymic disorder, particularly if:

• The depressive episodes don't meet criteria for "major depressive episodes"
• There are persistent mood shifts over a period of two years or more
• The episode shifts last for months at a time

While sometimes considered milder than Bipolar I or II, cyclothymic disorder can still be highly disruptive because episodes tend to last much longer.

Other Bipolar-Related Disorders

There are also unspecified bipolar-related disorders where symptoms don't clearly fit the above categories. These may include conditions where mania or depression is related to another medical condition or substance use.

How Is Bipolar Disorder Treated?

Bipolar disorders, regardless of type, are generally considered lifelong conditions. However, treatment can help many people—including those with the most severe forms—live full and meaningful lives.

At Next Step Psychiatry, we typically develop treatment plans that include medication management tailored to each patient's specific type of bipolar disorder and individual needs. Medications may include:

• Mood stabilizers like Lamotrigine (Lamictal)
• Second-generation antipsychotic medications
• Other medications as appropriate for your symptoms

Treatment is most effective when combined with regular psychiatric monitoring and lifestyle modifications that support mood stability.

Bipolar Disorder Treatment in Lilburn, Georgia

If you think you might be experiencing symptoms of bipolar disorder, it's important to see a psychiatric provider for proper evaluation. At Next Step Psychiatry, we provide comprehensive assessments and personalized treatment plans for all types of bipolar disorder.