Perhaps due to the stigmas often surrounding bipolar disorder, some may not understand the difference between bipolar I and bipolar II disorder. Understanding bipolar II disorder and what makes it different can be valuable in understanding the symptoms and taking a bipolar test to see how they may present.
What Is Bipolar Disorder?
Bipolar disorder statistics show that bipolar disorder affects approximately 5.7 million US adults yearly. It is a spectrum disorder with various subtypes, each with its own diagnostic criteria. Having family with bipolar disorder is one of the risk factors for developing it yourself. Often, the condition is marked by periods of mania, hypomania, or depression. Understanding each type of mania and how bipolar depression can appear may be valuable in understanding bipolar II disorder.
Mania is often marked by an elevated mood, increased energy, euphoria, and irritability. Other manic symptoms could include:
- Insomnia, sometimes going days without sleep
- Hallucinations or psychosis
- Feeling invincible or experiencing delusions of grandeur
- Talking fast, sometimes not making sense
- A heightened ability to complete tasks
- Risky or impulsive behaviors
In the DSM-V, a manic episode involves a distinct period of "abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week or any duration if hospitalization is necessary." Mania is only a symptom of bipolar I disorder and not bipolar II. Often, it may cause consequences in a person's life.
In the DSM-V, a hypomanic episode includes a distinct period of persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least four days and present for most of the day. It may include symptoms of inflated self-esteem, decreased need for sleep, fast talking, distractibility, and involvement in risky activities.
However, unlike a manic episode, a hypomanic period is marked by hypomanic symptoms that are not severe enough to cause social or occupational impairment. It also does not involve psychotic features, which are unique to mania. Any type of bipolar disorder can experience hypomania, but it is the only type of mania experienced by those with bipolar II disorder.
Some individuals experience depression as a symptom of bipolar disorder, with symptoms similar to major depressive disorder. For an episode to be considered a bipolar depression episode, it may last two weeks or more. Common symptoms of depression can include:
- A persistent low or depressed mood
- Loss of interest in previously enjoyed activities
- Difficulty sleeping or sleeping more than usual
- Changes in appetite
- Difficulty completing tasks or caring for oneself
- Suicidal thoughts*
*If you are experiencing thoughts or urges of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. They are available 24/7 to offer support.
Types Of Bipolar Disorder
Bipolar disorder is a mood disorder with four subtypes. The phases of mania, hypomania, and depression can differ for each. The severity and frequency of manic and major depressive episodes may vary depending on a diagnosis of bipolar I disorder, bipolar II disorder, or another subtype. Specific symptoms within each phase may vary.
Bipolar I disorder is a bipolar spectrum subtype that includes at least one manic episode lasting at least one week or requiring hospitalization. People with this subtype may also experience hypomania and depressive symptoms, although they are not a requirement.
Bipolar II disorder is a subtype of bipolar spectrum disorder characterized by periods of hypomania and at least one depressive episode. Although they do not experience mania, they may benefit from treatment for their hypomania symptoms and depressive episodes.
Cyclothymic disorder is a mood disorder within the DSM-5 that has features of hypomania and depression but does not meet the full criteria for bipolar disorder. Cyclothymic disorder may be marked by more rapidly cycling moods swings and mood symptoms, sometimes within the same day or week. It does not include the signs and symptoms of mania.
Bipolar Disorder, Not Otherwise Specified (NOS)
Bipolar disorder NOS is diagnosed that may be made if an individual has bipolar disorder symptoms that don't fit one of the above three categories.
Bipolar I Vs. Bipolar II: What's The Difference?
Since bipolar I and bipolar II disorder have bipolar symptoms in common, many individuals may wonder how the distinction is made. Below are a few differences.
Bipolar I disorder is the only subtype of bipolar disorder marked by manic episodes, as described above. Along with the elevated mood episodes accompanying mania, people with bipolar type I disorder may experience symptoms of psychosis such as delusions or hallucinations. Those diagnosed with bipolar 2 disorder do not experience these symptoms.
Both bipolar I and bipolar II disorder may feature hypomanic phases. In bipolar I disorder, a hypomanic episode may be followed by mania. A person with bipolar II disorder may experience hypomania without symptoms of mania. Often, hypomanic episodes may be shorter than manic episodes.
All subtypes of bipolar disorder may include mixed features, which are rapid cycling symptoms of hypomania or mania and depression within a short period.
Many individuals living with bipolar disorder have periods of mild to severe depression. However, depression is not required for bipolar I disorder, meaning those with the condition may only experience manic episodes. People with bipolar II disorder experience episodes of depression, which may be mild to severe.
Level Of Impairment
People with bipolar I disorder may struggle with daily functioning during manic phases. Their work, relationships, and hygiene might become challenging, leading to potential job losses or dysfunctional relationships.
People with bipolar II disorder may not experience as much impairment from hypomania but could experience it from depression. Although bipolar II may be seen as “milder form” or "less severe” version of bipolar I, it can have marked impacts on the individual diagnosed, and hypomania is not a "fun" or "lighthearted" form of mania. It can still cause impairment on a lesser level.
People with bipolar disorder who experience bipolar depression may be a risk of suicide. Studies have found that the risk may be upwards of 20% higher than in the general population. An overall review of the literature shows that there is no significant difference between the rates of suicide attempts in people with bipolar I and bipolar II disorder. However, those who experience bipolar I disorder without depression may have less of a suicide risk.
Please note that if you are experiencing suicidal thoughts, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to a crisis counselor. They are available 24/7 to offer support.
Summary Of Differences
In the final analysis, the differences between bipolar I disorder and bipolar II disorders include the following:
- Manic episodes of at least one week or requiring hospitalization are present in bipolar I disorder but not bipolar II disorder
- Significant impairments are often present in bipolar I disorder, whereas lesser impairments may be present in bipolar II disorder
- In bipolar I disorder, hypomania may escalate to mania, serving as one of the warning signs that mania may be coming, whereas in bipolar II disorder, it does not escalate
- People with bipolar I disorder may not experience depression
Diagnosing Bipolar Disorder
The DSM-V is often used to diagnose mental health conditions. It is formally known as the Diagnostic and Statistical Manual of Mental Disorders and has been used in its fifth edition since 2013. Psychiatrists and psychologists might use this manual to identify psychiatric disorders and anxiety disorders and distinguish symptoms of subtypes like bipolar I, bipolar II disorder, and related disorders.
Is There A Bipolar Disorder Test?
No lab test or brain scan can diagnose bipolar disorder. Instead, professionals may conduct psychological interviews or self-reported testing to understand an individual's symptoms. They may also observe the person's symptoms or behavior at the appointment.
If a person has been admitted to a psychiatric hospital in the past for manic-like or suicidal episodes, they may use this information to make an informed diagnosis. You can also take a free screening quiz for bipolar disorder online through Mental Health America. However, note that online screening tests do not replace a diagnosis. Bring your results to your mental health provider to further discuss your symptoms and learn about ongoing treatment options.
Recording Treatment For Bipolar Disorder
Psychiatrists and other mental health professionals record symptoms, diagnoses, and treatments using the ICD-10 bipolar disorder codes. The ICD-10 is the International Classification of Diseases, edition 10, a cataloging system used in the US for diagnosis and insurance purposes.
Recording these codes allows insurance companies to process claims. Additionally, providers might use bipolar disorder ICD-10 notations to help them track your symptoms over time. However, if you meet with a new provider, they won't be able to view your past codes unless they work for the same agency or mental health provider.
Does bipolar make you crazy? Labeling persons with bipolar as "crazy" can be stigmatizing. Bipolar disorder is a serious condition that can be managed with proper medication, like mood stabilizers, and therapy. If you feel you may be experiencing symptoms of bipolar I disorder, bipolar II disorder, or another subtype of bipolar disorder, consider reaching out to a counselor. Millions of people experience this condition yearly, and you're not alone. If you struggle to find a provider in your area due to barriers like cost, availability, or schedule, you can also find a bipolar disorder therapist online.
While an online therapist may not be able to provide a formal diagnosis, they can offer personalized treatment for your symptoms and provide you with coping mechanisms to use at home, as well as suggestions for other areas of support. You can also choose between phone, video, or live chat sessions and attend them from home, as long as you have an internet connection. One study on internet-based mindfulness therapy found that 95% of the clients with bipolar disorder had an increased quality of life after treatment.
If you're interested in reaching out to a provider to develop a treatment plan, consider signing up for an online platform like BetterHelp, which offers a growing database of trained and licensed mental health providers specializing in various areas of mental health.
What is a bipolar 2 person like?
A person experiencing bipolar 2 disorder may act in a different manner depending on whether or not they are experiencing a hypomanic or depressive episode. While those with bipolar 2 disorder tend to have less intense episodes than those with bipolar 1 disorder, they may still have a number of symptoms that cause them to act abnormally. Acute symptoms of bipolar 2 disorder will largely depend on what type of episode they are experiencing. Here are several examples of hypomanic and depressive symptoms.
Hypomanic Bipolar 2 Symptoms
- Impulsive behavior
- Excessive talking
- High energy levels
- Substance misuse
Depressive Bipolar 2 Symptoms
- Low energy
- Feelings of worthlessness
- Loss of interest in previously pleasurable activities
- Persistent sadness
What is the difference between bipolar 1 and 2?
While bipolar 1 and bipolar 2 disorder (sometimes referred to as bipolar I and bipolar II) share similarities, there are distinct components that set them apart. For example, while those with bipolar I disorder can have a manic or depressive episode, those experiencing bipolar II disorder may have hypomanic (a less severe form of mania) or depressive episodes. Individuals with bipolar II disorder will also typically exhibit no psychotic symptoms, while those with bipolar I can.
Managing bipolar II disorder may be easier than managing bipolar I disorder due to differences in symptom severity. As a result, individuals affected by bipolar II are often less likely to require hospitalization. In addition, those diagnosed with bipolar 1 disorder need to have had at least one manic episode in their lifetime to meet diagnostic criteria, while those with bipolar 2 need to have had at least one depressive episode.
How does bipolar 2 affect you?
Bipolar 2 disorder is characterized by periods of hypomania and depression, each of which has its own set of symptoms. During a hypomanic episode, a person may experience higher levels of energy and hyperactivity while feeling as though they require less sleep. These individuals may also feel an inflated sense of self-confidence, which may cause them to create grandiose plans that they are unlikely to follow through with.
During depressive episodes, which may follow a period of hypomania, individuals may experience noticeably different symptoms. The depressive symptoms of bipolar 2 disorder typically involve lower energy levels and a loss of interest in activities that previously brought someone joy. Individuals may feel inappropriate feelings of guilt or persistent thoughts of worthlessness in addition to insomnia or hypersomnia.
Is bipolar 2 mostly depression?
While each person’s experience with bipolar 2 disorder will differ, depressive episodes have the potential to last much longer than hypomanic episodes. These depressive episodes may follow shortly after periods of hypomania, potentially lasting for days, months, or even years.
How long an episode lasts may change depending on a person’s family history of mental illness and whether they are being treated for their bipolar 2 disorder. In addition, there can be long periods where people experience no symptoms. According to the American Psychiatric Association, some individuals experience significant instances of usual functioning and “normal mood” in between hypomanic and depressive episodes, while others may cycle consistently.
Should I marry someone with bipolar 2
It is possible to have a healthy relationship or marry someone experiencing bipolar 2 disorder. While the disorder may create challenges, there are ways to address concerns and manage the symptoms associated with bipolar 2 disorder. Disorder management may be completed through a combination of talk therapy and psychiatry, during which a person can be placed on a type of medication known as a mood stabilizer.
Couples may also engage in family focused therapy to address interpersonal concerns. With the right treatment and a healthy amount of communication, it's possible to manage bipolar 2 disorder in a way that makes romantic relationships more sustainable.
Can people with bipolar 2 love?
People experiencing bipolar 2 disorder can feel the same sense of love as neurotypical individuals and are capable of having healthy relationships. However, bipolar 2 disorder can create challenges that may affect the stability of a relationship, which may create the need for an individual to seek treatment. Here are a few problems that may be influenced by the presence of bipolar 2 disorder.
- Emotional Outbursts: Bipolar disorders have the potential to create mood swings and irritability in those experiencing them, which may be directed toward someone’s partner. Other emotions may also pop up and cause an outburst, which could be a strain on a relationship.
- Compassion Fatigue: Because a person with bipolar 2 disorder may require consistent care during their hypomanic or depressive episodes, their partner may become burned out. Partners may also feel that they are being neglected due to the overwhelming needs of their significant other. As a result, their own needs may not be met, which could create problems over time.
- Infidelity: Hypomania may cause unusual shifts in sexual urges or a state of hypersexuality, where a person may struggle to control their sexual impulses and pursue risky sexual encounters. If this is directed outside a relationship, a person may cheat on their spouse, which could potentially end their relationship.
Can bipolar 2 turn into 1?
In some cases, it may be possible for someone with bipolar 2 disorder to develop bipolar 1 disorder. One study that assessed 263 children and adolescents with bipolar disorders found that 20% of bipolar 2 participants converted to bipolar 1, while 25% of those with bipolar not otherwise specified (BP-NOS) converted to either bipolar 1 or 2 disorder.
It can also be possible for someone with bipolar 1 disorder to be initially misdiagnosed as bipolar 2. While this wouldn’t technically involve someone with bipolar 2 developing bipolar 1 disorder, it may lead to confusion or inadequate treatment protocols. In addition, rare forms of bipolar disorder like cyclothymia may develop into bipolar 1 or 2 disorder.
What triggers bipolar type 2?
Bipolar 2 can be triggered by a number of different situations, with episodes occurring more often based on exposure to specific risk factors. Here are several potential triggers for a bipolar type 2 disorder episode.
- Stress: High levels of stress have been known to trigger bipolar episodes. Poor sleep, significant weight gain or cycling, relationship struggles, pressure at work, or academic problems are all possible sources of stress that may exacerbate bipolar disorder symptoms.
- Substance Misuse: While the use of prescription or recreational drugs isn’t likely to cause bipolar disorder, it may increase the occurrence of hypomanic or major depressive episodes. According to one scientific review, the misuse of certain substances like amphetamines may cause more rapid cycling or induction of bipolar disorder episodes.
- Prescription Medications: Certain prescription medications like antidepressants may also trigger episodes of hypomania. Medical guidelines regarding the administration of antidepressants dictate that patients need to be monitored for signs of hypomania and may be instructed to cease their medication if a bipolar disorder episode is triggered.
Is bipolar 2 a mental illness?
According to the Diagnostic Manual of Mental Disorders 5th edition (DSM-5), bipolar 2 is a mental illness that was formerly categorized under mood disorders. In order to treat bipolar disorder, a person will first need to get diagnosed by a medical team. There are several aspects of an individual’s mental health history that the DSM-5 identifies as necessary for a diagnosis. These points include:
- A person must have had at least one hypomanic episode and at least one major depressive episode.
- A person must never have had a manic episode.
- The occurrence of hypomanic and major depressive episodes is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and psychotic disorders.
- The symptoms or unpredictability of depression and hypomania causes clinically significant distress or impairment in occupational, social, or other important areas of functioning (i.e. day to day tasks, responsibilities, etc.)
Can stress trigger bipolar 2?
One of the most common triggers for bipolar 2 disorder is stress. There are numerous stressful events that may trigger symptoms, including:
- A Lack of Sleep: Failing to get adequate sleep can cause an increase in a stress hormone known as cortisol. As a result, a person may become easily overwhelmed, angry, or low-energy. In those living with bipolar 2 disorder, these effects can worsen to the point where a hypomanic or depressive episode is triggered.
- Relationship Struggles: Trouble in one’s relationship or marriage can also create overwhelming amounts of stress. Episodes of bipolar 2 disorder may be triggered by significant strife or change in one’s relationship, including the shift to long-distance, a large fight, or a breakup.
- The Loss of a Loved One: The passing of someone close to someone can cause them to grieve, which is typically a healthy response to loss. However, for those experiencing bipolar 2 disorder, grief may cause an episode of hypomania, sometimes referred to as “funeral mania.”
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