What Is The Difference Between Bipolar 1 And 2?

Updated February 20, 2023by BetterHelp Editorial Team

As both professional and general understanding of bipolar disorder have evolved, so too have the ways we describe the unique experiences of those living with it. Many mental health professionals distinguish different subtypes of bipolar disorder based on the symptoms that they tend to produce. Bipolar I and II disorders are perhaps the most common and widely understood types of bipolar spectrum disorders, but they still have some key differences that separate them from each other. Understanding each one may help you better identify your own symptoms and seek appropriate treatment.

What Is Bipolar Disorder?

Bipolar disorder (BPD) is a mental illness typically characterized by intense mood swings from extreme highs (mania) to extreme lows (depression).  It can affect your energy levels, ability to function, and in some cases, may even cause hallucinations and delusions.

Living With Any Type Of Bipolar Disorder Can Be Hard

Most people who receive a BPD diagnosis do so during their 20s, but it’s possible for symptoms to manifest during childhood or a person’s teen years as well. Approximately 3% of adults in the United States have been diagnosed with bipolar disorder, and an even smaller percentage of this group experiences either bipolar I disorder or bipolar II disorder.

What Is Bipolar I And II Disorder?

The umbrella term “bipolar disorder” can actually refer to three distinct diagnoses: bipolar I disorder (“bipolar I”), bipolar II disorder (“bipolar II”), and cyclothymic disorder. 

Each of these subtypes of bipolar disorder may cause similar symptoms that can vary in their severity and duration. Additionally, each diagnosis typically comes with a slightly different type of experience; those with one type of BPD may experience mania more often than depression, for instance, but others may experience the opposite.

Bipolar I Disorder

To diagnose someone with bipolar I, all a doctor typically needs to know is that the person in question has had at least one manic period lasting more than one week. Although most people with bipolar I disorder have episodes of mania and depression, the latter is not a necessary part of its diagnostic criteria. 

Because the main feature of bipolar I tends to be its manic episodes, symptoms like those below may be most frequently experienced by those with the diagnosis:

  • Increased risky behavior, such as irresponsible spending or excessive substance use

  • An increase in energy levels and a lack of sleep

  • Racing thoughts

  • Feeling happier than usual, even euphoric

  • Increased talkativeness

  • Distractibility

  • Feelings of grandiosity or superiority over others

  • Hallucinations, false beliefs, or delusions

Bipolar II Disorder

To receive a diagnosis of bipolar II, you typically have to have at least one hypomanic period as well as a severe depressive period that lasts at least 14 days. Hypomania mimics many of the symptoms associated with mania, as listed above, but is generally less severe and intense than mania can be. It is also usually more acute, lasting for around four days on average.

Those who are living with bipolar II typically are still able to function at work and in social situations. Additionally, those with hypomania generally do not have psychotic episodes or hallucinations. Some examples of the symptoms of hypomania include:

  • Poor, impulsive decision making

  • Feeling upbeat, talkative, and happier than usual

  • An average or slightly enhanced ability to perform at work and home life

  • Feeling more creative and productive than usual

  • Being in a good mood for seemingly no reason

Those with bipolar two disorder may also have signs of depression, such as:

Living With Any Type Of Bipolar Disorder Can Be Hard

  • Intense feelings of sadness or disinterest in most activities

  • Inability to concentrate

  • Trouble making decisions

  • Sleeping more than usual, yet still feeling fatigued

  • Weight gain or loss, perhaps due to changes in appetite or eating patterns

  • Social withdrawal and isolation

  • Thoughts of harming oneself *

*If you or someone you know is experiencing suicidal thoughts, help is available. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7, or you can text the word “HOME” to 741741 to reach the Crisis Text Line.

Causes Of Bipolar I And II

Although experts have not found one proven cause of these disorders, there have been many studies done that connect the disorder to things like genetics. In fact, genetics may be the number one risk factor for developing bipolar disorder and the studies have shown some definite connections. 

However, there are other things that may increase a person’s chance of developing any type of BPD. Examples include:

  • Stressful or traumatic life events, such as divorce, job loss, etc.

  • Substance use: tobacco, alcohol, illicit substances, etc.

  • Abuse of any kind

  • Experiencing the loss of a loved one

Treatment

Treating bipolar I and II disorders usually consist of changes in lifestyle, therapy, and medication. Bipolar spectrum disorders typically respond well to treatment, so no matter how severe your symptoms may be, it’s likely that you can benefit from a plan tailored to your needs.

Medications

Some people with BPD find that prescription medications aimed at controling brain chemicals can help relieve or minimize the severity of symptoms. Different types of medication can be used to achieve this goal depending on your symptoms and individual needs.  

Examples of types of medication a psychiatrist or doctor may prescribe to a person with bipolar I or II include: of the drugs used by physicians for bipolar disorder typically include:

  • Antidepressants: these may be prescribed to those with bipolar II more frequently due to their ability to help manage depression

  • Mood stabilizers: these may help control or limit manic and hypomanic episodes

  • Antipsychotics: medications in this class may be helpful when depression or mania persists despite the efforts of other treatment options

  • Anti-anxiety medications: these may help a person sleep better and experience less anxiety. They are typically used on a short-term basis for those with BPD

Changes In Lifestyle

Making certain changes in your day to day life can help stabilize your mood and manage your symptoms. Below are a few ideas to get you started.

  • Educate yourself: Learning all you can about bipolar disorder may help you better understand your own symptoms and tell your experiences with others

  • Follow a regular sleep pattern: Getting enough sleep and having a routine may help you limit stress and minimize the impact of your symptoms.

  • Move often and eat well: Taking care of your body through exercise and a balanced diet may help promote steady energy levels.

  • Avoid substances like tobacco and alcohol: These can increase the severity of your symptoms and may interfere with prescription medications you take. s

Psychotherapy

Talk therapy can be an important part of treatment for any mental health disorder and can be extremely effective in treating bipolar disorders. No matter which form of bipolar disorder you think you or a loved one may have, speaking to a professional can be highly beneficial. A therapist can help you understand your symptoms, work to find strategies to manage them, and offer support as you learn how to navigate either bipolar I or II disorder.

It may be especially easy to get help through resources like online therapy. All you’ll need is an internet connection to receive the care and guidance you may need to take charge of your symptoms. Plus, online therapy can save you the time and money you might typically spend commuting to and from an in-person office.

Research suggests that digital therapy options can be effective for managing BPD symptoms, too. One recent review of several studies on online and smartphone-based treatment for bipolar disorder found that both treatment options could help patients manage their symptoms. Regardless of which type of BPD you live with, it’s likely that you’ll benefit from the tools that therapy can provide.

Takeaway

The main difference between bipolar I and II disorders is the type and severity of symptoms experienced by those living with either diagnosis. Regardless of which type of bipolar disorder you have, pursuing proper treatment can help you manage your symptoms and limit the impact that mania, hypomania, and depression might have on your life.

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