Couldn't find what you looking for?

TRY OUR SEARCH!

Defining Bipolar I Disorder: How Is It Different From Other Types of Manic Depression?

by — Last updated: 2020-04-10 in Mental Health

Bipolar I disorder is a mood disturbance with at least one manic episode that lasts at least for four consecutive days. Depressive episodes are also common part of bipolar I disorder, but are not required to make the diagnosis.

Bipolar disorder serious mental illness that affects a person’s energy levels and their overall ability to perform day-to-day tasks. It is known to cause extreme mood shifts — from emotional highs or mania, to emotional lows or depression. During manic episodes, a person feels happy and full of energy, while depressive episodes are characterized by the opposite — extreme fatigue and lack of energy. Either episode can last from only several days to even months, with two cycles per year on average. Mania usually strikes in spring or fall.

According to the American Psychiatric Association (APA), there are four main types of bipolar disorder:

  • Bipolar I disorder
  • Bipolar II disorder
  • Cyclothymic disorder (Cyclothymia)
  • Medication or substance-induced bipolar disorder (also called unspecified bipolar disorder)

What is Bipolar I Disorder?

According to the latest edition of the diagnostic and statistical manual of mental disorders (DSM-5), bipolar I disorder is a form of bipolar disorder characterized by at least one manic episode that lasts a minimum of four consecutive days. A person diagnosed with bipolar I disorder will experience a full-blown mania that may have been preceded or followed by hypomanic or depressive episodes. Depressive episodes usually occur, but are not required to be diagnosed with bipolar I disorder. Mania is either accompanied by psychosis, or will call for hospitalization to prevent the person from hurting oneself or other people. Depressive phases usually last around two weeks.

To be diagnosed with bipolar I, a person has to meet at least three — but often meets most —of the symptoms of mania from the DSM-5 list:

  • Feelings of superiority
  • No need for sleep
  • Talking a lot
  • Racing thoughts
  • Being unable to focus)
  • Being extremely goal-oriented
  • Engaging in risky behaviors

Other Types of Bipolar Disorder

Bipolar II Disorder

Unlike bipolar I disorder, which is characterized by at last one manic episode, to be diagnosed with bipolar II a person has to go through at least one hypomanic and one depressive episode. The only difference between the two types is the severity of the symptoms.

While mania causes significant impairments in a person’s personal and social life, hypomania is not severe enough to prevent normal functioning and rarely requires hospitalization. According to the DSM-5, if psychotic features are present, the episode is definitely manic.

A person must have at least five — but often, again, has most — of the symptoms of depression from the DSM-5 list to be diagnosed with bipolar II disorder:

  • Feeling sad most of the day
  • Decrease in energy levels
  • Decreased desire for activity
  • Increased anxiety
  • Forgetfulness
  • Sleeping problems
  • Changes in eating habits (leading to weight problems)
  • Losing interest in day-to-day activities
  • Sensitivity to things usually well-tolerated like sound or bright lights
  • Difficulties concentrating
  • Suicidal thoughts
People often wonder which of the bipolar types is easiest to live with, but there is no real answer. Manic episodes in bipolar I disorder are definitely more dangerous than the hypomania that is part of bipolar II disorder, but people with bipolar II can have longer depressive episodes. Increased energy during mania often leads to sleeplessness, which as consequence leaves a person drained during the day. Depression leaves you feeling like this most of the time, however.

According to research, about one third of people with bipolar II disorder will attempt suicide. The prevalence is a little bit higher than in people with bipolar I disorder.

Cyclothymic disorder

According to the DSM-5, to get diagnosed with cyclothymic disorder or cyclothymia, a person must go through numerous hypomanic-like and depressive-like symptoms during a period of two years (one year for children and adolescents), but never meet the criteria for hypomanic or major depressive episodes. People diagnosed with this kind of bipolar won't have a break from symptoms that lasts more than two months.

Unlike bipolar II disorder, which comes with major depressive episodes, cyclothymia never meets the criteria for either a manic or depressive episode. If a person experiences major depressive episode after being diagnosed with cyclothymia, the doctor will change the diagnosis. There is a 15 to 50 percent risk that someone with cyclothymia will develop bipolar I or bipolar II disorder.

Medication or substance-induced bipolar disorder

There are cases when a person goes through certain symptoms of hypomania, mania, or depression but doesn’t meet the specific pattern that matches any of the three main bipolar types. For instance, combinations can include:

  • Long-lasting depressive episodes without hypomania or mania
  • Short hypomanic episode with long depression
  • Hypomania without depression
  • Symptoms resembling cyclothymia lasting less than two years

Cases like this can occur after substance intoxication or withdrawal after exposure to certain medication. There are two types of medication or substance-induced bipolar disorder:

  • With onset during intoxication
  • With onset during withdrawal

According to the Nation Alliance on Mental Health (NAMI), if full criteria for either of the bipolar types cannot be met, a person is likely to be diagnosed with unspecified bipolar disorder. This usually happens when a doctor doesn’t have enough information about a patient.

The Bottom Line

It's common to have neutral or stable periods between hypomanic or manic and depressive episodes.

This doesn't mean that you are completely without emotions or cured, which can never happen — it only means that you manage your condition and its symptoms effectively. A person can feel stable and well in general for years before another episode strikes, but stable periods are usually shorter for most people with bipolar disorder.

With the right treatment that includes medication and therapy, as well as their own efforts, people diagnosed with any type of bipolar disorder can live rewarding lives, but because bipolar disorder is a chronic and lifelong illness, a person must be serious and persistent with the treatment.

  • Photo courtesy of SteadyHealth

Your thoughts on this

User avatar Guest
Captcha