Bipolar disorder is lifelong. It will never "go away", but it can be managed very well, especially once you get to the adult years and learn to stick to the recommended treatment.
The four types of biolar disorder
Bipolar Disorder type I is a diagnosis given to people who experience mania that lasts at least for four consecutive days, or severe mania that ends in hospitalization. According to the Diagnostic and Statistical Manual for Mental Disorders, a person doesn’t need to go through a depressive phase to be diagnosed with bipolar I disorder, but it’s a common part of the disease. You can read more about bipolar I disorder here.
Bipolar disorder type II involves at least one depressive and one hypomanic episode. Hypomania is a milder form of mania which rarely causes life-threatening experiences like mania does, but it’s still a serious condition that requires lifelong treatment. In fact, the severity of the manic episodes is the main difference between the two types; while patients with bipolar I will experience a full-blown mania that often requires hospitalization, hypomanias of bipolar II are a lot less severe.
Cyclothymic disorder or cyclothymia, unofficially called bipolar III disorder, is a spontaneous and persistent mood disorder characterized by mood swings that last at least two years. A person will experience both “highs” and “lows”, but the symptoms are not severe enough to be considered either mania or depression. It’s basically a less intense bipolar disorder seen equally in both men and women, only women seek treatment sooner, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
“Unspecified”, “not otherwise specified” or “other specified” bipolar disorder are all terms used when a person goes through symptoms of bipolar I, II, or cyclothymic disorder, but they don't fit the three main categories in a "textbook" manner.
This is one of those terms that can cause confusion, but it’s an indicative of a problem that is likely to be clearer and definitively diagnosed sometime in the future. This is why the American Psychiatric Association (APA) prefers the term “unspecified”— it shows the uncertainty of the diagnosis — which exists only to prevent people slipping through the cracks and is likely to be changed if another episode occurs.
More on Bipolar II Disorder
The DSM-5 defines hypomania as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least four consecutive days and present most of the day, nearly every day.”
During this time, at least three following symptoms must be present:
- Inflated ego
- Decreased need for sleep
- Talking loudly and too much
- Bursts of ideas (not necessarily good ones)
- Being easily distracted
- Psychomotor agitation
- Engagement in risky behaviors
When it comes to depressive episodes, the most detailed handbook in psychology clearly states that a person must experience two weeks of at least five of the following symptoms:
- Feeling “low” most of the day almost every day
- Losing pleasure in activities that usually bring joy
- Sudden and unplanned changes in body weight
- Changes in sleeping patterns
- Psychomotor retardation or agitation
- Being tired all the time
- Feelings of shame and worthlessness
- Difficulties concentrating
- Dark thoughts about death or suicide
The Bottom Line
People often wonder which type of bipolar disorder is the worst, but there is no correct answer. While bipolar II involves only hypomanic episodes, mania in bipolar I can be more devastating. On the other hand, depressive episodes are often longer in patients with bipolar II disorder. According to data, more people diagnosed with bipolar II will attempt suicide when compared to bipolar I disorder. This is probably due to the long-lasting depressive phases that bipolar I often comes without.
Possibly the hardest form of bipolar disorder to deal with is “mixed bipolar”, where patients go through simultaneous symptoms of both mood polarities: in one moment they are energetic, have racing thoughts and insomnia that are typical symptoms of mania, but also feel irritable, hopeless, and even suicidal, all signs of depression. They also have more frequent outbreaks of acute episodes and often take longer to find the right treatment. Regarding medications approved by the Food and Drug Administration (FDA), your doctor is likely to prescribe mood stabilizers or antidepressants.
- Photo courtesy of SteadyHealth
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