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Bipolar I vs. Bipolar II: The Similarities and Differences


We all experience mood swings from time to time. Subsequently, most of us know what it feels like to experience emotional highs and lows.

When people think about bipolar disorder, they often picture a series of rapid cycling of hot-and-cold emotions. In reality, this image is often a mental health myth, and the actual presentation of bipolar disorder can be completely different.

Likewise, many people indiscriminately use the term bipolar disorder without really understanding the nuances of this specific condition. However, awareness is important for understanding your situation- or understanding a loved one's particular set of symptoms. Let's get into what you need to know.

What Is Bipolar I Disorder?

Someone with bipolar I disorder has experienced at least one manic episode during their lives. Manic episodes are intense, frenzied, and often apparent to the outside world.

Manic symptoms can vary from person to person, but some of the common symptoms include:

  • having an increased surge of energy or restlessness

  • feeling extremely confident or euphoric

  • needing little to no sleep

  • high levels of distractibility

  • racing and intense thoughts

  • impulsivity (i.e., going on shopping sprees, making risky business decisions, jumping into a new relationship)

  • false confidence about capabilities

  • becoming completely immersed in a specific hobby or pursuit

If left untreated, manic symptoms can persist anywhere from a few days to several months. The symptoms are severe enough to affect one's level of functioning and cause significant distress. In some cases, mania can lead to severe consequences- people may become suicidal, relapse on drugs, end up in jail, or experience psychosis.

Unfortunately, the comedown from mania typically entails a depressive episode. For this reason, some people with bipolar I disorder hesitate to take medication. They may feel more 'functional' during a manic state and refuse clinical treatment.

Bipolar disorder symptoms can emerge at any time. However, the average age of onset is around 25. The condition affects both men and women relatively equally.

What Is Bipolar II Disorder?

Bipolar II disorder includes the combination of at least one depressive episode (that persists for 2+ weeks) and one hypomanic episode over the course of a lifetime. People with bipolar II disorder do not have a history of manic episodes.

It's not uncommon for people with bipolar II disorder to receive depression diagnoses. That's because the depressive symptoms may be more chronic and pervasive. Similarly, someone may dismiss their hypomanic symptoms as simply feeling "normal" or feeling like they're just having a good time.

Hypomanic symptoms are similar to manic ones. The difference lies in the timeline and severity. Someone experiencing a hypomanic episode typically experiences symptoms for a shorter length of time. The symptoms are not severe enough to severely affect the individual's functioning or necessitate hospitalization.

After a hypomanic episode, people may also experience a crash (similar to depression). They may feel ashamed or embarrassed over their behavior or feel anxious about new responsibilities they agreed to take. Memory recall is sometimes difficult, as the entire episode may seem somewhat fuzzy.

Understanding Cyclothymia

Cyclothymia (also known as cyclothymic disorder) is a condition associated with rapid emotional cycling. In one moment, the person may feel happy and energetic. Several moments later, they feel down and upset. Between these highs and lows, the person often feels "fine."

Generally speaking, these highs and lows are less intense than the symptoms present in a manic, hypomanic, or depressed episode. However, they can still be disturbing, and they can contribute to further mental health distress.

How Do You Treat Bipolar Disorder?

Bipolar disorder isn't curable, but the right treatment and support can help you control your symptoms and improve your level of functioning. Treatment typically consists of numerous components, and you may need to try several options before finding a plan that works best for you.


Therapy is an important component of bipolar disorder treatment. In therapy, people learn more about their emotional triggers and develop appropriate coping skills to manage depressed or manic episodes.

Therapy can also help with concurrent issues related to or exacerbated by bipolar disorder. These issues might include:

  • relationship dynamics

  • school or work stressors

  • self-esteem

  • trauma

  • significant life transitions

  • co-occurring mental health conditions (substance use, eating disorders, ADHD)


Many people with bipolar disorder benefit from taking mood stabilizers to manage their symptoms. Lithium, Depakote, and Lamictal, for instance, are popular mood stabilizers.

Your doctor might also recommend antipsychotics, like Zyprexa, Seroquel, Latuda, or Risperdal. Sometimes, these are prescribed with a mood stabilizer- other times, they are prescribed as a standalone treatment.

Finally, you might also take an antidepressant. On their own, antidepressants are typically advised for bipolar disorder, as it's believed these medications may trigger manic episodes. However, they are sometimes taken in conjunction with mood stabilizers or antipsychotics.

Lifestyle Changes

Along with therapy and medication, managing bipolar symptoms requires ongoing effort. You need to be proactive in looking after yourself.

Lifestyle changes may include some or all of the following components:

  • adhering to a set sleep schedule

  • having an accountability partner who recognizes your early symptoms

  • practicing structured mindfulness throughout the day

  • eating a balanced, nutritious diet

  • getting enough physical activity

  • acknowledging and managing stress as it arises

  • limiting or avoiding caffeine

  • avoiding alcohol and drugs

You may not be able to avoid a manic, hypomanic, or depressive episode entirely. But having an awareness of what's happening- and how you can take care of yourself- can be empowering. Over time, as you become more mindful of specific triggers, you may notice these episodes have less of a hold over your life.

Final Thoughts

Whether you have bipolar I or bipolar II disorder, it's important to take care of your emotional well-being. We understand that you have many options when it comes to optimal treatment and care.

But at Mental Health Transitions, we take pride in our compassionate approach and our ability to support people every step of the process. We are here for you and your loved ones. Contact us today to learn more!

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