For those unfamiliar with bipolar disorder, it may seem that it only consists of two phases: severe depression and acute mania. Bipolar disorder is complicated. The vast majority of it exists between the two poles. Those are the endpoints. The daily struggle with bipolar disorder is what happens both during episodes and between those poles. It is experienced differently by different people. Because there are differences in the way bipolar disorder presents itself, psychologists have divided the illness into two categories: bipolar type I and bipolar type II.
The way bipolar disorder is categorized is according to the level of manic symptoms. Those with bipolar I experience at least one episode of full mania, while those with bipolar II only experience hypomania.
Both types of bipolar disorder consist of similar symptoms. They both include mood swings as well as symptoms that occur between episodes. These mood swings include mania, which has the following symptoms:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or a pressure to keep talking
- Flight of ideas or racing thoughts
- Increase in goal-directed activity
- Excessive involvement in activities that have a high potential for painful consequences
Hypomania consists of the same symptoms as mania, except episodes do not tend to last as long in hypomania as they do in mania. Periods of mania also have a more severe impact on a person’s daily life. People with bipolar II do not experience periods of mania. If they have a manic episode, the diagnosis changes to bipolar I.
Periods of depression include the following symptoms:
- Depressed mood most of the day, nearly every day
- Lack of interest
- Significant weight loss or weight gain
- Insomnia or hypersomnia most days
- Psychomotor agitation
- Loss of energy
- Feelings of worthlessness or inappropriate guilt
- Distractibility or indecisiveness
- Recurrent thoughts of death
Everyone with bipolar disorder experiences a combination of these symptoms, but bipolar II patients seem to be more negatively affected in several different ways.
- They suffer from more severe depressive symptoms.
- Periods of depression are longer than those experienced in bipolar I.
- Atypical depression is more common in bipolar II.
- They have more cognitive functioning problems in areas like memory, attention, and critical thinking both during and between episodes.
- Overall social functioning is worse than in bipolar I.
- They tend to have more comorbid disorders like anxiety disorders or substance abuse disorder.
Bipolar II disorder is often considered a softer version of the disorder. In fact, it is not a softer version. Many people with bipolar II suffer the same or worse than those with bipolar I. It is simply a different way of experiencing the same mental illness.
Image credit: Tobias Wrzal