Types of Bipolar Disorder

There are several types of bipolar disorder, each with their own set of criteria for diagnosis. However, in my opinion, bipolar symptoms are quite unique to each person, and the distinction between different types of bipolar disorder can be rather fuzzy in some cases.

I see Bipolar disorder as more of a spectrum, than a distinctive category that is clear and easy to define in every case.

But for the sake of understanding and identifying your own symptoms, I will describe the different types of bipolar disorder:

  • Bipolar Type 1: Must have a history of at least one true "Manic" or "Mixed" episode. Mania is characterized by an abnormally elevated mood, sustained over time, and extreme enough to experience delusions, hallucinations, or extreme lapses in judgment or impulses that are not typical behavior for you. In mania there is often little or no need for sleep, yet a sustained level of intense energy and activity, racing thoughts, rapid speech, euphoria or agitation, grandiose ideas.

    In a Mixed episode, much of the same symptomology as Mania is present (especially high energy), however the tone, attitude, or thought process is extremely depressive, negative, self-critical, angry, agitated or suicidal.

    In Mania or Mixed Episodes the mood may be "labile." That is, emotions may change rapidly and spontaneously - from joyful, to tearful, to enraged and back again, within seconds or minutes. In a mixed episode, the feelings are predominantly negative but still may change rapidly.

    Being psychiatrically hospitalized adds to the likelihood of a diagnosis of Bipolar 1.

    May or may not also have history of Major Depressive episodes. Some people get occasional manic episodes, but have never been depressed, while others experience both ends of the spectrum.

  • Bipolar Type 2: History of at least one Major Depressive episode, and at least one "Hypomanic" episode. In hypomania the mood is elevated, energy is raised, goal directed activities are increased, you may be more impulsive, talkative, sexually driven, euphoric, or agitated, (like mania), but there are no psychotic symptoms (delusions or hallucinations), and no behaviors that are outrageous enough to land you in jail, or in a psych hospital.

    Basically, if you can still function in your daily life, take care of your normal tasks, get through a day of work, and you have some measure of self-awareness, you are probably "Hypomanic" rather than "Manic."

  • "Soft Bipolar": Not an official DSM diagnostic category, but a term that is gaining credibility, this type of bipolar disorder is often misdiagnosed or even unrecognized altogether. The "highs" or elevated mood state may be similar to the level of the average person while their feeling good, while the majority of the time might be spent in a state of mild depression or periods of moderate to severe depression. There is a lot of variation in soft bipolar. Jim Phelps, MD (author of "Why Am I Still Depressed"), has written a lot on this subject.

  • Cyclothymia:Thought of as a mild form of Bipolar Disorder. Characterized by distinct mood cycling from depression to elevated mood states, but with less severe highs and lows than full blown Bipolar Disorder (either I or II). The elevated mood would be classified as a hypomanic state (never manic).

    Learn more about symptoms in all types of Bipolar Disorder

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