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Bipolar 1 and 2 Difference: How to Tell Which One You Have

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You may have heard the phrase “stop acting so bipolar,” or you’ve seen how the condition is portrayed in movies or on television. While you might have an idea or what it refers to, it’s likely that its portrayal and what you believe about it is all wrong. Bipolar disorder isn’t a condition where you experience mood swings. Although mood swings are part of it, there’s much more than you’ve been led to believe. 

Bipolar disorder is a severe condition that affects the quality of a person’s life. However, with early intervention, the diagnosed individual can lead a healthy life. Its prevalence in the population isn’t significant. According to the Depression and Bipolar Support Alliance (DBSA), the condition affects 5.7 million adults in the United States, translating to 2.6 percent of the American adult population over the age of 18.

The DBSA also states that 25 is the median age of onset for the disorder. However, unlike other conditions, the onset can occur in early childhood or as late as age 40 or age 50. Bipolar disorder doesn’t discriminate. It affects both men and women equally in all races, ages, ethnic groups, and social classes. More than two-thirds of those with the disease have a close relative with the illness, which indicates it has a heritable component. 

The World Health Organization (WHO) considers bipolar disorder as the sixth leading cause of disability in the world. With that said, it’s vital to understand what bipolar disorder is and the two primary types, bipolar disorder 1 and bipolar disorder 2, and how to tell which one you or a loved one might have. 

bipolar-1-vs-bipolar-2

What Is Bipolar Disorder?

According to the National Institute of Mental Health (NIMH), bipolar disorder—once known as manic-depressive illness or manic depression—is a mental health disorder. It causes an unusual shift in activity levels, mood, energy, concentration, and the ability for a person to carry out routine day-to-day tasks. 

Three different types of bipolar disorder exist today, and all three involve changes in activity levels, mood, and energy. The moods can range from periods of highly elated, energized, or irritable behavior. These are known as manic episodes. It also includes extreme sadness, indifference, or hopelessness, which are known as depressive episodes. Less severe periods of mania are characterized as hypomanic episodes. 

Bipolar 1 Disorder

This form of bipolar is defined by manic episodes that occur for seven days or more and manic symptoms severe enough to warrant immediate hospital care. In most cases, depressive episodes will appear alongside the mania, which lasts at least two weeks at a time. Bouts of depression with other mixed features like manic symptoms and depressive symptoms at the same time are also possible. 

Bipolar 2 Disorder

Bipolar 2 disorder is defined by the National Institute of Mental Health as a pattern of hypomanic episodes and depressive episodes, but these are not the full-blown manic episodes a person would experience with Bipolar 1 disorder. While these can be severe, they may not always lead to immediate emergency care. However, a person should be monitored if they’re going through a depressive bout. 

Cyclothymic Disorder (Also Known as Cyclothymia) 

NIMH defines cyclothymia as a period of hypomanic symptoms that include bouts of depressive symptoms that last for a minimum of two years. For children and adolescents, the symptoms must be prevalent for a minimum of one year. However, these symptoms don’t always meet the diagnostic requirements for a depressive episode or hypomanic episode. 

A person may experience bipolar symptoms that don’t match the categories we’ve listed above. These are referred to as “other specified and unspecified bipolar or related disorders.” Bipolar disorder is most commonly diagnosed during the teen years or early adulthood, but on some occasions, these symptoms can show up in children. These symptoms will vary over time and will require lifelong treatment, but with the right help, symptoms can be managed and improve their overall quality of life.

Symptoms of Bipolar 1 and Bipolar 2 Disorder

The most common bipolar 1 and bipolar 2 disorder symptoms include depressive and manic episodes. However, the primary difference between the two is the length of symptoms and the severity. Below, we’ll delve into the differences between the two. 

Symptoms of Bipolar 1 Disorder

Those with bipolar 1 disorder will have manic episodes that last, at the very least, seven days and include three of the following symptoms. These include:

  • A sense of grandiosity (a person who has an exaggerated sense of self-esteem)
  • The individual doesn’t need much sleep and can stay awake for days 
  • The person will be easily distracted
  • The individual will talk much louder, faster, and more than they usually do
  • They will have lowered inhibitions, which leads them to engage in risky behaviors, such as spending too much money, speeding, experimenting with illicit drugs, or having unprotected sex with strangers
  • Individuals with bipolar 1 disorder report racing thoughts 
  • They will attempt to do a lot of activities at once

Those diagnosed with bipolar 1 disorder will experience depressive episodes that last two weeks. They will endure at least five of the following symptoms, which includes:

  • Helplessness, hopelessness, sadness, worthlessness, and despair
  • Feelings of extreme guilt
  • Losing joy in activities that made them happy
  • Either sleeping too much or not sleeping at all
  • Feeling restless or agitated
  • Not having any energy and feeling extremely tired
  • Having a hard time making decisions or concentrating
  • Constant thoughts of suicide or death

Symptoms of Bipolar 2 Disorder

If you’re diagnosed with bipolar 2 disorder, you’ll experience symptoms of depressive episodes that we described above. However, instead of manic episodes, you’ll endure hypomanic episodes. These are similar to manic episodes, but they’re much less severe. They typically last at least four days but won’t cause the serious issues that you’d encounter with manic episodes. 

You’ll likely return to normal between episodes. However, you might experience other issues like a substance use disorder (SUD) or an anxiety disorder

Causes of Bipolar 1 and Bipolar 2 Disorder

Although scientists haven’t been able to pinpoint a specific cause of bipolar 1 or bipolar 2 disorder, they believe several factors contribute to both disorders occurring, which include the following: 

Genetics

If you have a parent or sibling who has been diagnosed with bipolar disorder, your chances of developing it are much greater. However, most people who have a family history of the condition won’t develop it themselves. There have even been cases of identical twins where one twin developed the disease while the other didn’t.

Stress

Unfortunately, an extremely stressful event may trigger a depressive or manic episode. If you’re going through an event like a divorce, recently lost a job that you needed, or you’re experiencing financial hardship, it can also play a role in developing bipolar disorder. 

Brain Function and Structure

Researchers have found very subtle differences between the average size or activation of specific brain structures between those with and without bipolar disorder. However, you won’t be able to determine if someone has the condition with just a brain scan. 

How Are Bipolar 1 and Bipolar 2 Diagnosed?

Only a medical professional can determine if you have bipolar 1 or bipolar 2 disorder. During an appointment, they’ll discuss your symptoms, family history, and medical history. You’ll also go through a physical exam and blood tests to rule out any other potential causes of your symptoms. 

Your physician will also do a mental health evaluation and possibly refer you to a specialist with more experience treating bipolar disorder. Bipolar 1 disorder is diagnosed when you encounter at least one manic episode, whereas bipolar 2 is diagnosed when you’ve had at least one hypomanic episode. 

If you’re diagnosed with bipolar 1 or bipolar 2 disorder, it’ll require lifelong treatment, consisting of medication to balance mood, psychotherapy treatment, potential substance abuse treatment if you have a co-occurring condition, or hospitalization if you’re feeling suicidal. Fortunately, help is available, and you can lead a normal life with the disorder. However, you must reach out for the treatment you need because bipolar disorder can be dangerous without adequate help.

Sources

World Health Organization (November 2019) Mental Disorders. from https://www.who.int/news-room/fact-sheets/detail/mental-disorders

National Institute of Mental Health (April 2021) Bipolar Disorder. from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

National Institute of Mental Health (April 2021) Substance Use and Co-Occurring Mental Disorders. from https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health/index.shtml

Depression and Bipolar Support Alliance (April 2021) Bipolar Disorder Statistics. from https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/

National Institute of Mental Health (April 2021) Anxiety Disorders. from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

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