What Are the Different Types of Bipolar Disorder?

Bipolar disorder is a mental illness characterized by extreme mood swings. Cycling between emotional highs and lows (mania and depression, respectively) makes it hard for people with bipolar disorder to maintain healthy relationships, keep a steady job, and think clearly. Fortunately, mental health treatment can help patients manage their symptoms and lead fulfilling lives. This article will explore the different types of bipolar disorder and touch on effective treatment options.

Types of bipolar disorder

The main types of bipolar disorder are bipolar I, II, and cyclothymic disorder. Unspecified bipolar, also known as bipolar disorder not otherwise specified (NOS), is a lesser-known manifestation. Take a closer look at these variations below.

Bipolar I

Bipolar I is when the patient has experienced manic episodes, at least one of which has lasted no less than seven days or was so severe that it resulted in hospitalization. Mania is not the same as the average emotional high. A bipolar manic episode presents as being in extremely high spirits, having more energy than usual, or being very irritable while also displaying at least three of the following symptoms:

• Easily distracted
• Racing thoughts
• Abnormally fast speech
• Changes topics quickly when speaking
• Risky behavior and poor decision-making
• Increase in activity, such as working on multiple things at once
• Decreased need for sleep (e.g., barely sleeping but maintaining a very high level of energy)

There are also so-called psychotic features to manic episodes, which range from disorganized thinking to hallucinations. Not all patients experience these, however. Similarly, depressive episodes are not required for this diagnosis, although they are common among patients with bipolar I.

Bipolar II

Both depressive and hypomanic episodes characterize bipolar II. The depressive episode must have lasted at least two weeks, while hypomania must have lasted at least four days. A major depressive episode is marked by either a depressed mood or a loss of interest in hobbies and other activities. In addition, the patient must experience at least three of the following symptoms:

• Difficulty sleeping most days (insomnia or hypersomnia)
• Changes in appetite or weight
• Agitation, sluggishness, or difficulty speaking
• Fatigue that gets in the way of regular activities
• Trouble with decision-making and concentration
• Feeling worthless or extremely guilty
• Suicidal ideation, thoughts, or attempts

Hypomania is similar to mania, but its symptoms are less severe and, therefore, do not cause as severe of problems. Keep in mind that an episode may last several months. To be considered hypomania, the changes in behavior, mood, and energy must be substantial enough for others to notice.

Cyclothymic disorder

Also known as cyclothymia, cyclothymic disorder is when the patient experiences a chronically unstable mood. Specifically, it is when the patient fluctuates between hypomania and experiencing mild depressive symptoms for two years or more. According to the National Alliance on Mental Illness, or NAMI, it is common for patients to experience a normal mood periodically. However, if the normal mood persists for eight weeks or more, this diagnosis does not apply.

Unspecified bipolar

Suppose a patient experiences abnormal emotional highs but does not meet all the diagnostic criteria for the other types of bipolar. In that case, they may be diagnosed with bipolar disorder not otherwise specified (NOS). These mood fluctuations cannot be traced back to another medical condition, including another mental disorder or substance use. Just because bipolar disorder NOS is less severe does not mean that it does not get in the way of life. Many patients with bipolar unspecified benefit from mental health treatment.

Bipolar diagnosis and treatment

Only a mental health professional, like a psychiatrist or psychologist, can diagnose bipolar disorder. To do so, they will complete a psychiatric assessment to see if the patient meets the criteria detailed in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. Keeping a record of one’s mood and sleeping patterns (mood charting) may aid with diagnosis. A medical doctor will also check to ensure there are no underlying medical conditions that could be causing the patient’s symptoms.

Treatment for bipolar I, II, NOS, and cyclothymic disorder typically involves psychotherapy and prescription medications. Cognitive behavioral therapy, or CBT, is the most commonly used approach, as it helps patients respond to their symptoms in more positive ways. The patient will also learn how to recognize the signs of manic and depressive episodes, thereby making them easier to manage.

Since bipolar disorder is marked by extreme mood changes, many patients find mood stabilizers and antipsychotic medications integral to treatment. In some cases, antidepressants may also prove beneficial. Speak to a mental health provider about whether medication could bolster the patient’s treatment plan.

Consult a mental health professional

If you or a loved one has been struggling, there is help. Treatment can help patients with bipolar disorder live happy, fulfilling lives. Call our team to learn more.

Request an appointment here: https://nycpsychiatricassociates.com or call NYC Psychiatric Associates at (917) 391-0076 for an appointment in our New York office.

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