Bipolar I and II Explained: Unpacking the Unique Mood Cycles

“I was equal parts terrified and relieved [when I was diagnosed]. Terrified because the veil was lifted but relieved that I finally had the knowledge of why I had suffered with various depressions and anxieties for so many years.” –Selena Gomez, on her bipolar I diagnosis.

Living with a serious mental health condition isn’t easy, but it’s not as rare as you may think. As of 2023, an estimated 796,000 adults in the state of Texas had a serious mental health condition, like bipolar disorder. For context, that’s more people than the entire population of El Paso. 

At Oceans Healthcare, we understand just how isolating it can feel to find out that you have a serious mental health condition. That’s why we’re dedicated to providing people with compassionate, destigmatizing, and nuanced educational resources about mental health. Today, we’ll take a look at bipolar I vs. bipolar II and explore their similarities and differences. 

Bipolar is a serious mood disorder that is typically associated with both manic and depressive symptoms. Mood changes are a part of everyday life. However, people living with bipolar disorder usually experience highs and lows very intensely for an extended period of time, known as an “episode.” The two most common forms are bipolar I and bipolar II. Let’s review their unique differences.

To be diagnosed with bipolar I, you must experience manic symptoms that last for at least one week. When you’re in a manic state, you’ll experience:

A manic episode is not always noticeable to the person experiencing it, but is usually obvious to the people who know them well. To be considered a manic episode, your symptoms must be a marked change from your usual behavior. They must also cause significant dysfunction in social settings, at work, or at school. 

In more severe cases, manic episodes can produce psychosis. If you experience psychosis, you’ll lose touch with reality. Many people with psychosis experience delusions, paranoia, and hallucinations. Psychosis is an immediate medical emergency, and if you or someone you love experiences it, you should get medical help immediately. 

In addition to manic episodes, some people with bipolar I also experience depressive episodes of two weeks or more, but it’s not a requirement for the diagnosis. In some cases, people experience what’s known as mixed episodes, where they have depressive and manic symptoms at the same time. 

If you’re living with bipolar II, you’ll experience a depressive episode that lasts for at least two weeks. These episodes can last for months or longer without proper treatment. Because of the intensity of depression associated with bipolar II, it is common for people with the condition to be misdiagnosed with major depressive disorder before getting the correct diagnosis. 

If you experience bipolar II, you will not have a full manic episode. Instead, you’ll experience hypomania. Hypomania is less intense than mania and usually lasts for 4 days or less. Hypomania can be much more difficult to identify than mania. Hypomania may even feel like a welcome reprieve from depressive symptoms. 

People with hypomania experience a sudden burst of energy, but it doesn’t necessarily cause problems at work or school. It sometimes improves productivity.

Bipolar depression is a term that refers to the low episodes that people with bipolar I and, primarily, bipolar II experience. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), you have to meet at least 5 of the following 9 criteria for your symptoms to amount to a major depressive episode:

There are many similarities between bipolar I and II. They’re both mood disorders that cause you to cycle between high and low moods. Without proper treatment, the symptoms of either condition will cause significant disruptions in many areas of your life. 

Mania and hypomania, which are associated with bipolar I and bipolar II, respectively, produce similar symptoms. For example, you’re likely to feel more talkative, impulsive, and excitable during both a manic and a hypomanic episode. It’s also common to experience physical symptoms, like insomnia or restlessness, during either type of episode. 

You can experience rapid cycling with both bipolar I and II. Rapid cycling is defined as experiencing 4 or more episodes of mania, hypomania, or depression during a single year. There is no clear way to predict when rapid cycling will occur, but keeping a record of your moods from day to day will help you identify how quickly you cycle through episodes. During rapid cycling, your moods can shift over hours or days.

Regardless of which type of bipolar disorder you have, your treatment options will be similar. Although bipolar disorder is a lifelong condition, it doesn’t have to hold you back in life. Both forms of bipolar are manageable with a combination of therapy and medication. 

Cognitive behavioral therapy (CBT) is one of the most effective evidence-based psychotherapies used to treat bipolar disorder. In CBT, you’ll work with a therapist to identify harmful thought patterns and how they relate to self-destructive behaviors. Throughout CBT, you’ll develop healthy coping strategies. Medication is another tool that you’ll utilize to manage your condition. Antipsychotics and mood stabilizers are commonly used to treat both forms of the condition. Antidepressants are used to treat depressive symptoms on a case-by-case basis, but are known to trigger mania in some people with bipolar I. 

Bipolar I and II both fall under the bipolar umbrella of mood disorders with intense “highs” and severe “lows.” However, it’s important to note that bipolar I and bipolar II are 2 distinct diagnoses with different criteria. One type of bipolar is not more severe than the other; they just have two different, although overlapping, sets of symptoms. 

Mania vs. hypomania marks one of the distinct differences between the two types of bipolar. To receive a bipolar I diagnosis, you will have experienced a full manic episode. Some people with the condition also experience a hypomanic episode, but it isn’t a defining characteristic of the condition. If you’re living with bipolar II, you will not experience mania, but you will experience hypomania. Mania is more intense than hypomania and includes the possibility of psychosis, which hypomania does not. Manic episodes also last longer than hypomanic episodes and often require more specialized treatment. 

As discussed in the Bipolar II section, depression is a defining characteristic of bipolar II. While it’s possible you’ll experience episodes of depression with bipolar I, it isn’t likely to be as frequent, and it’s not inherent to the diagnosis. If you have bipolar II, you’re likely to need treatment that specifically focuses on treating the depressive aspect of the condition. 

A bipolar diagnosis doesn’t change who you are; it just helps you understand yourself and your needs better. With the right treatment for bipolar disorder, you’ll find a path forward. Effective treatment won’t just get you “back to normal.” It’ll empower you with the tools to move through life as your most authentic self, with self-understanding and compassion. 

Our compassionate Oceans Healthcare staff will empower you with the coping skills you need to manage bipolar disorder symptoms and side effects. A board-certified psychiatrist oversees every program to ensure that you get the world-class treatment you deserve. We also prioritize fostering a collaborative environment, so you’ll have a whole team working together to find the unique care options that work for you. Call us today at 888-293-6899 to learn more. 

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