5 Types of Bipolar Disorder: Why the Distinction Matters

You have probably heard of the term “bipolar disorder.” Perhaps you know someone who has been diagnosed with bipolar disorder, or you think you may experience symptoms of bipolar disorder yourself. Bipolar disorder is a mental health condition that was previously referred to as “manic depressive disorder.”

Types and Prevalence of Bipolar Disorder

The Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition (DSM-5) has classified five types of bipolar disorder, and 2.8% of adults in the United States have been diagnosed with some type of bipolar disorder. The five types of bipolar disorders listed in the DSM-5 are:

  • Bipolar I
  • Bipolar II
  • Cyclothymic disorder
  • Bipolar disorder “other specified”
  • Bipolar disorder “unspecified”

It is important to note that the DSM-5 lists bipolar disorder other specified and bipolar disorder unspecified as two separate diagnoses. However, both conditions represent a diagnosis of bipolar disorder when a person does not meet the criteria for bipolar I, bipolar II, or cyclothymic disorder. You can learn more information about the differences between bipolar I and bipolar II here.

Differences and Commonalities

What makes bipolar disorder distinct from other mental health disorders is its unique symptoms, particularly changes in energy levels, activity levels, and mood. The mood changes can range significantly from periods of intense energy to periods of very low mood. Periods of high energy are referred to as “manic episodes,” and periods of low mood are referred to as “depressive episodes.” Each form of bipolar disorder encompasses these symptoms to some degree; however, distinct differences exist.

Symptoms of mania include:

  • Lessened need for sleep.
  • Feelings of high energy, jumpiness, and irritability.
  • Hyperverbal (i.e., talking very rapidly).
  • Racing thoughts.
  • Trying to do many things at one time.
  • Feelings of grandiosity (i.e., powerful, important).
  • Risky behaviors (e.g., eating too much, using substances excessively, and risky driving).
  • Hallucinations and delusions (e.g, seeing things that don’t exist or believing a reality that doesn’t exist).

Symptoms of hypomania are less severe than mania or manic episodes. They do not include psychosis (e.g., hallucinations and delusions), but they do include:

  • Talkativeness.
  • Lessened need for sleep.
  • Racing thoughts.
  • Increase in goal-directed behaviors.
  • An exaggerated sense of self-esteem.

Symptoms of depression or low mood include:

  • Feelings of hopelessness, sadness, and low mood.
  • Low energy.
  • Weight gain and increased appetite.
  • Slowing down of thoughts.
  • Little interest in once pleasurable activities.
  • Sleep problems (e.g., oversleeping and not sleeping enough).

Distinctions Among the Types of Bipolar Disorders

Bipolar I symptoms include:

  • Manic episodes that last for at least a week or require hospitalization due to the severity of symptoms.
  • Depressive episodes lasting at least two weeks.

Bipolar II symptoms include:

  • Presence of both hypomanic and depressive episodes, but not manic episodes.

Cyclothymic symptoms include:

  • Presence of hypomanic and depressive symptoms lasting at least two years.
  • Symptoms present do not meet the criteria for hypomania and depressive episodes.

Bipolar disorder “other specific” and “unspecified” are used when the individual:

  • Doesn’t meet the criteria for bipolar I, bipolar II, or cyclothymic disorder.
  • Experiences periods of clinically substantial mood disruption and mood elevation.

Treatment Options

Understanding the differences among the types of bipolar diagnosis can help you and your doctor develop an effective treatment plan based on your symptoms and needs. Treatment is tailored to your goals and symptoms. It’s important to remember that everyone responds to treatment differently, so one method may work for one person but not another.

Common treatment options include:

  • Medication such as anti-psychotics, anti-depressants, and mood stabilizers.
  • Talk therapy.
  • Education.
  • Complementary therapies such as meditation, prayer, and exercise.

Conclusion

Bipolar disorder is treatable. If you experience symptoms of bipolar disorder, you are not alone. If you believe you may be experiencing bipolar disorder, talk to your primary care physician and discuss whether telehealth or in-person treatment is best for you. If you have thoughts of suicide, call the national suicide crisis number at 800-273-8255. If you are considering acting on your thoughts, please call 911 or go to your local emergency department to get the support you may need. Valera Health can help you on your personal journey to wellness. We offer psychiatric and therapeutic services through telemedicine for anxiety, depression, ADHD, and bipolar disorder.

Sources:

  1. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder
  2. https://www.nimh.nih.gov/health/topics/bipolar-disorder/
  3. https://www.uofmhealth.org/health-library/aa167947