Types of Bipolar Disorder

Learn More About the Types of Bipolar Disorder

What Are the Different Types of Bipolar Disorder? There are several different types of bipolar disorder, which differ in their symptoms and severity. A hallmark of every type is discrete mood episodes that are interspersed with periods of normal, level mood, and functioning.  Your doctor will diagnose your condition based on the length, frequency, and pattern of episodes of your mania and depression.

There are Four Types of Bipolar Disorder

Bipolar I

This is considered the most severe form of the condition. People with bipolar I experience at least one manic episode, and most people will also have depressive episodes — or at least some features of depressive episodes. Episodes are defined as symptoms that affect a person every day for at least a week. The manic episodes that people with bipolar I experience are often extreme.

Bipolar II

This type of bipolar disorder is usually diagnosed after a person experiences at least one major depressive episode and at least one episode of hypomania. The highs in bipolar II aren’t as high as those in bipolar I, although it’s important to understand that bipolar II is a separate condition, not a milder form of bipolar I. Unfortunately, bipolar II is sometimes misdiagnosed as major depressive disorder when a person’s hypomanic episodes go unrecognized.

Cyclothymia

This is a milder form of bipolar disorder that’s sometimes referred to as cyclothymic disorder.  Both cyclothymia and bipolar disorder are characterized by extreme mood swings, from the highs of mania to the lows of depression, with short periods of neutral time in between.  The difference lies in the intensity: People with bipolar disorder will experience clinically diagnosed mania and usually major depression, while people with cyclothymia have low-grade depression and mild symptoms of hypomania.

​With cyclothymia, “It may seem like you’re just going through a string of good days and a string of bad days,” says psychiatrist Kathleen Franco, MD, of the Cleveland Clinic Lerner College of Medicine in Cleveland. “But the mood shifts keep going, and there’s little neutral time in between.”

Other Specified or Unspecified Bipolar Disorder

When a person doesn’t meet the criteria for any of the other types of bipolar disorder but still experiences periods of a significant, abnormal elevation in mood, this diagnosis is used.

Symptoms of Cyclothymia

What to look for besides cycling between the two mood extremes, there are other criteria that will determine a diagnosis of cyclothymia:

• You’ve experienced these mood swings for at least two years.
• At least once in the two-year period, you have had significant distress or social impairment.
• Your symptom-free intervals last no more than two months.
• Your symptoms don’t meet the requirements of any other bipolar disorder.

Cyclothymia vs. Bipolar Disorder

What’s the Difference? Only a doctor can accurately make the clinical distinction between cyclothymia and bipolar disorder. Generally speaking, the symptoms of major bipolar depression are debilitating and can include an inability to get out of bed, feeling overwhelmed or unable to make even the simplest decisions, and having obsessive thoughts, especially about loss, personal failure, or guilt.  These symptoms, which can be long-lasting, affect your ability to function, and can dramatically reduce your quality of life.

The same kinds of symptoms may be present in cyclothymic depression, but they’re less severe in degree. Cyclothymic symptoms may last no more than two weeks and may cause less of a disruption in your daily routine. The true mania of bipolar disorder, essentially the opposite of major depression, can likewise be debilitating.  It may be accompanied by feelings of euphoria and indestructibility that can include reckless behaviors.

A manic person may go a day or two without sleeping.  They may talk rapidly, moving from topic to topic without making much sense. The hypomania symptoms seen with cyclothymia are less dramatic and not as long-lasting.  They may be so mild as to seem normal — mild sleeplessness, for example, or chattiness and increased energy. Some people living with cyclothymia are happy to go without treatment, however, it may be important for others to recognize and monitor the condition. It’s estimated that there’s a 15 to 50 percent risk that people with cyclothymic disorder may go on to develop full-blown bipolar disorder. This escalation is especially prevalent if bipolar disorders run in the family.