Bipolar Disorder 1 vs. Bipolar Disorder 2: Key Differences, Causes, Symptoms
Bipolar Disorder 1 vs. 2: Differences, Symptoms & Treatment
Globally, an estimated 46 million people, including 2.8% of the U.S population, have bipolar disorder. If left untreated, bipolar patients may die almost 10 years earlier than the rest of the population.
Bipolar disorder is a serious mental health condition that causes extreme changes in mood, energy, sleep, and cognitive abilities. It involves alternating episodes of emotional highs (mania/hypomania) and emotional lows (depression).
It is an incurable, chronic mental illness. However, it can be managed with a treatment that combines medicines and psychotherapy. Read ahead for a comprehensive idea of the types of bipolar disorder, key differences between bipolar 1 and 2, mania and hypomania, their symptoms, causes, diagnosis, and treatment.
What are the Types of Bipolar Disorder?
Bipolar disorder can be of the following types:
1. Bipolar 1 Disorder
Bipolar 1 disorder involves one manic episode in a lifetime, before or after hypomanic or depressive episodes. In severe manic episodes, Bipolar 1 can lead to psychosis or dissociation from reality.
2. Bipolar 2 Disorder
Bipolar 2 disorder happens when one hypomanic episode and one major depressive episode occur. Bipolar 2 patients do not experience mania.
3. Cyclothymia
Cyclothymia is another type of bipolar disorder with milder symptoms. One undergoes many hypomanic and depressive episodes for a minimum of two years to have cyclothymia.
How are Bipolar 1 and Bipolar 2 Different?
The differences between bipolar disorder 1 and 2 are depicted in the following table:
| Bipolar 1 | Bipolar 2 |
| Minimum one manic episode | No manic episode, minimum one hypomanic episode |
| Full-blown or severe manic symptoms | Less intense hypomanic symptoms |
| Manic episode - up to a week | Hypomanic episode - up to four days |
| Depressive episodes are not required for diagnosis | Minimum one depressive episode for diagnosis |
| Lesser and shorter depressive episodes | Frequent and longer depressive episodes |
| Can need hospitalization | Does not need hospitalization |
| Higher suicide risk | Lower suicide risk |
| Manic episode causes functional impairment | A hypomanic episode does not cause functional impairment |
What are the Differences between Mania and Hypomania?
The table below presents a comparison of mania vs. hypomania:
| Mania | Hypomania |
| Intense and dangerous symptoms | Mild to moderate symptoms |
| Can include psychosis | Does not include psychosis |
| Often needs hospitalization | Does not need hospitalization |
| Episode for at least a week | Episode for a minimum of four days |
| Hindrance in daily activities | Normal functioning in daily activities |
| Impaired productivity | Increased productivity |
| Negative effect on social relationships | No adverse effect on social relationships |
| Always a part of Bipolar 1 | Can occur in Bipolar 1 and 2 |
What are the Causes of Bipolar Disorder?
There is no single cause for bipolar disorder. A combination of various factors can lead to it. Such causes are as follows:
- Differences in Brain Chemistry : A difference in brain structure can cause a change in neurotransmitter function, increasing the risk of developing bipolar disorder.
- Family History : Bipolar disorder can be linked to genetics. If you have a family history of bipolar disorder, you are at a higher risk of inheriting it.
- Age : Bipolar disorder is usually diagnosed first in teens and in young adults over 20 years, though it can develop in adults too.
- Life-Changing Events : Stressful life incidents like bereavement, divorce, financial loss and poverty, significant life changes, and times of uncertainty can often trigger bipolar episodes.
- Certain Medications : Bipolar episodes may result as a side effect of taking some medications, including antidepressants.
- Substance Abuse : Drug and alcohol abuse can worsen or trigger bipolar episodes.
What are the Symptoms of Bipolar Disorder?
Bipolar disorder involves symptoms of mania and/or depression. Manic or hypomanic symptoms can be:
- Happy mood
- High energy
- Excitement, agitation, and restlessness
- Racing thoughts
- Increased talkativeness
- Easy distraction
- Lesser need for sleep
- Impulsivity and reckless behaviors like overspending, gambling, fast driving, excessive sexual activity or substance abuse
- Grandiosity and high confidence
- Irritability, aggression, and anger
- Psychosis in severe mania
Depressive symptoms can be :
- Incessant sadness or low mood
- Despair and helplessness
- Irritability and anxiety
- Low self-esteem and guilt
- Loss of interest in previously enjoyable activities
- Lack of energy or fatigue
- Cognitive dysfunction
- Eating too much or too little, causing a gain or loss in weight
- Disturbed sleep or oversleeping
- Self-harming tendencies or suicidal ideation
How is Bipolar Disorder Diagnosed?
Diagnosing bipolar disorder can be done through a mental health assessment and the DSM-5. A mental health assessment includes:
1. Initial Interview and Physical Assessment
The healthcare provider will ask questions about medical history and any existing mental health conditions. Physical assessment involves physical examination and laboratory tests, done to help detect medical conditions that may be the underlying cause of bipolar symptoms.
2. Cognitive and Mental Evaluation
The mental health professional can use various screening tools that help in diagnosing bipolar disorder. These help understand identified symptoms in detail, including mood, thoughts, emotions, and behaviours.
For bipolar disorder, these tools may be:
- Mood Disorders Questionnaire
- Hypomania Checklist 32
In addition, the patient's family and friends may be asked about the patient's symptoms to reach an accurate diagnosis.
3. Mood Tracking
The patient may be asked to maintain a daily mood chart to help track mood, sleep, appetite, and other potential factors that may assist in the correct diagnosis.
4. DSM-5
A mental health professional can also diagnose the types of bipolar disorder, mania or hypomania and bipolar depression based on the standard criteria given in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, to identify Bipolar 1, Bipolar 2, Cyclothymia, mania/hypomania or depression in bipolar disorder.
How is Bipolar Disorder Treated?
Listed below are some of the ways to treat bipolar disorder:
1. Psychotherapy
Psychotherapy or talk therapy involves speaking to a mental health professional about bipolar and related symptoms and their impact on daily life. The following therapies can be given for managing bipolar symptoms :
- Interpersonal and Social Rhythm Therapy
- Cognitive Behaviour Therapy
- Psychoeducation
- Family-focused Therapy
2. Medications
Essential medications used to manage bipolar disorder episodes can be :
- Mood Stabilizers, eg, Lithium.
- Antipsychotics in combination with a mood stabilizer (Cariprazine)
- Antidepressants in combination with a mood stabilizer (Venlafaxine)
- Antidepressant-antipsychotic combinations (Symbyax)
Though bipolar disorder is a chronic illness, early diagnosis can help manage symptoms better and prevent extreme episodes. Consult a mental health professional for a customized treatment plan based on the severity of symptoms.
HELP CENTRE
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Yes. People with a childhood history of physical, emotional, or sexual abuse have a higher chance of developing bipolar disorder. Childhood trauma could also include bullying and loss of a parent or caregiver.
A mixed bipolar episode presents both manic and depressive symptoms at one time.
Attention deficit/hyperactivity disorder, anxiety disorders, and post-traumatic stress disorder are some mental health conditions that can occur with bipolar disorder.
Yes. Bipolar disorder can often be misdiagnosed as unipolar depression, schizophrenia, or borderline personality disorder.
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