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So, What's The Difference: Bipolar I vs. Bipolar II

Bipolar I vs. Bipolar II: What’s the Difference?

Many of us are familiar with the term bipolar disorder, it may have impacted those close to us or even impacted our own lives, but how familiar are you with the different types of bipolar disorder? As part of this post, we will be taking a look at two different types of bipolar disorder so we can identify the differences among them. Before we get started, it is important to highlight a few keywords associated with bipolar disorder, as outlined by the DSM-5 criteria.1

  1. Manic Episode: A period of at least one week where an elevated, irritable mood exists, as well as an increase in goal-directed activity or energy. The change in mood causes a marked impairment of social or occupational functioning, or leads to hospitalization. A manic episode could be considered euphoric, making someone feel like they’re “on top of the world.”

  2. Hypomanic Episode: A period lasting at least four days, where an elevated, irritable mood exists, and there is an increase in activity or energy. The episode leads to a change in functioning that is not usual of the individual and can be observable by others. The episode is not severe enough to impair social or occupational functioning, and does not lead to hospitalization.

  3. Major Depressive Episode: A two week period in which at least five symptoms are present, including either depressed mood or loss of interest or pleasure. Some of these symptoms include insomnia, psycho-motor agitation, fatigue, feeling of worthlessness, indecisiveness, recurrent thoughts of death, and more. These symptoms include impairment in social, occupational, or other important areas of functioning.

Bipolar I Disorder

The criteria for a manic episode has to be met for a person to be diagnosed with bipolar I disorder. During a manic episode, an individual might be talkative with strangers, they might want to start new projects (without prior knowledge of this project), or they might excessively plan activities. Commonly, an individual might feel awake and rested off little or no sleep. The activities and the poor judgement that happens during a manic episode might lead to negligent behavior that can cause major social or occupational problems, and might even lead to hospitalization. Symptoms of depression can also occur with bipolar I disorder.

Bipolar II Disorder

Bipolar II is characterized by one or more major depressive episode (lasting over two weeks) and at least one hypomanic episode (lasting over 4 days). The hypomanic episode generally does not cause impairment to the individual, otherwise a manic episode may need to be further considered. The individual might not even notice the hypomanic episodes. It might take information from friends or family for a correct and full diagnosis. Major depressive symptoms are more apparent than hypomanic symptoms in bipolar II disorder and usually impair the individual the most. Ultimately, the hypomania in bipolar II might be described as depression with increased energy.

To the general public, bipolar II might seem like it is just a milder form of bipolar I, but this is not true. In fact, individuals with bipolar II may have a greater chronicity of illness and spend more time in a major depressive episodes, which can be quite severe. Both of these illnesses have different qualities and cannot simply be measured by level of severity. Hopefully this helps distinguish the differences between bipolar I and bipolar II.

**Please note that this information should not be used to diagnose or treat. It is meant to be educational, and should not be seen as a substitute for evaluation and treatment from a qualified mental health provider. The above must not be viewed as medical advise. Please contact Dr. Miles if you have any questions or concerns. **


1 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.

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