Bipolar ii Disorder and Bipolar I disorder- what is the difference?

What is the difference between Bipolar ii Disorder and Bipolar I Disorder? Do you know the answer? Many don’t though it’s very specific.

Bipolar ii disorder has all of the same symptoms as bipolar I disorder with one MAJOR difference. Bipolar I disorder has full blown mania that often comes with psychosis. Bipolar ii disorder has hypomania that rarely comes with psychosis. My dear friend Alena has bipolar I disorder. She has to be very careful as her mania is always lurking around and waiting to take over. She takes lithium and zyprexa to keep the mania and psychosis at bay. I have bipolar ii hypomania. Mine is very euphoric though it can be agitated. Mine doesn’t have psychosis- my bipolar psychosis can be around without any other serious mood swings though I am usually depressed.

Bipolar I disorder was the only bipolar disorder recognized for many, many years. Recently, the bipolar ii disorder diagnosis has become more common as doctors now know the signs of hypomania.
I have just as much trouble with bipolar ii disorder as my friend Alena has with her bipolar I diagnosis. Just in different ways.

This is a fascinating topic- there is a lot of information on the right that describes the difference between the two bipolar disorder diagnoses. Which one do you have? If you care about someone with the illness? What is their diagnosis? Knowing your diagnosis is extremely important as it determines the medications used to treat the illness!

Julie

11 comments to Bipolar ii Disorder and Bipolar I disorder- what is the difference?

  • Danielle

    Thanks for the breakdown for those out there that dont know the difference!

  • Jaime Guvench

    I have Bipolar 11 and some doctors try and say i dont have Bipolar because of the lack of pyscosis, they are still unaware of the two kinds and the differences, It gets very frustrating…

    Hi Jaime,

    I assume you are talking with general doctors? They don’t study much psych in school and unless they do a lot of outside study, it can be really hard to understand the ins and outs of bipolar II. My doctor is a general doctor and he is wonderul- what I admire most is that he will ask me for information when he is not sure of something.

    So, I do care about and respect doctors greatly, but the doctors you have talked with are confused. The difference between bipolar I and bipolar II is the intensity of the mania. The diagnosis has nothing to do with psychosis. Psychosis is certainly present for a lot of people with bipolar II, but it’s not a prerequesit! Also, it may be that you have had psychosis that you didn’t know was psychosis. That happened to me for over ten years. My psychosis article will be out in the next few months. There will be a link on this blog- I think it will clear up a lot of misperceptions about bipolar disorder and psychosis!

    Thanks for writing, Julie

  • dear Julie.

    I just found your blog yesterday while looking for some self-injury prevention websites. I’m only 20 years old, but I’ve been having some strange mental symptoms since I was a child and I’m concerned about where to turn. I don’t know if this is even the right place to ask…

    basically, when I was younger I’d have trouble sleeping because I’d constantly see things that werent there… as I grew older, I stopped seeing things, but have been considered an insomniac since I was a small child. Except, I love sleeping. I sleep for a long time, and sometimes I can’t make it through the day without taking a nap. Sometimes I can’t sleep at all. Then I was diagnosed with ADD by a neurologist and put on medication that made me lethargic and very irritable. I’ve always had those negative thoughts in my head saying I was ugly and unwanted and stupid, and have even argued with them aloud. As I grew older, high school hit, and my junior year, I was transformed. I was in a turbulent romantic relationship, and before I knew it, I was 18, and my just-turned-17 year old self who’d never had more than a sip of alcohol, vehemently virginal in all senses (despite on-and-off extremely sexual urges) had been hospitalized for a suicide attempt, was frequently indulging in self-harm, had become extremely promiscuous, was kicked out of college after my first semester for poor marks, and was experimenting with drugs and alcohol.

    The doctor who performed my psych-ward-intake asked me questions about bipolar and had come to the conclusion I did not have it. I was required to see a psychiatrist and a counselor after my discharge. After being placed on Zoloft for anxiety (in high school I started having panic attacks a lot) and Trazodone for my “insomnia” things were getting marginally better, but I was still either exciteable or depressed, just not as extreme as before. The psychiatrist suggested trying Seroquel as a mood stabilizer. I have an aunt (adopted) with bipolar I and when I asked him (in my mother’s presence, since I was a minor) if he suspected I had bipolar disorder, he said he wanted to try it and my mother said no. (She lived in a troubled home as a child, and often had to take care of my severely bipolar aunt, who was often becoming violent and being placed in mental hospitals for it as a child.) My mother did not want to associate me with my aunt’s kind of uncontrollable nature. She said I was not bipolar, she knew me, and I was nothing like her.

    After that, I was taken off Zoloft, Trazodone, and my ADD medication. I have not been medicated since, and my symptoms are becoming as severe as they were when it began. Does this sound like bipolar disorder? I know you’re not a psychiatrist, but I’m wondering if I should be reevaluated and if I should pursue bipolar treatments now that I’m old enough to do so, and out of my parents’ home. I fit many of the symptoms of bipolar II, and I’m often having mood swings reminiscent of rapid cycling, not that I’m qualified to self-diagnose, either. I don’t really have all the funds to go on a wild goose chase for a diagnosis, though. 🙁 please help.

  • Hi Jasmine,

    You really show a lot of insight and courage. You should DEFINITELY see a health care professional and get a second opinion. You don’t have to live with these mood swings. If you do have bipolar disorder, antidepressants are not the correct treatment at all as they can cause mania and agitations- and a lot of sleep problems. The true definition of bipolar disorder is.. bipolar disorder is an illness that makes it difficult for people to regulate their moods. There are two main mood swings in bipolar disorder: mania, depression and psychosis. but a person with bipolar also experiences anxiety including OCD symptoms and ADHD symptoms. If you have mania, you have bipolar disorder.

    You can’t have bipolar without having had a manic episode – either a full blown episode or a hypomanic episode. This is the #1 criteria for bipolar. So, you definitely need more answers. And answers create hope. You have a lot going for you and I can see that you will find the answers and get the help you need.

    Julie

  • Thank you. I’m getting really sick of being the “crazy” girl who sporadically cries for no reason, but will also ride on the hoods of cars for a thrill. It’s getting a little too weird for me! haha. and thank you very much for your compliments, it means a lot. You’ve also helped me accept that, bipolar or not, I need to figure something out. I’m almost grown, after all.

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  • Susan in Alaska

    Hi Julie,

    A member of the Bipolar Spectrum Disorders family which never gets mentioned is Cyclothymia, which is a “milder” form. My Docs seem to think this is the diagnosis I have, but I have to tell you that there is nothing “milder” about it. If I truly am not Bipolar II (and I question that I’m not), then what I experience with Cyclothymia may be less challenging than some but is still hell to live with. Mania, for example, may be less pronounced on the relative scale of things, but it’s still crazy for ME, and no less damaging. Any version of Bipolar, no matter what the label, is devastating. I’d be interested in learning how many of your readers may have been diagnosed with Cyclothymia.

    Thanks,
    Susan

    • Hello Susan, as always. I love your comments. It really doesn’t matter what your doc says- bipolar is bipolar and whether it’s cyclothymia or full blown bipolar I, the treatment is the same- managing mood swings. I’d like to answer your question on facebook. It’s at Julie A. Fast.

      I know that so many people have the same questions- what diagnosis means what! Cyclothymia is MILD bipolar and very difficult to notice as a person can simply seem moody. If your mania is obvious, regular and disrupting, I would call it bipolar II. It is all about the mania. I will write more about this.

      I have your contact info and will write soon! Julie

      My friend Dr. Jim Phelps has written a superb book on Bipolar Spectrum Disorders. http://www.amazon.com/Depressed-Recognizing-Managing-Bipolar-Disorder/dp/0071462376/ref=sr_1_1?ie=UTF8&qid=1353389313&sr=8-1&keywords=jim+phelps

      He is a true pioneer in the management of the non bipolar I forms of the illness!

      He lives a few hours from me. What a coincidence! Julie

  • KJM

    Is there a long questionnaire you could post or link to that helps a person know their differential diagnosis i.e. Bipolar I, Bipolar II, or Cyclothymia?
    I’m bipolar, I have a family member who has been in I (with delusions etc.) when severely manic before properly medicated, and a generation or two before that before there were proper meds a family member was institutionalized for what probably was bipolar 1, I am assuming. I also have 2 good friend with bipolar, and I’m not sure if they are I or II. From what my experience has been is that a person could seem to be II until they go into a strong deep high or low at which point they start having hallucinations or delusions. So, how does a bipolar person know if they themselves are 1, 2, or cyclothymic, and how do they know someone else is which of the 3, and what are the different treatments for these 3 and how can the wrong treatment hurt? I know that treating bipolar like monopolar/unipolar depression is disastrous because it can trigger a manic phase, but what are the dangers of misdiagnosing or treating one of the three types of bipolar as another type? Thank you
    -KJM

    • This is a great question. I will create a questionnaire and post it as a blog. I will email you when it’s ready. Any one else can comment on how they tell the difference! Julie

  • Lauren Lathrop

    Hi,
    My mom sent me the link to your blogs. She has taken it upon herself to help me with my recent diagnosis of bi polar 1. I am happy to have her support, but I am still in the phase where it’s hard to accept my diagnosis. I have done much research on bi polar before I was officially diagnosed because I was suspicious that I may have it. (My grandmother had bi polar 1 really bad). But then later talked myself out of the idea. Close friends would tell me things like “you don’t have bi polar Lauren. I know people that have it and you aren’t like them at all. You just seem hyper-sensitive to life.” Or something of that sort. And that’s just the thing. I think it’s hard for me to accept the diagnosis because I have ALWAYS been this way. Major mood swings. Major ups and major downs. Almost resembling two different people. Even as a child. The older I got and the larger the opportunities became, my approach to them began to wave red flags. That I was not making decisions and living in a way that most people would. Yet, that’s always been me. Unique, independent, and unpredictable. I always just figured I was a very avantguard person. However, when the depressions would come randomly and for no reason, I would get confused. Like, where did this come from? And why is it sticking for so long? So then I thought, I’m just an avantguard person who suffers from anxiety and depression sometimes. But then there would be this middle mood. Where I didnt feel so crazily adventurous and independent and ambitious. But didn’t feel scared, anxious, or sad either. Where I could feel my heart softened but not drenched in emotion. Where my heart didn’t feel so calloused and careless rather filled with healthy, tender feelings that focused on other people and self-improvement… That was me. Normal me. I’m not really explaining myself in an orderly fashion right now. What I’m trying to get at is I finally realized that contrasting moods were really making me into 3 different people. Or shall I say one person, with upswings and downswings. I realized that when I was in the best moods–the moods where I felt I could do anything in the world successfully and felt soooo stimulated just by driving down the freeway listening to a good song so much so I would scream out loud and feel adrenaline pump through my veins as I wore an outlandish outfit that screamed LAUREN! and my foot like metal on the gas pedal. I was in an upswing. Where I didn’t care about morality that I previously held so deeply to my heart. Where I could toss a previous mental resolve with the same ease as tossing a dirty shirt in the hamper. Where I would get these crazy sexual impulses and need to be around people and need my body to feel as stimulated as my mind. Where I would have a hard time not running after the next opportunity that presented itself and couldn’t stay settled for the life of me. Couldn’t feel content without go go going on the next adventure. Would through cautious to the wind as if nothing could harm me. Had all the mental energy for all of my endeavors and would force my body to keep up unwittingly. Only to crash. Crash so hard I would sleep for 14+ hours a day. Crash so hard I couldn’t be around people without feeling anxiety that would shake my bones. Crash so hard I would feel scared of making any decisions. Would feel like everything can harm and exhaust me. So what’s the normal me? An outgoing friendly person who enjoys adventure but also enjoys consistency. Someone who feels deeply about pleasing her God even though she may battle some fleshly desires. But still at least has a moral compass. Someone who cares about being loyal and honest to those she loves. Rather than scheming behind their backs to fulfill selfish pleasures. Like I do when I’m manic. I naturally have anxiety as my timidness gets in the way of my passions. But that is a normal contrast….. Anyway, I have had to recently deeply analyze the difference between normal personality contrasts with bi-polar swings that are not natural. Even if they may be “normal” to me as I have lived with them for the majority of my life. I have finally accepted the diagnosis but it’s hard to believe I might ever experience psychosis. Which brings me to the next discussion point–how I was diagnosed with bi-polar 1 instead of bi polar 2. I always thought you never experience psychosis as bi polar 2. I always read you only experience psychosis if you are bi polar 1. So that made me fearful that one day my bi polar may get worse and I will start going crazy. I have experienced suicial thoughts during such low depressions and anxiety attacks. I have self-abused myself verbally, sometimes physically and sexually. But never have I experienced psychosis or done anything “crazy” when I was manic besides living recklessly and fearlessly. I figured if anything I was bi polar 2. But my psychiatrist said what makes a person bi polar 1 strictly depends upon the length of their mania. If I lasts longer than a few weeks, you are automatically diagnosed bi polar 1. Well, my mania tends to last for months. My depressions can last for as little as a week to as long as 8 months. Sometimes I rapid cycle between the both. I guess my question to you is, have you heard anything about this “time barrier” strategy for diagnosing between bi polar 1&2?