Bipolar I and Bipolar II
A Brief Introduction to Clinical Bipolar Disorder
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the antiquated term for Bipolar Disorder is manic-depression, clearly indicating the dualistic experience of both mania and its opposite, a depressive state. While most people who endure a manic episode will at some point meet the criteria for a major depressive episode in their lifetime, the experience of a Major Depressive Episode is no longer necessary for a diagnosis of Bipolar I, however, both the experience of mania and depression is necessary for the diagnosis of Bipolar II. For the individual with Bipolar, the lived experience of the manic episode may feel euphoric with exaggerated happiness; this may switch into irritability if wants are denied. While in a manic state, this individual may be experienced as charismatic, charming, and magnetic. The manic state creates a feeling of invincibility, and the individual in this state may feel boundless and apply themselves to multiple new projects simultaneously regardless of skill level, practicality, and previous interest or knowledge. These projects may be social, religious, political, or industrious.
The manner of speech is also marked and the individual may dominate conversations, often with jokes, and volume, sometimes peppered with a singsong voice. Speech in this state will be relentless and can be experienced by the listener as a barrage of stimulus delivered to them without their consent. The individual experiencing mania will often increase their sociability with familiars and strangers, reaching out across a multitude of platforms, making contact however they can. Increased sexual desire, fantasy, and behavior is often a part of a manic episode, often including infidelity and anonymous sex that is not a part of the individual’s normal behavior. Manic episodes often contain fiscal cacophony such as busying expensive items on credit and giving them away. A hallmark of the episode of mania is the decreased need for sleep (different than the experience of insomnia). In a manic episode, the individual can stay up for hours on end, perhaps sleeping for a few hours, awaken feeling energetic, and continue this cycle for days on end.
What is the Difference Between Clinical Bipolar I and Bipolar II?
The distinguishing factor between Bipolar I and Bipolar II has to do with the severity of the manic episode and the presence or absence of a major depressive episode. An individual with Bipolar I will have experienced a state of mania that is longer in sustained duration and has a stronger negative impact on life functioning than that experienced by a person diagnosed with Bipolar II. The manic episode experienced in Bipolar II is called hypomania because it is shorter in duration and has a lesser detrimental effect on social and occupational functioning than the manic episode experienced in Bipolar I. As well, the diagnosis of Bipolar II depends on the presence of a Major Depressive Episode.
What Are the Different Types of Clinical Bipolar Disorder?
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, differentiate between six types of clinical Bipolar:
- Bipolar I Disorder
- Bipolar II Disorder
- Substance/Medication-Induced Bipolar and Related Disorder
- Bipolar and Related Disorder Due to Another Medical Condition Disorder
- Other Specified Bipolar Disorder
- Unspecified Bipolar and Related Disorder
What are the Signs and Symptoms of Clinical Bipolar I Disorder?
The diagnosis of Bipolar I depends on the experience of a manic episode. A manic episode is defined by lasting for at least seven days, for most of the day, nearly every day, and entails an inflated, extreme amount of goal-driven energy and activity. The behaviors during the manic episode are so extreme as to cause noticeable impact socially or at work, or to necessitate hospitalization as the individual is at risk for harm to self or others, or the individual shows noticeable signs of psychosis (as in the experience of hallucinations or delusions that are driving and fueling the goal-driven behavior). During this period three of the following symptoms are experienced to an extreme and noticeable degree, with a marked difference from the individual’s normal display of characteristics. If the underlying mood is irritable, then four of the following symptoms must be present for the Bipolar I diagnosis.
- Inflated self-esteem
- Feeling rested after only three hours of sleep
- Incessant talking
- Racing thoughts or “flight of ideas,” meaning a series of unrelated thoughts
- Distractibility with attention being drawn to unimportant external stimuli
- Goal-directed driven behavior socially, sexually, vocationally, educationally; or, physical agitation toward non-goal directed activity
- Participation in high risk behaviors, especially with social, sexual, or financial risk.
An individual with Bipolar I may also experience instances of hypomania and a Major Depressive Episode but this is not necessary for the Bipolar I diagnosis.
What are the Signs and Symptoms of Bipolar II Disorder?
An individual with Bipolar II Disorder experiences a hypomanic episode and a Major Depressive Episode. A hypomania episode is comprised of the same symptomology as a hyper mania, however, it lasts for four days as opposed to seven in hyper mania. Also, for a hypomania episode to be determined the episode does not cause serious detriment to social and occupational life, does not require hospitalization, and does not involve psychosis. To be diagnosed with Bipolar II, the individual also needs to experience a Major Depressive Episode, which is described here. (Link to Depression page).
Treatment for Bipolar Disorder at Silicon Beach Treatment Center
At Silicon Beach Treatment Center, our task when treating any area of client suffering is to identify the nature of your experience with it, explore the underlying causes, and work together to usher in resiliency, foster a more hopeful outlook, and restore equilibrium. Our caring, trained professionals will work diligently to bring you the support, interventions, and treatment you need.
Please note, the information on this page is based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition, however, it is in no way exhaustive on the subject of each disorder discussed. This text is not intended to be the basis of self-diagnosis of any disorder. Only a trained mental health provider can provide you with an accurate diagnosis based on a myriad of factors and details specific to your particular case.