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Bipolar I vs. Bipolar II: Key Differences, Diagnosis, and Treatment

Emotional upheaval is part and parcel of life for many, and it’s pretty common. But what if the up and down feelings reach an extreme level? Those extreme ups and downs might be due to a mental health condition called bipolar disorder. In this disorder, a person experiences manic highs, other times sinking into depressive lows. Not everyone who has the disorder goes through the same experience, though. Symptoms and the course of the illness vary for different types of this disorder, such as Bipolar I vs. Bipolar II.

There are three types of bipolar disorder:

Among the three types, Bipolar I and Bipolar II are the two primary forms. Both of them involve similar dramatic mood shifts. However, there are differences between them.

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

Although extreme mood disorder is common in both bipolar disorder types, the key difference lies in the intensity of mood extremes.

Whereas a person with Bipolar I experiences a full-throttle manic state, a person with Bipolar II goes through a hypomanic (a milder form of mania) state instead.

In the case of Bipolar I, the person may or may not experience a severe depressive state, whereas a person with Bipolar II will go through a major depressive episode.

Bipolar I

Bipolar I is defined by full-fledged manic episodes. The duration is at least seven days and symptoms are visible most of the day throughout the period. Often they are so intense that day-to-day functioning is impaired, and the person may need to be hospitalized.

Manic episodes may or may not be followed by a depressive episode that usually lasts at least two weeks.

Characteristics of a manic episode:

  • Increased energy
  • Restlessness
  • Inability to concentrate
  • State of extreme happiness or euphoria
  • Risky behaviors
  • Lack of sleep

Bipolar II

Bipolar II includes a major depressive episode of at least two weeks. Soon after, the person experiences one hypomanic episode that persists for at least four days. In the case of Bipolar II, the person doesn’t go through extreme manic conditions as in Bipolar I.

Characteristics of a depressive episode:

  • Depressed mood
  • Lack of energy and less activity
  • Isolation and withdrawal
  • Feelings of guilt or worthlessness
  • Less appetite
  • Suicidal thoughts

Bipolar II is often misinterpreted as depression since depressive symptoms are prominent.

Symptoms of bipolar disorder: Bipolar I vs. Bipolar II

Mania, hypomania, and depression are three major symptoms associated with bipolar disorder. Below are details of these symptoms.


In Bipolar Disorder I, mania lasts at least a week. What happens to a person while in a manic state?

During a manic state, individuals feel so ecstatic that there is less need for sleep, and they may experience delusions or hallucinations. They feel more energetic and may indulge in risky or reckless behavior. In a manic condition, someone may exhibit uncharacteristic sexual behavior or make impulsive decisions.

While in mania, it’s not necessarily true that the person will become violent or dangerous.


In hypomania, the symptoms are similar. People in a hypomanic state associated with bipolar II experience increased energy and decreased need for sleep. However, hypomania does not usually result in a situation where the person requires hospitalization, which is more likely the case with mania.


In the case of Bipolar disorder I and II, depressive symptoms are identical to typical clinical depression. It involves feelings of sadness and isolation. The person who experiences a depressive mental state loses interest in people, feels exhausted and irritated, has trouble concentrating, and may engage in irrational crying. Sadness and hopelessness associated with depression may lead to suicidal thoughts or actions.

What causes bipolar disorder?

Medical science does not know what exactly causes bipolar disorder. Genetic abnormalities or an imbalanced brain chemistry are the probable causes.

Many studies suggest that bipolar disorder risks are higher if a family member already has it. Though not conclusive yet, the search continues for the genes that cause bipolar disorder.

Many researchers believe intense stress, substance or alcohol abuse, or severely troubling events might trigger bipolar disorder symptoms. Even childhood abuse or the sudden departure of a loved one may contribute to the condition.

Bipolar disorder: How is it diagnosed?

Bipolar disorder is usually diagnosed by a psychiatrist or certified mental health professional through physical examination, interview, and lab tests. They will also review medical and family history and inquire about symptoms related to mania and depression. Lab tests help rule out any other physical illnesses resembling the disorder, such as hyperthyroidism or side effects caused by steroids.

If a person experiences mania or hypomania for at least one episode, a mental health professional uses the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose whether the person has bipolar disorder and the type. To determine bipolar disorder, professionals analyze the pattern of symptoms and how the person is affected in the most intense situations.

Bipolar disorder: Treatment

Bipolar disorder responds well to treatments if the person agrees to participate in ongoing care. Bipolar disorder is usually treated with medications and psychotherapy. Bipolar disorder treatment centers are available all over the US to provide proven support and care the person might need.

Among drugs, mood stabilizers are an excellent option for long-term use. Some medications have side effects such as low thyroid functions, indigestion, and joint pain. During a manic state, antipsychotic medications are often used as part of the treatment.

Usually, mental health experts begin with a low dose of any medication, monitor the response, and gradually increase the dosage if needed. The diagnosed patient may require a combination of medicines to timid your symptoms. Note that all medications are subject to side effects and interactions with other drugs.

To monitor the effectiveness of therapy, medications, and overall treatment, experts recommend maintaining a diary to track moods, sleeping, eating patterns, etc.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

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About the Author: Alan Spear is a medical tourism expert with over two decades of experience in medical tourism and hospitality. MedTourAgency is one of his ventures to help people looking for exotic destinations to tend to their medical needs.

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The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.

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