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Previously known as manic-depressive disorder, bipolar disorder is a mental illness with rapid and extreme shifts between depressive and manic emotional states. Commonly appearing in teenage and adolescents, the condition affects approximately 2.6 percent of the U.S. adult population. Living with bipolar disorder is undoubtedly challenging, as the symptoms tend to linger for days or weeks. While it may make someone feel supercharged, sharp, and invincible at one point, these feelings of mania rapidly drain and are quickly replaced by a depressive episode to dash all the happy dreams. The constant cycling between these episodes can leave the afflicted individual feeling sad, fatigued, and defeated. Moreover, the intense mood shifts can be extremely disruptive even if long periods of calm separate them.

While there is no definitive cure for bipolar disorder, it is possible to manage it with medication, therapy, and self-education about it and its common types.

Figure representing the feeling of a bipolar person

Before learning about the four types of bipolar disorder, it is imperative to familiarize yourself with the presentation of this disease. Most cases of bipolar disorder include two sets of symptoms, i.e., manic and depressive symptoms.

Manic Symptoms

Manic episodes form a key feature of bipolar I disorder. Mania refers to a condition in which an individual experiences a period of abnormally high or extremely irritable mood in addition to extreme changes in thoughts, energy, talkativeness, emotions, and activity levels. This unusually high level of physical and mental energy is easily noticeable by others.

People experiencing mania frequently take part in activities that bring them social, financial, or physical harm. For example, they may suddenly spend a huge amount of money on gambling or drive recklessly without caring for their own or others’ lives. Some of these individuals may occasionally develop symptoms of psychosis, such as hallucinations and delusions, which make it difficult for experts to distinguish bipolar disorder from other similar psychiatric issues, like schizophrenia.

A slightly less-intense version of mania, called hypomania, may also occur, especially in people with bipolar II disorder. Hypomania symptoms are less intense and may not last as long as manic episodes. This condition is also not severe enough to interfere with daily functioning.

Depressive Symptoms

The depressive symptoms of bipolar disorder are similar to those of major depression and typically include the following:

  • Lack of motivation
  • Overwhelming sadness
  • Irritability
  • Uncontrollable crying
  • Feelings of worthlessness and hopelessness
  • Fatigue
  • Low energy
  • Difficulty concentrating
  • Poor decision-making skills
  • Loss of enjoyment in things that you once loved
  • Appetite changes
  • Altered sleep habits
  • Thoughts of self-harm or suicide

While different experts have varying opinions about the number of bipolar disorder subtypes, most agree on the following four:

Bipolar I disorder

The diagnostic criteria for Bipolar I disorder include at least one manic episode lasting for at least seven days or a manic episode with symptoms severe enough to require urgent psychiatric hospitalization and care. This type of bipolar disorder involves depressive episodes that typically last at least two weeks. Some individuals with this disorder may experience depressive episodes with some manic features or manic episodes with few depressive features.

Bipolar II disorder

Bipolar II disorder includes alternating episodes of hypomania and depression but lacks the severe and highly impairing manic episodes that occur in bipolar I disorder. People with this subtype of bipolar disorder experience at least one episode of hypomania and major depression throughout their life. The condition generally causes the afflicted people to experience more than one episode of depression, unlike bipolar I, where depressive episodes may occur.

Between the depressive and hypomanic episodes, individuals with bipolar II disorder are capable of living everyday life.

Cyclothymic Disorder

Also known as cyclothymia, the cyclothymic disorder is a milder form of bipolar disorder comprising cyclical periods of highs and lows that persist for days or weeks. The highs and lows of this subtype are not as intense and rarely qualify as depressive or hypomanic episodes. Adolescents are typically more prone to developing this subtype.

People with cyclothymia usually appear to act and function normally, though some may call them difficult or moody. Those struggling with this problem often do not seek professional treatment as their mood swings are not severe. However, cyclothymia carries a high risk of transitioning into bipolar disorder if left untreated.

Unspecified Bipolar Disorder

Some people exhibit all symptoms of bipolar disorder, but their symptoms do not follow a specific pattern or do not fall into any of the three categories of this condition described above. However, in some ways, these symptoms still align with the criteria set for abnormal mood changes associated with bipolar disorder. For instance, an individual may go through mild hypomanic or depressive symptoms that resolve before the specified duration for cyclothymia. Alternatively, a person may have severe depressive episodes followed by experiencing mood elevation that is too brief or mild to be labeled hypomania or mania.

While experts consider these cases bipolar disorder, they do not fall under the aforementioned types.

Regardless of the type of bipolar disorder, treatment usually involves integrating medications with psychotherapy.

Medicines

You may need to try different types of medications under the supervision of a licensed doctor before finding what works best for your bipolar disorder management. Most healthcare providers prescribe the following medications to treat the symptoms of this psychiatric issue:

  • Mood stabilizers
  • Second-generation or atypical antipsychotics
  • Antidepressants

Some patients may benefit from a combination of the medications mentioned above for more effective management.

Psychotherapy

Psychotherapy, also known as talk therapy, can equally benefit patients suffering from different types of bipolar disorder. Some of these therapies include the following:

 

  • Psychoeducation is a type of talk therapy in which mental health professionals teach patients about their health conditions and help them learn how it can affect their lives and their loved ones.
  • Interpersonal and social rhythm therapy (IPSRT) is a type of therapy that focuses on techniques to help patients manage stressful situations, improve medication adherence, and reduce disruptions in social rhythms. It also teaches them skills using which patients can protect themselves from developing any depressive or manic episodes in the future.
  • Family-focused therapy is a type of therapy for both children and adults with bipolar disorder, along with their caregivers. Both the patient and their loved ones attend therapy together, where they learn more about bipolar disorder, seek communication improvement training, and acquire problem-solving skills.
  • Cognitive behavioral therapy is a goal-oriented, well-structured type of talk therapy in which the therapist helps patients take a closer look at their emotions and thoughts and learn how they affect their actions. Through this therapy, patients can unlearn negative behaviors and thoughts while adopting healthier habits and thinking patterns.

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