Apr 1, 2025
Around 2.8% of adults in the U.S. will experience Bipolar Disorder. The mood disorder is characterized by extreme mood swings involving a manic phase and followed by a depression phase. Although commonly referred to as simply “Bipolar”, there are actually four different types of bipolar disorders. The most common two are Bipolar 1 and Bipolar 2. Knowing the difference is important to understanding what treatments are available and how to cope with symptoms.
This article covers the difference between Bipolar 1 vs Bipolar 2 and the treatment options available for both. Although both forms of Bipolar are often life-long disorders, with treatment and medication the symptoms can be well managed.
Types of Bipolar Disorders
Within the umbrella of bipolar disorders, there are three diagnoses that can be given by a licensed therapist or psychiatrist:
- Bipolar I disorder: The most severe of the four disorders, Bipolar 1 is characterized by an extreme Manic phase. Often this is followed by a depressive episode, but it is not required for a diagnosis.
- Bipolar II disorder: Bipolar 2 disorder may be less disruptive than bipolar 1 but is still a serious disorder that requires treatment. For diagnosis, phases of hypomania—a less severe manic stage—and depression must be present. Depression is required for diagnosis.
- Cyclothymic disorder: Also called cyclothymia, this form of Bipolar Disorder is more rare. It is characterized by an unstable mood for a period of at least 2 years. Mood swings may range from mild depression to low-levels of hypomania, but never reach a full-blown manic stage (during which a Bipolar 1 diagnosis would be given). Sometimes, a normal mood known as euthymic may occur, but only lasts up to 8 weeks.
When symptoms do not fit the above descriptions, a diagnosis of “Other specified and unspecific bipolar and related disorders” may be given, although this is rare.
Bipolar 1 vs 2
Let’s dive into the main difference separating Bipolar 1 and Bipolar 2: Mania vs Hypomania. The presence of a Manics stage is the hallmark of Bipolar 1. People with Bipolar 1 may experience hypomania, but if they also experience Manic stages, then they have Bipolar 1 and not Bipolar 2.
What is Mania?
A manic episode is a period of elevated mood or an extreme high. During a manic episode, people may feel really good. They may not understand that they are not well and instead believe that they are doing better than ever before. This can add to the danger of a manic episode, as it lends itself to risky behavior that is physically and financially unsafe. Spending a lot of money or doing overly risky things are common symptoms of a manic episode.
Other symptoms of a manic episode include:
- Elevated Mood: In a manic episode, individuals may experience an intense euphoria or extreme happiness that is unusual for them.
- Decreased Need for Sleep: People going through a manic episode may require very little sleep without feeling tired or fatigued.
- Rapid Speech: Speech during a manic episode might be rapid, pressured, or difficult to interrupt, with a flight of ideas and tangential thinking.
- Racing Thoughts: Thoughts may race, making it challenging to focus or concentrate on one task or topic.
- Increased Energy Levels: Individuals in a manic episode may exhibit high levels of energy, engaging in multiple activities simultaneously.
- Impulsivity: Impulsive behaviors, such as reckless spending, risky sexual behavior, or substance abuse, are common during manic episodes.
- Grandiosity: People experiencing mania may have an inflated sense of self-esteem or belief in their abilities, often taking on unrealistic projects or goals.
- Irritability or Agitation: Alongside euphoria, some individuals may also experience irritability, aggression, or emotional volatility during a manic episode.
- Decreased Inhibition: Manic episodes can lead to a lack of judgment and inhibition, resulting in behavior that is out of character.
- Difficulty Focusing: Individuals may find it hard to maintain attention on one task or conversation, easily getting distracted by external stimuli.
People who experience manic episodes may believe that no harm can come to them or that everything will turn out right, which leads them to make financially unsound decisions like buying a boat, selling their house, or investing or giving away all their money. The increased risk-taking and impulsivity may result in harmful consequences that they will have to deal with long after the mania subsides.
What is Hypomania?
Hypomania is like a “mini” manic stage. It can still have harmful consequences, but the risk is less than that of a manic episode. People experiencing hypomania are likely to have some reservations when it comes to risky behavior, impulsivity, and financial decisions.
Symptoms of hypomania include:
- Increased Energy and Productivity: Individuals experiencing hypomania often have heightened energy levels, leading to increased productivity and a decreased need for sleep.
- Elevated Mood: During hypomanic episodes, one may feel a sense of heightened mood, enthusiasm, or euphoria, which is notably different from their typical state.
- Enhanced Creativity: Some individuals may experience a surge in creativity, leading to the generation of multiple new ideas and projects.
- Racing Thoughts: Thoughts may speed up, making it difficult to focus on one particular task or follow a logical sequence of thoughts.
- Increased Talkativeness: Those in a hypomanic state might exhibit rapid speech, with thoughts tumbling out quickly and a tendency to talk more than usual.
- Heightened Confidence: Individuals may display heightened self-confidence or grandiosity, feeling capable of taking on larger-than-life tasks or projects.
- Engagement in Risky Behaviors: Some people in a hypomanic state may exhibit impulsive behaviors without considering the potential consequences, such as reckless spending or risky decision-making.
- Decreased Need for Sleep: Individuals might require less sleep without feeling the typical effects of fatigue.
In general, hypomania is less severe as mania, but the symptoms are relatively the same. If you think you’ve experienced either hypomania or mania, talk to a therapist about receiving a bipolar diagnosis. Treatment is necessary to control the symptoms of bipolar disorders.
What Does a Bipolar Depression Feel Like?
According to the DSM-5, the diagnostic handbook therapists use to diagnose and treat their clients, a major depressive episode is only required in diagnosing Bipolar-2. People with Bipolar-1 frequently do experience major depression, but it is not necessary for a diagnosis to be given.
Bipolar Depression is much the same as Major Depression. People experience depressive symptoms such as:
- Persistent Sadness or Emptiness
- Loss of Interest and Pleasure
- Changes in Appetite or Weight
- Sleep Disturbances
- Fatigue and Low Energy
- Feelings of Worthlessness or Guilt
- Difficulty Concentrating and Making Decisions
When depression is bad, recurrent thoughts of death or suicidal ideation may occur. Studies have shown that more than half of people with Bipolar experience anhedonia with their depression, which is the loss of pleasure in things you used to enjoy.
How to Treat Bipolar 1 and 2
Treatment for Bipolar 1 and 2 usually requires a combination of therapy and medication. Although these disorders are lifelong, they can be well managed through these treatments. Most people with Bipolar experience a full life and are able to pursue their dreams. It can take some time to get the medication type and dosage right, and therapy can help unpack some of the trauma of living with untreated Bipolar as well as help you manage your triggers and adapt your lifestyle to the needs of the medication, which may include things like limiting alcohol and having a stable sleep schedule.
Bipolar Disorder Medication
Medication for Bipolar Disorder is often taken for years and even decades after your last manic episode. This is known as "maintenance therapy” and is important in not triggering another manic episode and keeping you healthy. Remember, if you haven't had a manic or hypomanic episode while on your medication, it’s because the medication is working, not because you don’t have Bipolar.
Two common types of medications for bipolar disorders are:
- Mood stabilizers: One of the first go-to drugs when treating Bipolar disorder, this type of medicine will work on treating both the mania and the depression. Some medicines may be better at treating one more than the other. A commonly prescribed mood stabilizer is lithium.
- Antipsychotics: The word “antispychotic” may be misleading, as it’s not always used to treat psychotic episodes. In the case of Bipolar, antipsychotics are a powerful way to help treat manic episodes.
There is a long list of medicines that have been proven to be effective in treating bipolar disorder. A psychiatrist is a medical professional trained to treat mental health disorders who can help you find the right medication for you.
Therapy for Bipolar Disorder
Therapy is another important piece in the treatment plan for bipolar disorder. A therapist will be there to check-in with how you’ve been managing the medication and help you manage any emotions that may come up along the way.
To see a therapist for bipolar disorder, contact Lifebulb’s support team. We have online therapists who can meet your needs today.
