Bipolar disorder can negatively affect the energy level of a person and their daily activities. It is a mental health condition that causes unusually high and low moods. The most prevalent types of bipolar disorder among the numerous types are bipolar I and bipolar II.
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Types of bipolar disorder
There are four main types of bipolar disorder:
- bipolar I disorder
- bipolar II disorder
- cyclothymic disorder, or cyclothymia
- other specified and unspecified bipolar disorder
People with bipolar disorder may experience unusual highs (manic episode) or lows (depressive) in mood. During a manic or high episode, people feel extreme energy or excitement.
During a “low,” or depressive episode, they experience depression such as hopelessness, gloom, and sadness.
A doctor can diagnose a person with one of the above types based on the duration and intensity of their symptoms.
Bipolar I vs. bipolar II
Bipolar I and bipolar II have similar patterns in which symptoms occur. People with bipolar II may experience less manic episodes than people with bipolar I. This type of mania is known as hypomania.
To receive a diagnosis of bipolar II, A person must experience a major depressive episode to receive a bipolar II diagnosis, which does not apply in a diagnosis of bipolar I.
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A doctor can diagnose bipolar I based on the presence of a manic episode alone. People with bipolar I have at least one manic episode that persists for a week or longer or severe mania that may require hospitalization.
Those with bipolar II disorder do not require hospitalization during hypomanic periods. Doctors sometimes misdiagnose bipolar II as depression because the symptoms can be very elusive.
The main symptoms of bipolar I and bipolar II are mania, hypomania, and depression.
Mania periods can affect a person’s daily activities and their relationships with others. During a manic episode, people can experience:
- intense eagerness, happiness, or excitement
- anger, restiveness, or irritability
- increased energy, characterized by being over-talkative or overactive
- less need for sleep and difficulty sleeping
- racing thoughts
- difficulty concentrating and making decisions
- wild behavior
- pleasure-seeking behaviors, such as increased interest in sex, drugs, and alcohol
- high self-esteem
In a state of hypomania, people experience symptoms similar to those in mania, except less severe. Hypomania can still affect a person’s quality of life, and family and friends may notice that the person is undergoing mood changes.
People with bipolar disorder may experience depressive symptoms that are the same as those experienced in cases of clinical depression. These include:
- changes in sleeping patterns
- changes in appetite
- poor concentration
- loss of interest in formerly enjoyable activities
- suicidal behavior
- aches and pains that have no apparent physical cause
- thoughts of suicide or death
Doctors consider these symptoms to be a depressive episode if they persist for 2 weeks or more.
Persons will need to see a psychiatrist or psychologist to receive diagnosis of bipolar disorder. A doctor will assess the person’s medical history and symptoms. This psychiatric exam will focus on a person’s thoughts, feelings, and behaviors.
Some people might find it helpful to have a loved one present to provide the doctor with valuable information about other symptoms, especially during manic periods.
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The psychiatrist or psychologist may also ask a person to keep a mood diary to track their moods, sleep patterns, and other symptoms. This diary can help with a diagnosis.
The psychiatrist or psychologist will compare the person’s symptoms to the criteria for bipolar disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
The psychiatrist or psychologist may carry out blood tests, a physical examination, or brain imaging tests to rule out other causes of the symptoms.
Treatment for bipolar I disorder and bipolar II disorder consists of medications, psychotherapy, and lifestyle changes.
Doctors may prescribe mood stabilizers, such as lithium, for bipolar disorder. They may also prescribe antipsychotic drugs for manic episodes and antidepressants for depression.
Since antidepressant medications may cause manic episodes in some people, doctors might recommend a combination of antidepressant and antipsychotic drugs to ease depression while stabilizing mood.
For people who have anxiety, anti-anxiety medications, such as benzodiazepines, may assist. However, this strategy may come with a risk of dependence to benzodiazepines. People can start taking medications right away, even if they are not currently experiencing a manic or depressive episode.
It is vital to continue taking medications even during periods of stable mood to avoid relapse.
Psychotherapy is a vital part of treatment for bipolar I and II disorders. Therapy may take place on a one-to-one basis, as part of a group, or in a family setting.
Several different types of therapy can help, including:
- Interpersonal and social rhythm therapy (IPSRT), which focuses on establishing a structured routine to help people cope with symptoms.
- Cognitive behavioral therapy(CBT), to challenge negative thoughts.
- Family-focused therapy, to enhance communication
Many people can make lifestyle changes to manage their symptoms and help stabilize their moods. Examples of helpful changes include:
- exercising regularly
- eating a balanced diet
- avoiding alcohol and drugs
- reducing stress where possible
- establishing a sleep routine
- attending a support group for people with mood-related disorders
- learning more about their condition
- practicing mindfulness and meditation
Some people also find it helpful to keep a daily mood diary. Keeping a journal can allow people to see patterns in their behaviours, moods and thoughts.