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Understanding the Different Types of Bipolar Disorder

The different types of bipolar disorder are categorized by the symptoms, patterns of symptoms, and severity.

View from the back of a woman with bipolar disorder looking out at the sea

Bipolar disorder takes a person's moods, thoughts, and behaviors through a cycle of intense highs and lows—sometimes in cycles, sometimes all at once. The mood peaks are called mania, and are characterized by a big burst of energy, elation, little need for sleep, and other elated feelings, but also irritability, impatience, and risky behavior. The depressive episodes present with low moods, low energy, pessimism, and other negative emotions. Many people with bipolar disorder also experience what are called mixed episodes, which include a mix of mania and depression symptoms.

Bipolar disorder can be a very different experience for different people. One major factor that determines a person's experience with bipolar disorder is the type of bipolar disorder that they have. Different types of bipolar disorder are characterized by the symptoms, the pattern those symptoms follow, and the severity of the symptoms.

  • Bipolar disorder I. This type is characterized by extreme mania or mixed episodes as well as at least one single event of major depression. In severe cases, it can cause a complete loss of touch with reality (psychosis) and may include hallucinations and delusions. Hospitalization may be needed.
  • Bipolar disorder II. The lows of bipolar disorder II can dip just as low as they do with bipolar disorder I, but the highs are not as high. These more subtle highs are called hypomania. But, unlike bipolar disorder I, psychosis is not a feature of bipolar disorder II.
  • Cyclothymia. This type is considered more mild, but it still has the potential to severely disrupt a person's life. It consists of more shallow lows than bipolar I or bipolar II. Instead, it's a persistent alternation of hypomania and low-grade depression (dysthymia).
  • Other types of bipolar disorder. There are other types that don't fit neatly into any established categories. For example, a person may experience recurring episodes of hypomania but no major depression or dysthymia. These are called bipolar disorder not otherwise specified (NOS).

Bipolar disorders affect men and women in equal numbers, but women tend to experience more depressive and mixed-mood episodes than men do. The median age of onset for both men and women is 25.

Difficult diagnosis

Altogether, nearly 3% of adults suffer from some form of bipolar disorder, a percentage much greater than researchers once thought. Unfortunately, many of those people are undiagnosed or misdiagnosed. In fact, people with bipolar disorder spend an average of 8 to 10 years seeing multiple healthcare professionals before getting the proper diagnosis and treatment.

Treatment

Getting an accurate diagnosis is the first and one of most essential steps to treating bipolar disorder. Misdiagnosed, inappropriately treated, or untreated bipolar disorder can have serious consequences. Left untreated, symptoms tend to become more frequent and more severe.

Bipolar disorder can make work, home life, and relationships difficult. In some cases, bipolar disorder can lead to hospitalization or suicide.

However, people who have bipolar disorder can lead active, productive lives once they're properly diagnosed and treated.

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