Bipolar I disorder usually involves recurring episodes; 50% of patients with the disorder end up developing a second episode within two years of the first one4.
Bipolar II, says Dr. Wang, involves less severe depressive and manic episodes than bipolar I, although some people experience severe depression and hypomania, a milder form of mania.
To be diagnosed with bipolar II, Dr. Zimbrean says someone has to have at least one episode of hypomania lasting at least four days and one major depressive episode.
Bipolar II is milder than bipolar I, but you shouldn’t confuse it as a form of bipolar I disorder because it’s a separate medical diagnosis2. It’s also just as important to treat. People with bipolar II may not experience extreme mania or do anything super risky, but they can be depressed for longer periods of time, which may interfere with their ability to function in daily life.
Cyclothymic disorder is another condition on the bipolar spectrum. However, people with cyclothymic disorder don’t have full-blown mania or depression, so they can’t be diagnosed with bipolar disorder7. “Their mood is basically constantly fluctuating between mild depression and periods of elevated mood, but it’s not severe enough to be incapacitating or recognized as very abnormal,” Francis Mondimore, M.D., director of the Johns Hopkins Mood Disorders Clinic and associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, tells SELF. “When it is diagnosed, these mood fluctuations are very treatable and often very responsive to treatments with medication.”
Unclassified bipolar disorder
Sometimes, a person can exhibit symptoms of bipolar disorder but don’t meet the criteria for having bipolar disorder. For example, Dr. Wang says illicit drug use can complicate bipolar symptoms, making it difficult to tell if depression and mania stem from the drug use, from the person’s genetics, or both.
What are some signs of bipolar disorder?
Because there’s not just one type of bipolar disorder, people’s symptoms and the severity of those symptoms can be different. That said, all types of bipolar include episodes of mania or hypomania and depression, potentially resulting in distress and difficulty functioning in everyday life2. Mood episodes can vary in duration, but symptoms usually last every day for most of the day, for as long as several days or weeks.
It’s also important to note that a person’s bipolar disorder signs and symptoms can change over time. For example, bipolar symptoms can occur only in pregnancy or change when the seasons change2. And some people may also experience anxiety in addition to their mood episodes.
Here are some of the most common symptoms of depressive, manic, and mixed bipolar episodes that can occur with bipolar disorder.
What are some signs of depression?
One of the primary features of bipolar disorder is periods of depression. Depressive episodes in bipolar disorder can look a lot like major depressive disorder7, which includes symptoms such as:
- Persistent sadness
- Loss of interest in activities
- Loss of energy
- Trouble concentrating
- Memory issues
- Changes in appetite
- Changes in sleep habits
- Suicidal thoughts