Identifying the different types of bipolar disorder

Bipolar disorder is a complex condition with several types, including Bipolar 1 and Bipolar 2. Despite its complexities, it is important to remember that each person's experience with bipolar disorder is unique. Symptoms can range from feeling highly energised and motivated to
feeling irritable and angry.

Bipolar 1 disorder

The defining characteristic of Bipolar 1 disorder is the occurrence of significant mood swings, which can involve periods of elation and low moods, including depression.

Bipolar 1 is also characterised by full manic episodes, defined as a period of elevated, expansive, or irritable mood lasting at least one week, accompanied by increased energy and activity. A manic episode may also include:

• High self-esteem
• Little need for sleep
• Fast speech
• Racing thoughts
• Easy distractibility

In addition to manic episodes, people with Bipolar 1 can also experience major depressive episodes. To diagnose major depression, the DSM-5 requires the presence of either a depressed mood or loss of interest or pleasure and four or more additional symptoms during the same two-week period. These symptoms may include significant weight changes, slowed thoughts and movement, fatigue, worthlessness or guilt, difficulty thinking or making decisions, suicidal thoughts, and changes in sleep patterns (insomnia or hypersomnia).

Observers should be able to notice physical symptoms such as decreased movements or agitation, not just the individual's self-reported feelings.

Bipolar 2 disorder

Diagnosing Bipolar 2 can sometimes be challenging as it may be mistaken for recurring depression due to the alternating experience of major depressive episodes and hypomania, a mild form of mania.

Hypomanic episodes typically last around four days, shorter than the manic episodes in Bipolar 1. During a hypomanic episode, symptoms are not severe enough to cause significant impairment in daily functioning and are not accompanied by psychotic symptoms.

Substance/medication-induced bipolar disorder

Recent studies have revealed that some individuals undergoing antidepressant treatment, such as medication or electroconvulsive therapy, may develop manic or hypomanic episodes that persist beyond the effect of the treatment.

Illegal drugs like cocaine or amphetamines can also trigger medication-induced bipolar disorder. Symptoms may include elevated mood that persists even after the substance has cleared the body.

Diagnosing substance and medication-induced bipolar disorder is complex and requires a skilled psychiatrist. If you are experiencing negative reactions while taking medication, it's important to seek professional help promptly.

Dynamic bipolar with rapid cycles

This form of bipolar involves experiencing four or more episodes of mania, hypomania, or depression in a span of 12 months. The shifts from one mood to another or periods of remission lasting at least eight weeks separate these episodes.

Dynamic bipolar with rapid cycles affects many people and is more common in those with a long-standing bipolar history, early onset of the condition, heavy use of alcohol/illegal drugs, and a history of suicidal thoughts/attempts. The cause of rapid cycling remains uncertain, but factors such as antidepressant usage and hypothyroidism are known to contribute to its development.