If you think bipolar disorder describes a mental health condition that can cause extreme changes in mood and behavior, you’ve mostly got the basics. But its two main subtypes—bipolar I and bipolar II—are a testament to how nuanced this condition actually is.
Bipolar disorder can indeed bring on drastic changes in a person’s mood, energy levels, and behavior, according to the Mayo Clinic. These shifts, which are known as mood episodes, are generally divided into two groups: manic episodes and depressive episodes, according to the National Institute of Mental Health (NIMH). There are also hypomanic episodes, which are similar to manic episodes except on a less severe scale. These mood episodes can occur infrequently or happen multiple times a year, and between these periods, someone may have few or no symptoms.
With that information in mind, you have a solid foundation for understanding the major subtypes of bipolar disorder: bipolar I and bipolar II.
Both mania and hypomania elevate a person’s mood and energy levels, which can translate into behavior changes. The key thing to remember here is that mania is more severe than hypomania, so it’s more likely to cause obvious issues with a person’s work, school, and social life, the Mayo Clinic explains.
In order for someone to have a diagnosable manic or hypomanic episode, they generally need to exhibit a prolonged unusual mood, plus three or more of the following symptoms (although there are some exceptions that we’ll get to in a second):
- Being abnormally upbeat
- Being jumpy
- Feeling euphoric
- Increased energy or activity levels
- Increased self-esteem
- Racing thoughts
- Being more talkative
- Being easily irritated
- Needing less sleep
- Taking more risks than usual, which can result in poor decisions
Now, about those exceptions. If someone has manic symptoms resulting in psychosis (hallucinations or delusions) or their symptoms are intense enough that hospitalization is necessary, that counts as having a manic episode.
As for a depressive episode, that requires having five or more of the following symptoms for at least two weeks (and one of the symptoms must be either a sad mood or loss of interest or pleasure in life):