Bipolar One Disorder Versus Bipolar Two Disorder: What’s The Difference?
By Gina Cipriano
Bipolar disorders are considered mood disorders; often moods can switch between high and low periods. The American Psychiatric Association’s (APA, 2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) explains that, in bipolar one disorder, there must be an episode of mania. During a period of mania, a person may experience the following symptoms: an increase in self-esteem, decrease in amount they sleep, acting in more impulsive ways (doing drugs, engaging in self-harm, harming others), and increased or decreased ability to stay focused on a particular task (APA, 2013). In bipolar two disorder, criteria for a manic episode is not met. However, criteria for a hypomanic episode must be met (APA,2013). Interestingly, the symptoms may be similar (such as not getting sleep and acting in more impulsive ways) (APA, 2013). However, manic episodes are severe enough to result in hospitalization or to significantly impact a person’s career or relationships (APA, 2013). Whereas in hypomanic episodes, a person’s symptoms would not result in these extreme consequences (APA, 2013).
While in bipolar one disorder a hypomanic episode may also occur, there MUST be an episode of mania (APA, 2013). Further, in bipolar one disorder an episode of mania may be followed by a major depressive episode. However, in bipolar two disorder, there must be both a hypomanic episode AND a major depressive episode (APA, 2013). A major depressive episode may entail some of the following symptoms: feelings of hopelessness, changes in body weight, thoughts of suicide, and changes in sleep (APA, 2013).
Bipolar one and two disorders are treatable. However, it can be difficult to treat because people may be mis-diagnosed as having depression. It is important to note if your moods have ever fluctuated between low and high energy levels. Bipolar disorders often co-occur with anxiety, substance use, alcohol use, binge eating disorder, and attention-deficit hyperactivity disorder (APA, 2013).
How Bipolar Disorders Are Treated:
• Pharmacology: Lithium is often prescribed for people with bipolar disorder to manage symptoms of depression and mania (Swartz & Swanson, 2014).• Psychoeducation: Understanding the course of bipolar disorder is extremely important for clients. Some people who have symptoms of mania may want to continue to experience these symptoms due to the increases in energy and goal-directed behavior it can provide. However, this can prevent a person from seeing the hardships these episodes bring (such as difficulties in relationships and difficulties controlling impulsive behaviors). Psychoeducation can help provide information in how to identify when episodes are going to occur, before they happen (Swartz & Swanson, 2014). Further, it can provide information on coping skills to use (Swartz & Swanson, 2014). • Cognitive Behavioral Therapy: CBT will entail assisting people in preventing relapse of mania or depression. It may include monitoring moods and recording thoughts (Swartz & Swanson, 2014). Then, clients will be asked to confront maladaptive thoughts to see changes in moods and behaviors (Swartz & Swanson, 2014).• Interpersonal and social rhythm therapy (IPSRT): IPSRT was specifically developed for the treatment of bipolar disorders. IPSRT aims to increase a person’s social rhythm which entails managing “sleep and wake schedules, mealtimes, start time for work/school, and daily exercise” (Swartz & Swanson, 2014, p.261). During episodes of depression and mania, a person’s circadian rhythm, or their bodies’ internal clock, are negatively affected (Swartz & Swanson, 2014). IPSRT helps a person learn to manage these internal clocks to ultimately have control over their moods.
ReferencesAmerican Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425787 Swartz, H. A., & Swanson, J. (2014). Psychotherapy for bipolar disorder in adults: A review of the evidence. FOCUS, 12(3), 251-266. https://doi.org/10.1176/appi.focus.12.3.251
