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Difference Between Bipolar I and Bipolar II

Bipolar I vs Bipolar II

Bipolar I and Bipolar II are two forms of bipolar disorder, also known as bipolar affective disorder. This particular disorder is a psychotic disorder characterized by elevated moods or energy and mood swings.

Bipolar I is characterized by manic and depression episodes. On the other hand, bipolar II is characterized by hypomania and depression. The difference between mania and hypomania is also one of the important contrasts between the two types of disorders. The term “episode” is applicable to both disorders. An episode consists of a particular stage (mania, hypomania, depression or neutral) that can shift to another stage or episode. An occurrence of two states in a relatively short time is called a “mixed” episode.

Mania is a mood condition where there is an elevated level of energy or emotion. In addition, mania can also manifest in hyperactivity, irritability, and extreme or unpredictable actions from the person. Meanwhile, hypomania is a milder form of mania. However, hypomania being the milder form doesn’t lessen the impact of the disorder to the quality of life in a patient diagnosed with either type.

Another distinction between bipolar I and bipolar II is the occurrence of psychosis. Psychosis in bipolar I occurs in the manic stage while the same phenomenon occurs in the depressive part in bipolar II patients.

Depression is another form of comparison. Bipolar II patients have a more intense degree of depression compared to people who suffer from bipolar I. In most cases, patients with bipolar II are in a state of serious depression for a long period of time before returning to a normal state or hypomania.

Treatment of both bipolar disorders tends to be the same but may differ in the focused areas. General treatment includes medication, psychotherapy, lifestyle change or hospitalization. Application of treatment depends on each patient’s case and their degree of the disorder.  In terms of medication, bipolar I patients are usually prescribed with mood stabilizers. Bipolar II patients, in contrast, may require antidepressants rather than mood stabilizers.


  1. Both bipolar I and bipolar II are forms of bipolar disorder. Both types have an “episode” or  have mood swings from one state to another. Two common episodes or stages of both types of disorder are depression and neutral or normal state.
  2. Patients with bipolar I have episodes of mania and depression while bipolar II patients suffer from hypomania and depression. Aside from these two episodes, there are also instances of a neutral state where a patient functions normally.
  3. Mania is described as an abnormal and elevated energy mood or emotion. On the other hand, hypomania is a lower state or degree of mania. Mania requires medication in the form of mood stabilizers while hypomania does not.
  4. The duration of mania, hypomania or depression can last weeks, months or any period of time depending on the severity of the disorder.
  5. Psychosis occurs in bipolar I patients during manic episodes. The same psychosis happens in bipolar II patients during the depression stage.
  6. Bipolar I is mainly associated with mania. In contrast, bipolar II sees a depressive state rather than the hypomania state. Both the depressive state in bipolar I and bipolar II can lead to suicide or a more depressed outlook on life since the patient feels more depressed for a longer period of time.
  7. Bipolar I can cripple a person’s lifestyle. In contrast, those with bipolar II are able to function normally.
  8. Treatments for both types of bipolar disorder include medication, hospitalization, psychotherapy and changes in lifestyle. In terms of medication, bipolar I patients are usually prescribed mood stabilizers while patients of bipolar II are prescribed with anti-depressants.

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1 Comment

  1. This is a great site, but I often find myself wondering if any authentication or similar accuracy checking takes place when writing an article.

    For example, there are indeed vast differences between Bipolar I and Bipolar II disorders. Your article addresses these differences, although not without the inclusion of misleading and/or inaccurate specifics.

    BP I can, and often does, include psychotic symptoms, which ARE typically more often presented while a patient is experiencing mania, especially during combined periods of rapid cycling between depression and mania. Characteristically, BP I symptoms (psychosis) and the severity of such symptoms can be most pronounced during these mixed state episodes. Oftentimes the most dangerous outcomes from BP I symptoms are almost always related to severe, mixed state episodes and rapid cycling.

    In patients who struggle with BP II disorder, presentation of “mania” is almost always apparent in almost subtle and vague ways, and arguably challenging to identify. A patient may vacillate between severe depression, or any number of variable combinations, but never display manic tendencies. Maybe the observations remain focused on degrees if depression.

    An example of this “hypo-mania” could be shopping binges, impulsive redecorating, new hobby interest out of nowhere, relocating to another town without proper planning etc.

    These behaviors needn’t show up more than once or twice to suggest BP II, rather than just depression, clinically speaking.

    Another VERY important issue to consider is medication; while on the surface it might seem that medication treatment for each of these may likely be similar, nothing could be further than truth. Treating BP I symptoms with atypical SSRI anti-depressants can actually result in making things worse for the patient. SSRIs have been known to trigger hypo-mania, or even straight mania which can easily be misinterpreted as a “remission” in symptoms. Basically, contraindicated. (As is EMDR) However, the patient may be on a roller-coaster ride ending in a rebound depressive state worse than before. SSRIs can trigger mania and should be avoided in the treatment approach for BP II.

    Also, this article states that BP I patients struggle with symptoms so intrusive that the ability to live a normal life isn’t easy compared with BP II patients. This statement is almost categorically incorrect and in opposition to the truth. Patients who have BP I symptoms, and properly medicated, can actually function quite well. Millions do. Patients with BP II disorder, in comparison, despite having tried numerous medication strategies, rarely reach a point that is manageable and without debilitating symptoms.

    Most recently, the efficacy of just about any SSRI has been determined to hover around 30%, and other drugs like mood stabilizers like Lithium, Lamictal etc, come with dramatic side effects and often do little to stabilize symptoms, specifically severe depression.

    As far as psychosis and depression with BP II, if psychosis is a typical symptom, it is one of considerably less prominence than other symptoms. Maybe even rare, in my experience.

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