The Big 4: Types & Phases

Bipolar disorder is a mental illness that features extremes between manic states and depressive states. That’s your basic, textbook definition, anyway. What gets lost in translation is the fact that there is more than just one type of bipolar disorder. Whether it be from just a lack of knowledge or from all the convoluted hearsay surrounding mental illness in general, all things “bipolar” get lumped into one category. However, there are four different types and each one is different.

Bipolar I: Bipolar I is probably the most “well-known” type. With this specific type of the disorder, one must have one or more manic episodes lasting at least 7 days, often times requiring hospitalization. One might experience less severe hypomanic and depressive states, as well. However, these are not necessary for a diagnosis.

Bipolar II: This type of the disorder is characterized by having both hypomanic and depressive states. One must not have ever experienced a full-blown manic episode to be diagnosed with type II. Depression is more prevalent in bipolar II than in bipolar I, but those with bipolar II will experience hypomania, which is shorter spurts of mania.

Cyclothymic disorder: Cyclothymia is a milder, yet chronic form of bipolar disorder. In cyclothymia, the severity of the manic and depressive states are not as intense, but the symptoms of the cycles one experiences remain constant. These symptoms must be present in the patient for at least two years with no symptom-free period of time.

Unspecified bipolar disorder (NOS): This type of bipolar disorder is diagnosed when one exhibits both manic and depressive symptoms that do not meet the criteria for either bipolar I or bipolar II. One may rapidly cycle between extremes or feel both manic and depressed at the same time.

Just as there four types of bipolar disorder, there are different phases that characterize the illness in general, as well.

Mania: A stage of bipolar I set apart by irritability and energetic activity. Other symptoms might include less need for sleep, racing thoughts, engaging in risk-taking behavior like spending binges, sexual activity and substance use.

Hypomania: Hypomania is similar to mania, only not as severe. One experiencing hypomania may experience the same symptoms of mania, however these episodes are marked in shorter spurts than full-blown mania.

Depression: Depression is characterized by extreme melancholy and sorrow. Symptoms include sadness, loneliness, worthlessness, guilt, and hopelessness. One may have sleep issues, issues with appetite, sluggishness, and problems with concentration and focus.

Some people even experience what are called mixed episodes or rapid cycling.

Mixed Episodes: Mixed episodes refer to the existence of the symptoms related to mania, hypomania, and depression either at the same time or one after the other. During this phase, a major depressive state may be directly followed by a period of mania or hypomania.

Rapid Cycling: Rapid cycling refers to someone who experiences four or more phases of mania, hypomania, depression, and mixed episodes over a period of 12 months. This phase is not an uncommon one, but episodes are more random in both severity and duration.

Getting a diagnosis of bipolar disorder, no matter which type, can be scary. Initially, shame and fear may play a big role in one’s next steps forward. Living with the disorder can be challenging, frustrating, and present one with a slew of hardships that can make daily living near impossible at times.

Although there is no cure, all types of bipolar disorder are manageable with the right treatment plan, usually consisting of a combination of medication and psychotherapy.

Anyone experiencing any of the above-stated symptoms or feel they may be bipolar should contact a mental health professional immediately.

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