What Is the Difference Between Bipolar1 and Bipolar2?

About 2.8% of people in the United States have bipolar disorder, according to the National Alliance on Mental Health.

Bipolar disorder, formerly referred to as manic depression, is a serious, lifelong mental health condition characterized by episodes of mood swings. People with it can quickly shift from being extremely happy, energetic and mentally sharp to experiencing intense feelings of fatigue, sadness and confusion.

The average age of onset is about 25, but it can occur in the teens, or more uncommonly, in childhood.

The condition usually worsens if left untreated. However, with psychotherapy, medications, a healthy lifestyle, a regular schedule and early identification of symptoms, many people live well with it.

Types of bipolar disorder

People with bipolar experience high and low moods, known as mania and depression. These drastic shifts differ from the everyday ups-and-downs most people experience.

Mania is an overblown level of energy, activity, or behavior that deviates from your usual self and is clearly noticeable by others. Depression, a better-known mood extreme, involves a persistent feeling of sadness and loss of interest.

There are two main types of bipolar disorder: bipolar 1 and bipolar 2. The two can present themselves similarly, but mental health professionals categorize bipolar patients based on one key difference: People with bipolar 1 have at least one episode of mania in their lifetime; bipolar 2 is a milder disorder.

Most people diagnosed with bipolar 1 experience episodes of both mania and depression. However, an episode of depression is not necessary for a diagnosis. To be diagnosed with bipolar I, a person’s manic episodes must last at least seven days or be severe enough for hospitalization, according to the National Alliance on Mental Illness.

Bipolar 2 is diagnosed in people who experience episodes of depression that alternate with “hypomanic” episodes. Hypomania is a milder form of mania that lasts for a short period, usually a few days. Mania is typically much more severe and longer in duration, often weeks.

People with bipolar 2 never have a full, long-lasting manic episode. This creates a clear distinction between those who are diagnosed with bipolar 1.

Cyclothymia is a third, less common form of bipolar disorder. People with it experience ups and downs that are not as extreme as those that come with bipolar I or bipolar 2.

Causes, diagnosis and treatment

Researchers have yet to discover a single cause for bipolar disorder. However, genetics are believed to be a factor. An person’s inability to handle stressful situations can also play a role in the development of the mental disorder, as can brain structure.

Mental health care professionals can diagnose bipolar disorder by carefully evaluating a person’s pattern of symptoms, including their severity, length, and frequency. Brain scans cannot diagnose bipolar disorder, according to the National Institute on Mental Illness.

There is currently no cure for bipolar disorder. However, it can be treated and managed in these ways:

• Psychotherapy, such as cognitive behavioral therapy and family-focused therapy.
• Medications, such as mood stabilizers, antipsychotic medications and, to a lesser extent, antidepressants.
• Self-management strategies, like education and recognition of an episode’s early symptoms.
• Complementary health approaches, such as aerobic exercise meditation, faith and prayer, can support, but not replace, treatment.