Are There Different Types of Bipolar Disorder?

Table of ContentsView AllTable of ContentsWhat Are Mood Episodes, Exactly?The 5 Types of Bipolar DisorderMisdiagnosis Is CommonCauses and Risk FactorsTreatment for Different Types of Bipolar Disorder

Table of ContentsView All

View All

Table of Contents

What Are Mood Episodes, Exactly?

The 5 Types of Bipolar Disorder

Misdiagnosis Is Common

Causes and Risk Factors

Treatment for Different Types of Bipolar Disorder

Close

At a Glance

No matter the type, the condition is often misdiagnosed for other conditions, including ADHD, BPD, or depression. Treatments for bipolar disorder usually involve medications, therapy, and lifestyle modifications, but your doctor will make recommendations specific to the type you have.

People with bipolar disorder may experience periods of unusually intense emotion, changes in energy and activity levels, and uncharacteristic behaviors. These distinct periods are calledmood episodes. During a mood episode, a person might feel extremely energetic or very depressed.

There are three main mood episodes that characterize bipolar disorders:

Some people can even experience symptoms of depression and mania at the same time (or one right after the other). This is called amixed episode.

Changes in the DSM-5 for Bipolar Disorder

The APA classifies bipolar disorder according to the type, duration, and severity of a person’s mood episodes. According to the fifth edition of the APA’s “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR), there are five different types of bipolar disorder a doctor may diagnose you with:

Other specified bipolar and related disorder, together with unspecified bipolar and related disorder both used to fall under the category of bipolar disorder not otherwise specified (NOS) in the DSM-IV. However, the “not otherwise specified” category was removed and broken out into these two condition names in the DSM-5.

Bipolar I Disorder

To be diagnosed with bipolar I disorder, you must have experienced one or more manic episodes. These episodes must last at least seven days or be so severe that you need to be hospitalized.

Depressive episodes are common, although not necessary for the diagnosis.

Bipolar II Disorder

Bipolar II is not simply amilder formof bipolar I disorder. It is a distinctively different disorder.

Bipolar I vs. Bipolar II

Cyclothymic Disorder

Also calledcyclothymia, this mood disorder consists of numerous alternating periods of hypomanic and depressive symptoms.

Unlike bipolar I and II disorders, the highs and lows of cyclothymia are not severe enough to fit the full criteria for manic, hypomanic, or major depressive episodes. However, these symptoms must be present for at least half the time for a period of at least two years, with no symptom-free period for more than two months.

Although the mood episodes are less extreme than those of bipolar disorder, it’s critical to seek help. Not only can these symptoms interfere with your daily life, but they also may develop into bipolar I or bipolar II disorder later in life.

Other Specified Bipolar and Related Disorder

This type of bipolar disorder is diagnosed when you have symptoms of bipolar disorder (such as manic or depressive episodes), but they don’t fit into other bipolar categories.

For instance, you may have cyclothymic symptoms that haven’t lasted two years, or maybe you have hypomanic episodes without depressive episodes.

Understanding Bipolar NOS

Unspecified Bipolar and Related Disorder

This diagnosis is similar to specified bipolar and related disorder. It’s used when a doctor doesn’t have enough information to make a specific diagnosis, such as in an emergency room.

How Common Is Bipolar Disorder?Studies suggest there is a lifetime prevalence rate of about 0.6% for bipolar type I and 0.4% for bipolar type II. The overall prevalence for all types of bipolar disorders is 2.4%.

How Common Is Bipolar Disorder?

Studies suggest there is a lifetime prevalence rate of about 0.6% for bipolar type I and 0.4% for bipolar type II. The overall prevalence for all types of bipolar disorders is 2.4%.

Of all the mental health disorders, bipolar is perhaps one of the most commonly misdiagnosed.Sometimes it’s not clear which one of the types of bipolar disorder a person’s symptoms align with.

Bipolar disorders can also be difficult to diagnose because they share symptoms with so many other conditions. These mental health conditions often get mistaken for bipolar disorder:

Being correctly diagnosed is an important step toward getting the right treatment. The most important thing you can do to increase your chances of receiving an accurate diagnosis is to tell a doctor about all the symptoms you’ve been experiencing.

Signs of Bipolar Disorder in Men

The exact causes of different types of bipolar disorders are not entirely understood, but genetic factors are believed to play a significant role. Research suggests that certain risk factors can increase the likelihood that a person will develop bipolar disorder, including:

Treatment for any bipolar disorder generally involves medications and some form of psychotherapy. The specific treatment your doctor recommends may vary depending on the type of bipolar disorder you are diagnosed with.

Medications

Medication is the key to stabilizing most bipolar disorders. However, the type of medication a doctor prescribes depends on your symptoms and their severity.

Mood Stabilizers

The main treatment for mood episodes in bipolar disorder is amood stabilizer. Examples of mood stabilizers include:

Antidepressants

Antidepressants may be prescribed for depressive episodes in bipolar disorder. Common antidepressants includeselective serotonin reuptake inhibitors(SSRIs) such asZoloft(sertraline),Prozac(fluoxetine), orLexapro(escitalopram).

Because antidepressants can trigger manic episodes, they tend to be avoided in bipolar I disorder and are generally prescribed along with a mood stabilizer.

Antipsychotics

If you experiencepsychotic symptomsduring a manic or depressive episode, a doctor will likely prescribe anantipsychotic. Examples of the newer atypical antipsychotics include:

Many of the atypical antipsychotics have mood-stabilizing properties. Latuda and Seroquel are the only two antipsychotics that are officially FDA-approved to treat depression in bipolar disorder.

It can take a while to find the right bipolar medication. Most people with bipolar disorder take more than one medication.

Psychotherapy

Depending on your situation, psychotherapy might also be necessary. In fact, research shows that psychotherapy combined with medication can be more beneficial than medication alone.

Psychotherapy can help you better understand and cope with your illness. It can also help you improve your ability to manage relationships with others.

Psychotherapies that are effective for bipolar disorder include:

As with medication, there is no single therapy approach that everyone will find useful.

Helpful Online Bipolar Disorder Support Groups

Takeaways

If you orsomeone you know is experiencing symptoms of bipolar disorder, it’s important to talk to a physician. A physician may want to rule out any potential physical health issues that may be contributing to your symptoms.

A physician may also refer you to a psychiatrist or other mental health professional for an evaluation. Be sure to speak openly about your behaviors, moods, and anything else you notice. Open, honest communication is essential to receiving a correct diagnosis andtreatment plan.

What It’s Like Living with a Mood Disorder, As a Mental Health Professional

13 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Bipolar disorder.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Datto C, Pottorf WJ, Feeley L, LaPorte S, Liss C.Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression.Ann Gen Psychiatry. 2016;15:9. doi:10.1186/s12991-016-0096-0Culpepper L.The diagnosis and treatment of bipolar disorder: decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01609. doi:10.4088/PCC.13r01609Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Shen H, Zhang L, Xu C, Zhu J, Chen M, Fang Y.Analysis of misdiagnosis of bipolar disorder in an outpatient setting.Shanghai Arch Psychiatry. 2018;30(2):93-101. doi:10.11919/j.issn.1002-0829.217080Comparelli A, Polidori L, Sarli G, Pistollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatry. 2022;13:949375. doi:10.3389/fpsyt.2022.949375Sanches M.The limits between bipolar disorder and borderline personality disorder: A review of the evidence.Diseases. 2019;7(3):49. doi:10.3390/diseases7030049Jiang X, Cao B, Li C, et al.Identifying misdiagnosed bipolar disorder using support vector machine: feature selection based on fMRI of follow-up confirmed affective disorders.Transl Psychiatry. 2024;14(1):9. doi:10.1038/s41398-023-02703-zBobo WV.The diagnosis and management of bipolar I and II disorders: Clinical practice update.Mayo Clin Proc. 2017;92(10):1532-1551. doi:10.1016/j.mayocp.2017.06.022American Psychiatric Association.Practice guideline for the treatment of patients with bipolar disorder (revision).Am J Psychiatry. 2002;159(4 Suppl):1-50.Centers for Medicare & Medicaid Services.Atypical antipsychotic medications: Use in adults.Miklowitz DJ, Efthimiou O, Furukawa TA, et al.Adjunctive psychotherapy for bipolar disorder: A systematic review and component network meta-analysis.JAMA Psychiatry. 2021;78(2):141-150. doi:10.1001/jamapsychiatry.2020.2993

13 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Bipolar disorder.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Datto C, Pottorf WJ, Feeley L, LaPorte S, Liss C.Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression.Ann Gen Psychiatry. 2016;15:9. doi:10.1186/s12991-016-0096-0Culpepper L.The diagnosis and treatment of bipolar disorder: decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01609. doi:10.4088/PCC.13r01609Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Shen H, Zhang L, Xu C, Zhu J, Chen M, Fang Y.Analysis of misdiagnosis of bipolar disorder in an outpatient setting.Shanghai Arch Psychiatry. 2018;30(2):93-101. doi:10.11919/j.issn.1002-0829.217080Comparelli A, Polidori L, Sarli G, Pistollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatry. 2022;13:949375. doi:10.3389/fpsyt.2022.949375Sanches M.The limits between bipolar disorder and borderline personality disorder: A review of the evidence.Diseases. 2019;7(3):49. doi:10.3390/diseases7030049Jiang X, Cao B, Li C, et al.Identifying misdiagnosed bipolar disorder using support vector machine: feature selection based on fMRI of follow-up confirmed affective disorders.Transl Psychiatry. 2024;14(1):9. doi:10.1038/s41398-023-02703-zBobo WV.The diagnosis and management of bipolar I and II disorders: Clinical practice update.Mayo Clin Proc. 2017;92(10):1532-1551. doi:10.1016/j.mayocp.2017.06.022American Psychiatric Association.Practice guideline for the treatment of patients with bipolar disorder (revision).Am J Psychiatry. 2002;159(4 Suppl):1-50.Centers for Medicare & Medicaid Services.Atypical antipsychotic medications: Use in adults.Miklowitz DJ, Efthimiou O, Furukawa TA, et al.Adjunctive psychotherapy for bipolar disorder: A systematic review and component network meta-analysis.JAMA Psychiatry. 2021;78(2):141-150. doi:10.1001/jamapsychiatry.2020.2993

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute of Mental Health.Bipolar disorder.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Datto C, Pottorf WJ, Feeley L, LaPorte S, Liss C.Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression.Ann Gen Psychiatry. 2016;15:9. doi:10.1186/s12991-016-0096-0Culpepper L.The diagnosis and treatment of bipolar disorder: decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01609. doi:10.4088/PCC.13r01609Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Shen H, Zhang L, Xu C, Zhu J, Chen M, Fang Y.Analysis of misdiagnosis of bipolar disorder in an outpatient setting.Shanghai Arch Psychiatry. 2018;30(2):93-101. doi:10.11919/j.issn.1002-0829.217080Comparelli A, Polidori L, Sarli G, Pistollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatry. 2022;13:949375. doi:10.3389/fpsyt.2022.949375Sanches M.The limits between bipolar disorder and borderline personality disorder: A review of the evidence.Diseases. 2019;7(3):49. doi:10.3390/diseases7030049Jiang X, Cao B, Li C, et al.Identifying misdiagnosed bipolar disorder using support vector machine: feature selection based on fMRI of follow-up confirmed affective disorders.Transl Psychiatry. 2024;14(1):9. doi:10.1038/s41398-023-02703-zBobo WV.The diagnosis and management of bipolar I and II disorders: Clinical practice update.Mayo Clin Proc. 2017;92(10):1532-1551. doi:10.1016/j.mayocp.2017.06.022American Psychiatric Association.Practice guideline for the treatment of patients with bipolar disorder (revision).Am J Psychiatry. 2002;159(4 Suppl):1-50.Centers for Medicare & Medicaid Services.Atypical antipsychotic medications: Use in adults.Miklowitz DJ, Efthimiou O, Furukawa TA, et al.Adjunctive psychotherapy for bipolar disorder: A systematic review and component network meta-analysis.JAMA Psychiatry. 2021;78(2):141-150. doi:10.1001/jamapsychiatry.2020.2993

National Institute of Mental Health.Bipolar disorder.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Datto C, Pottorf WJ, Feeley L, LaPorte S, Liss C.Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression.Ann Gen Psychiatry. 2016;15:9. doi:10.1186/s12991-016-0096-0

Culpepper L.The diagnosis and treatment of bipolar disorder: decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01609. doi:10.4088/PCC.13r01609

Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235

Shen H, Zhang L, Xu C, Zhu J, Chen M, Fang Y.Analysis of misdiagnosis of bipolar disorder in an outpatient setting.Shanghai Arch Psychiatry. 2018;30(2):93-101. doi:10.11919/j.issn.1002-0829.217080

Comparelli A, Polidori L, Sarli G, Pistollato A, Pompili M.Differentiation and comorbidity of bipolar disorder and attention deficit and hyperactivity disorder in children, adolescents, and adults: A clinical and nosological perspective.Front Psychiatry. 2022;13:949375. doi:10.3389/fpsyt.2022.949375

Sanches M.The limits between bipolar disorder and borderline personality disorder: A review of the evidence.Diseases. 2019;7(3):49. doi:10.3390/diseases7030049

Jiang X, Cao B, Li C, et al.Identifying misdiagnosed bipolar disorder using support vector machine: feature selection based on fMRI of follow-up confirmed affective disorders.Transl Psychiatry. 2024;14(1):9. doi:10.1038/s41398-023-02703-z

Bobo WV.The diagnosis and management of bipolar I and II disorders: Clinical practice update.Mayo Clin Proc. 2017;92(10):1532-1551. doi:10.1016/j.mayocp.2017.06.022

American Psychiatric Association.Practice guideline for the treatment of patients with bipolar disorder (revision).Am J Psychiatry. 2002;159(4 Suppl):1-50.

Centers for Medicare & Medicaid Services.Atypical antipsychotic medications: Use in adults.

Miklowitz DJ, Efthimiou O, Furukawa TA, et al.Adjunctive psychotherapy for bipolar disorder: A systematic review and component network meta-analysis.JAMA Psychiatry. 2021;78(2):141-150. doi:10.1001/jamapsychiatry.2020.2993

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