Differentiating Subtypes of Bipolar Disorder

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Signs and Symptoms

Complications and Comorbidities

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Bipolar disorder isn’t just about having mood swings. It’s a serious mental health condition that used to be referred to as manic depression. There are two main types of bipolar disorder that differ in terms of severity, duration, and nature of their symptoms.

This article discusses the symptoms of bipolar disorder, including symptoms of both mania and depression. It also covers potential complications that may occur.

Information presented in this article may be triggering for some people. If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

Information presented in this article may be triggering for some people. If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Overview of Bipolar Disorder

Signs & Symptoms of Bipolar Disorder

People with bipolar disorder experience dramatic shifts in mood that may include periods of depression and mania. The nature and severity of these symptoms depend on the type of bipolar disorder that they have.

Differences Between Depression and Bipolar Disorder

Bipolar Mania or Hypomania Symptoms

Symptoms of a manic or hypomanic episode include:

Manic episodesmust last at least seven days to meet the criteria for bipolar I disorder and can last much longer. Hypomanic episodes involve the same symptoms, but the individual’s functioning isn’t markedly impaired, and there are no psychotic symptoms.

Bipolar Depression Symptoms

During a depressive episode, an individual may experience the following symptoms:

Cognitive difficulties can interfere with an individual’s thinking and make hard for them to complete tasks.

Physical Symptoms Associated With Depressive Episodes

During depressive episodes, individuals may experience a variety of physical symptoms, including unexplained aches and pains.

Changes in weight are also common. While some people struggle to eat when they’re feeling down, others turn to food for comfort. Thus, both weight loss and weight gain can be symptoms of a depressive episode.

Rare Symptoms

While less common, people may sometimes experience a mood disorder known ascyclothymia. This condition causes mood changes that are not as severe as those in bipolar I or bipolar II disorder. Cyclothymia often emerges in adolescence. In many cases, it can be a precursor to bipolar I or II disorder.

Recap

Complications & Comorbidities

Bipolar disorder can lead to complications in a person’s life. It can also present differently in certain groups. There is no cure for bipolar disorder, but the symptoms can be managed effectively with appropriate treatment. Some potential complications that can occur if the condition is not treated include:

Differences in Men and Women

Bipolar disorder occurs in men and women at approximately the same rates. However, the presentation of symptoms and course of the condition may differ depending on the sex an individual was assigned at birth.

Men are often diagnosed at an earlier age, experience more severe episodes, and are more likely to have co-occurring substance use issues. Women tend to have more depressive episodes and morerapid cyclingbetween manic and depressive episodes.

Note that symptoms of bipolar disorder are the same in women and men, but societal and gender roles can affect how they manifest or how others perceive them.

In Children

While bipolar disorder is most frequently diagnosed in adults over the age of 18, it can alsooccur in children. The course of the condition tends to be more severe when this diagnosis happens during childhood.

Symptoms also often manifest differently in children than in adults. Some of the symptoms that children may experience include:

During depressive episodes, children may exhibit somatic symptoms such as headaches, stomachaches, excessive sleep, changes in appetite, and lack of energy.

Because these symptoms are not always specific to bipolar disorder and are often associated with other conditions, it is essential to receive an evaluation and diagnosis from a healthcare professional. Getting an accurate diagnosis early on can lead to more effective interventions and improve treatment outcomes.

Temper Tantrums: A Sign of Disruptive Mood Dysregulation Disorder

Co-Occurring Conditions

There are a number of conditions that can co-occur alongside bipolar disorder or that have similar sets of symptoms that may complicate diagnosis. Some of these co-occurring conditions include:

Attention Deficit Hyperactivity Disorder (ADHD)

Hyperactivity and distractibility are two of the hallmark symptoms ofattention deficit hyperactivity disorder (ADHD). However, they are also quite predominant in bipolar disorder, especially as it relates to children. To further complicate things, these conditions can often co-occur.

Alcohol or Substance Use

It is very common for those with bipolar disorder to struggle with alcohol and substance use. This is often an attempt, even on an unconscious level, toself-medicate. To make matters worse,alcohol may interactwith the medications used to treat bipolar disorder.

Borderline Personality Disorder

Borderline personality disordercauses impulsivity, suicidal behavior, reactivity of mood, inappropriate anger, and transient paranoia, which are also associated with bipolar disorder. It is possible for an individual to be diagnosed withboth of these disordersas well.

Depression

The one thing thatdistinguishes depressive disorders(unipolar depression) from bipolar disorder is mania/hypomania. If a patient with depression swings into an episode of mania, the diagnosis becomes a bipolar disorder.

Misdiagnosed bipolar disorder is sometimes discovered after people start taking antidepressants, leading to the onset of mania.

Eating Disorders

It is not uncommon for those with bipolar disorder to experienceeating disorders.Moreover, depression, anxiety, and irritability often result from eating disorders.

Panic Disorder

Schizophrenia

Schizophrenia is a mental disorder that causes intense disturbances in cognition (thinking), behaviors, and emotions. Symptoms of the condition include delusions, hallucinations, disorganized speech and thinking, disorganized behavior, catatonic behavior, inappropriate moods, flattened emotions, lack of speech, and a reduction in goal-directed behavior. The symptoms of schizophrenia areeasily confusedwith those of bipolar disorder.

Schizoaffective Disorder

Schizoaffective disorderinvolves having symptoms of major depression or mania, along with specific symptoms of schizophrenia. However, the delusions or hallucinations must persist for periods when the mood symptoms aren’t present. As you might expect, there is a great deal of confusion and controversy surrounding differentiating this disorder from bipolar disorder.

RecapCo-occurring conditions can affect the course of bipolar disorder or contribute to misdiagnosis. Bipolar disorder is often misdiagnosed as depression, and people who have bipolar disorder may be more likely to use alcohol or other substances to cope with symptoms of their condition.

Co-occurring conditions can affect the course of bipolar disorder or contribute to misdiagnosis. Bipolar disorder is often misdiagnosed as depression, and people who have bipolar disorder may be more likely to use alcohol or other substances to cope with symptoms of their condition.

Can Bipolar Disorder Be Cured?

Frequently Asked Questions

The two types of bipolar disorder share common symptoms but differ in the way that mania presents. Because symptoms of mania are more severe in bipolar I disorder, people who have that condition may need different treatments in order to help manage their symptoms.In order to diagnose bipolar disorder, a healthcare provider will assess your symptoms, including their frequency, duration, and severity.If you are currently experiencing a depressive episode, be sure to mention whether you have experienced symptoms of mania or hypomania in the past.

The two types of bipolar disorder share common symptoms but differ in the way that mania presents. Because symptoms of mania are more severe in bipolar I disorder, people who have that condition may need different treatments in order to help manage their symptoms.

In order to diagnose bipolar disorder, a healthcare provider will assess your symptoms, including their frequency, duration, and severity.If you are currently experiencing a depressive episode, be sure to mention whether you have experienced symptoms of mania or hypomania in the past.

Certain medications used to treat major depressive disorder can contribute to the onset of mania if a person has bipolar disorder. Unfortunately, it is not unusual for people with bipolar disorder to be misdiagnosed with depression.According to a study published in 2018, 60% of patients seeking care for recurring depression actually have bipolar disorder.This is often because people are more likely to seek treatment while experiencing a depressive episode.

Certain medications used to treat major depressive disorder can contribute to the onset of mania if a person has bipolar disorder. Unfortunately, it is not unusual for people with bipolar disorder to be misdiagnosed with depression.

According to a study published in 2018, 60% of patients seeking care for recurring depression actually have bipolar disorder.This is often because people are more likely to seek treatment while experiencing a depressive episode.

Living With Bipolar Disorder

12 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.Culpepper L.The diagnosis and treatment of bipolar disorder: Decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01609American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Perich T, Mitchell PB, Loo C, et al.Clinical and demographic features associated with the detection of early warning signs in bipolar disorder.J Affect Disord. 2013;145(3):336-340. doi:10.1016/j.jad.2012.08.014Rijavec N, Grubic VN.Depression and pain: Often together but still a clinical challenge: A review.Psychiatr Danub. 2012;24(4):346-352.Baldessarini RJ, Vázquez G, Tondo L.Treatment of cyclothymic disorder: Commentary.Psychother Psychosom. 2011;80(3):131-135. doi:10.1159/000322234National Institute of Mental Health.Bipolar disorder in children.Ghouse AA, Sanches M, Zunta-Soares G, Swann AC, Soares JC.Overdiagnosis of bipolar disorder: a critical analysis of the literature.ScientificWorldJournal. 2013;2013:297087. doi:10.1155/2013/297087Paris J, Black DW.Borderline personality disorder and bipolar disorder: What is the difference and why does it matter?J Nerv Ment Dis.2015;203(1):3-7. doi:10.1097/NMD.0000000000000225Gitlin MJ.Antidepressants in bipolar depression: An enduring controversy.Int J Bipolar Disord. 2018;6(1):25. doi:10.1186/s40345-018-0133-9Kornstein SG, Kunovac JL, Herman BK, Culpepper L.Recognizing binge-eating disorder in the clinical setting: A review of the literature.Prim Care Companion CNS Disord. 2016;18(3). doi:10.4088/PCC.15r01905Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Kyriazis O, Fountoulakis KN.Prevalence and treatment of panic disorder in bipolar disorder: Systematic review and meta-analysis.Evid Based Ment Health. 2018;21(2):53-60. doi:10.1136/eb-2017-102858Phillips ML, Kupfer DJ.Bipolar disorder diagnosis: Challenges and future directions.Lancet. 2013;381(9878):1663–1671. doi:10.1016/S0140-6736(13)60989-7

12 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.Culpepper L.The diagnosis and treatment of bipolar disorder: Decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01609American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Perich T, Mitchell PB, Loo C, et al.Clinical and demographic features associated with the detection of early warning signs in bipolar disorder.J Affect Disord. 2013;145(3):336-340. doi:10.1016/j.jad.2012.08.014Rijavec N, Grubic VN.Depression and pain: Often together but still a clinical challenge: A review.Psychiatr Danub. 2012;24(4):346-352.Baldessarini RJ, Vázquez G, Tondo L.Treatment of cyclothymic disorder: Commentary.Psychother Psychosom. 2011;80(3):131-135. doi:10.1159/000322234National Institute of Mental Health.Bipolar disorder in children.Ghouse AA, Sanches M, Zunta-Soares G, Swann AC, Soares JC.Overdiagnosis of bipolar disorder: a critical analysis of the literature.ScientificWorldJournal. 2013;2013:297087. doi:10.1155/2013/297087Paris J, Black DW.Borderline personality disorder and bipolar disorder: What is the difference and why does it matter?J Nerv Ment Dis.2015;203(1):3-7. doi:10.1097/NMD.0000000000000225Gitlin MJ.Antidepressants in bipolar depression: An enduring controversy.Int J Bipolar Disord. 2018;6(1):25. doi:10.1186/s40345-018-0133-9Kornstein SG, Kunovac JL, Herman BK, Culpepper L.Recognizing binge-eating disorder in the clinical setting: A review of the literature.Prim Care Companion CNS Disord. 2016;18(3). doi:10.4088/PCC.15r01905Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Kyriazis O, Fountoulakis KN.Prevalence and treatment of panic disorder in bipolar disorder: Systematic review and meta-analysis.Evid Based Ment Health. 2018;21(2):53-60. doi:10.1136/eb-2017-102858Phillips ML, Kupfer DJ.Bipolar disorder diagnosis: Challenges and future directions.Lancet. 2013;381(9878):1663–1671. doi:10.1016/S0140-6736(13)60989-7

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.

Culpepper L.The diagnosis and treatment of bipolar disorder: Decision-making in primary care.Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01609American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787Perich T, Mitchell PB, Loo C, et al.Clinical and demographic features associated with the detection of early warning signs in bipolar disorder.J Affect Disord. 2013;145(3):336-340. doi:10.1016/j.jad.2012.08.014Rijavec N, Grubic VN.Depression and pain: Often together but still a clinical challenge: A review.Psychiatr Danub. 2012;24(4):346-352.Baldessarini RJ, Vázquez G, Tondo L.Treatment of cyclothymic disorder: Commentary.Psychother Psychosom. 2011;80(3):131-135. doi:10.1159/000322234National Institute of Mental Health.Bipolar disorder in children.Ghouse AA, Sanches M, Zunta-Soares G, Swann AC, Soares JC.Overdiagnosis of bipolar disorder: a critical analysis of the literature.ScientificWorldJournal. 2013;2013:297087. doi:10.1155/2013/297087Paris J, Black DW.Borderline personality disorder and bipolar disorder: What is the difference and why does it matter?J Nerv Ment Dis.2015;203(1):3-7. doi:10.1097/NMD.0000000000000225Gitlin MJ.Antidepressants in bipolar depression: An enduring controversy.Int J Bipolar Disord. 2018;6(1):25. doi:10.1186/s40345-018-0133-9Kornstein SG, Kunovac JL, Herman BK, Culpepper L.Recognizing binge-eating disorder in the clinical setting: A review of the literature.Prim Care Companion CNS Disord. 2016;18(3). doi:10.4088/PCC.15r01905Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Kyriazis O, Fountoulakis KN.Prevalence and treatment of panic disorder in bipolar disorder: Systematic review and meta-analysis.Evid Based Ment Health. 2018;21(2):53-60. doi:10.1136/eb-2017-102858Phillips ML, Kupfer DJ.Bipolar disorder diagnosis: Challenges and future directions.Lancet. 2013;381(9878):1663–1671. doi:10.1016/S0140-6736(13)60989-7

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

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787

Perich T, Mitchell PB, Loo C, et al.Clinical and demographic features associated with the detection of early warning signs in bipolar disorder.J Affect Disord. 2013;145(3):336-340. doi:10.1016/j.jad.2012.08.014

Rijavec N, Grubic VN.Depression and pain: Often together but still a clinical challenge: A review.Psychiatr Danub. 2012;24(4):346-352.

Baldessarini RJ, Vázquez G, Tondo L.Treatment of cyclothymic disorder: Commentary.Psychother Psychosom. 2011;80(3):131-135. doi:10.1159/000322234

National Institute of Mental Health.Bipolar disorder in children.

Ghouse AA, Sanches M, Zunta-Soares G, Swann AC, Soares JC.Overdiagnosis of bipolar disorder: a critical analysis of the literature.ScientificWorldJournal. 2013;2013:297087. doi:10.1155/2013/297087

Paris J, Black DW.Borderline personality disorder and bipolar disorder: What is the difference and why does it matter?J Nerv Ment Dis.2015;203(1):3-7. doi:10.1097/NMD.0000000000000225

Gitlin MJ.Antidepressants in bipolar depression: An enduring controversy.Int J Bipolar Disord. 2018;6(1):25. doi:10.1186/s40345-018-0133-9

Kornstein SG, Kunovac JL, Herman BK, Culpepper L.Recognizing binge-eating disorder in the clinical setting: A review of the literature.Prim Care Companion CNS Disord. 2016;18(3). doi:10.4088/PCC.15r01905

Preti A, Vrublevska J, Veroniki AA, Huedo-Medina TB, Kyriazis O, Fountoulakis KN.Prevalence and treatment of panic disorder in bipolar disorder: Systematic review and meta-analysis.Evid Based Ment Health. 2018;21(2):53-60. doi:10.1136/eb-2017-102858

Phillips ML, Kupfer DJ.Bipolar disorder diagnosis: Challenges and future directions.Lancet. 2013;381(9878):1663–1671. doi:10.1016/S0140-6736(13)60989-7

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