Types of Bipolar Disorder

This post is going to be a bit longer and take a step back from my last post, which was more based on personal experience. This post will be more fact-based, and the purpose of it is to give you quick definitions of the different types of bipolar disorder all in one place, so you can easily refer back to them as you read through other posts on my blog.

             Most people are surprised to know there isn’t just one, definitive type of bipolar disorder, but a few different types and sub-types, which I define below.

Here’s a handy little scale I made that I’ll use to help define the different types:

(Various Sources)

Note: this is not a definitive list of symptoms, and different sources will list different symptoms for each mood state. This is just meant to give you a general idea of how the states present.

First let’s look at the three main types:

1.     Bipolar Disorder Type 1: Blocks 1 to 5, the whole scale. Type 1 is defined by alternating states of severe depression and mania. Type 1 is usually what people think of when they hear the words “bipolar disorder,” and is marked by severe manic periods that can progress into a state of psychosis.

2.    Bipolar Disorder Type 2: Blocks 1 to 4, occasionally some of 5, excluding symptoms of psychosis. Type 2 is defined by alternating states severe depression and hypomania. Type 2 has the longest depressive states of all the types, and puts sufferers at an increased risk for suicide. Type 2 is also frequently misdiagnosed as unipolar depression, because its hypomanic periods can pass unrecognized or be mistaken for periods of “high-functioning.”

3.    Cyclothymia (NOT TYPE 3!): Blocks 2 to 4. Cyclothymia is defined by alternating states of hypomania and depression, usually with more frequent episodes of hypomania than of depression. Cyclothymia is known as a “milder form of bipolar disorder.”

Here’s a visual representation of these three types:

Source: One Mind Institute

Other types and sub-types:

•      Rapid Cycling: Rapid Cycling is not a type of bipolar disorder on its own, but a sub-classification of the three types defined above. Rapid Cycling is defined by experiencing four or more manic, hypomanic, or depressive episodes within a year. States can alternate every few days or even within the same day, which is referred to as “ultra-rapid cycling.”

•      Bipolar NOS (not otherwise specified): Can be all blocks (1 to 5), or any combination in between. NOS is defined by the irregular fluctuation of its states and cycles, and therefore cannot be classified as any of the other types.

•      “Mixed Features” or a “Mixed State”: This is not a type of bipolar disorder, rather, a mood state that (I assume) can occur in any of the aforementioned types. Mixed states are defined by feeling both depressed and manic/hypomanic at the same time. Symptoms typically include high energy, sleeplessness, and racing thoughts along with feelings of hopelessness, despair, irritability, and suicidal thoughts.

•      Bipolar Depression: You may have seen commercials on TV for the anti-psychotic drug “Latuda,” which can be used to treat “bipolar depression” and schizophrenia. “Bipolar Depression” is not a type of bipolar disorder in and of itself, it simply refers to the depressive states within bipolar disorder.

•      Bipolar Disorder Type 3: I don’t think Type 3 is an official diagnosis yet, but from what I can gather, there is speculation that there is another type of bipolar disorder that will cause patients to flip into a mania/hypomania after taking antidepressants to treat depressive states.

•      Soft Bipolar: I can tell you from experience that there is nothing “soft” or forgiving about bipolar disorder, but to be honest I don’t know much about this type, so here’s a link to some information about it from BipolarLives.

Here’s where I got my information from:
•      Depression and Bipolar Support Alliance
•      BipolarLives
•      WebMD
•      Latuda

So, you think you have Depression? It could be Bipolar Disorder.

As many as 1 in 5 people that go to their doctor complaining of depression actually have type 2 bipolar disorder, like me. But how are you supposed to know you might have bipolar disorder if you don’t even know what it is?

Simply put, bipolar disorder is a mood disorder characterized by alternating states (also called episodes) of depression and mania or hypomania, sometimes with periods of normalcy in between. But that definition won’t help you at all unless you’re able recognize what it means.

Depressive states present with the same symptoms as typical unipolar depression: sadness, loss of interest, lethargy, you know the rest. Thing is, you may have times where you feel better with no cause, like your depression has suddenly “cleared up,” only to be devastated when it shows up again.

Those times you felt better? They may have been manic or hypomanic episodes.

Whaaaaat!?

You may be going “What!? What’s a (hypo)manic episode? I didn’t even know I was having them!”

I didn’t know I was having them either, until my random happiness and giddiness about life progressed into agitation and irritability. I was hostile towards my friends. I literally had days where I woke up angry. But I don’t consider myself a mean or angry person, so that told me that something was wrong.

Increased happiness, agitation, and anger are just a few symptoms of a manic or hypomanic episode. Because there’s also a boost to your energy when you’re manic or hypomanic, you’ll probably feel better. Really, anything feels better than being depressed, so you may not see this occasional, unexplained anger as a problem like I did. Maybe you just assume you have a bad temper and leave it at that. 

But, while you’re here, take a look and see if you experience any of these common symptoms of hypomania and mania (this is not meant to be an exhaustive list, so take it with a grain of salt):

Hypomania

“Good” symptoms:

• Happiness.

• Joy or giddiness about life or living.

• Generally elevated mood.

• High energy.

• Increased motivation.

• Confidence.

“Bad” symptoms:

• Anxiety.

• Impulsivity.

• Racing thoughts.

• Insomnia.

• Irritability.

• Anger.

• Bloated self-image (to the point of being narcissistic).

Mania

All the symptoms of Hypomania plus:

• Euphoria or feeling “on top of the world.”

• High sex drive.

• Hyperactivity.

• Feeling a “reduced need to sleep.”

• Aggression.

• Hostility.

• Engaging in risky or self-destructive behavior.

Mania can progress into a state of Psychosis:

• Paranoia.

• Hallucinations (usually shadowy figures).

• Delusions about what is really happening around you.

If you’re sometimes having symptoms of depression and sometimes having symptoms of mania or hypomania, try taking this test and see how you do. Along with doing some of my own research, it helped me figure out that I had bipolar disorder, not just depression.