Different Types of Bipolar Disorder

Symptoms Can Vary Depending on the Type of Disorder

Bipolar disorder, former known as manic depression is a lifelong mental health disorder that can have serious consequences. This crippling mental illness is typically seen as alternating episodes of radical mood swings. These mood swings alternate between the polar opposites of mania and depression, hence the terms “bipolar” and “manic depression”. The emotional upheaval this disorder causes can be difficult to deal with.

The symptoms can vary from person to person and will depend largely upon the type of disorder the person has. Because some of the symptoms can mimic other medical and mental health issues and may depend largely on external events, it can also be tricky to diagnose and treat properly.

The extreme ups and downs that are the hallmark of bipolar disorder are caused by an imbalance in the brain that the body is unable to correct without some assistance, whether the assistance is in the form of medication, diet, psychotherapy or some other external form of prompting. The degrees to which the manic or depressive episodes occur vary. Come can be intense and extreme, even debilitating and dangerous while others can be relatively mild. Recognizing the symptoms and getting the proper diagnosis is the key to getting the correct treatment.

Specific Types of Bipolar Disorder

There several basic types of bipolar disorder as well as several less common forms. The most common types of bipolar disorder are labeled as Type 1, Type 2 and Cyclothymic Disorder. Mixed bipolar and rapid-cycling bipolar disorders occur less frequently.

Type 1 Bipolar

This type of bipolar disorder is also referred to as manic depressive disorder, though this term is somewhat retired. The condition is marked by at least one manic episode which is a period of time during which the affected person experiences an unusually elevated mood that can feel somewhat euphoric accompanied by behavior that disrupts their life. One of the details of this disorder is the variance in time spent experiencing episodes.

Typically, the episodes can last for months and sometimes even years. These episodes may be misinterpreted as symptoms of issues such as menopause, puberty or other life events that can be responsible for mood swings. In fact, it’s often the timing or length of time of the episode that can cause the questioning of what the episode really is. For instance, a 23 year old woman cannot realistically blame puberty or menopause for her episode.

The manic episode is followed by a period of depression. The depressive state is usually comparable to the manic state in terms of length of time of the episode as well as the extremes of the episode. The two states typically follow a pattern that cycles back and forth between the two states of mania and depression. There are sometimes periods between the episodes of mania and depression during which sufferers are able to experience normal life.

Who Is at Risk

The disorder can strike anyone and usually manifests in people I their late teens to early 20s. Nearly all sufferers will develop the disorder before the age of 50 and those with an immediate family member who suffer from bipolar type 1 are at higher risk.

What Are the Symptoms

The manic episode is experienced as a feeling of euphoria or irritability. Behavior inconsistent with the person’s typical behavior can occur and may include such things as bouncing from one idea to another rapidly, rapid and loud speech, excessive spending, not sleeping, hyperactivity with an inability to focus on a single topic as well as generally increased energy, substance abuse and hyper sexuality. Some of the more subtle signs of a manic episode would include interrupting speech, fidgeting and emotional outbursts.

Examples would be spending money beyond their means, promiscuous sexual activity with people they would not normally be intimate with or making and pursuing unrealistic plans. During severe episodes, the individual may become delusional, lose touch with reality and behave in outlandish ways. The symptoms may persist for a few days, a few weeks or last for several months without treatment.

The depressive episodes in bipolar 1 are like those of clinical depression. Symptoms include loss of appetite, low energy, a depressed mood, lack of ability to feel pleasure, feeling worthless or guilty and thoughts of suicide. The symptoms of depression in bipolar disorder can last for weeks or years.

A few people with bipolar type 1 experience rapid cycling, where alternating between manic and depressed states can occur in the same day. Others can go for extended periods between episodes

Type 2 Bipolar

Like Type 1 Bipolar Disorder, Type 2 Bipolar Disorder is a mental illness that causes fluctuations in mood alternating from high to low over a period of time. One of the major differences is that with Type 2, the highs or manic episodes never reach full blown mania. These lesser “up” episodes are also called hypomanic episodes or hypomania.

The condition is defined by having at least one hypomanic episode during the individual’s lifetime. Sufferers also often experience bouts of depression. Between the episodes of hypomania and depression, most people are able to lead normal lives.

Who Is at Risk

The risk factors for Type 2 Bipolar Disorder are the same as those for Type 1. People in their late teens and early 20s are more likely to show symptoms and generally it does not make a first appearance in those already over 50. Having an immediate family member with some form of the condition can also raise the risk factor.

What Are the Symptoms

The symptoms of the manic episodes are not as exaggerated as they are with Bipolar Type 1. They are still described as euphoric or irritability. Jumping from one thought to another, rapid and loud speech, increased energy and a lower need for sleep are typical symptoms. The difference is that the “high” manifests as more of a “life of the party” type of experience. The person is congenial, fun to be around and their happiness can be infectious. Problems arise when the mood leads to erratic or irresponsible behavior. Over spending, promiscuous sex and other risky behavior can emerge.

The hypomanic episode is often followed by a severe depression though the arrival of this episode can be immediate or take an undetermined amount of time to occur. Feelings of worthlessness, guilt, fatigue and depressed mood along with a lack of desire for anything pleasurable and lower than normal energy levels are typical symptoms. The depressed episode can last from days to in some cases, years. Typically it last for several weeks to a few months.

Rapid Cycling

While rapid cycling in and of itself is not a type of bipolar disorder, it is a type of pattern that occurs within bipolar disorder sufferers. Between 10% and 20% of all bipolar sufferers are rapid cyclers. Someone who is a rapid cycler experiences four or more episodes of mania or depression in a single year.

The risk factors and basic symptoms of a rapid cycler are the same as someone with either Type 1 or Type 2 Bipolar Disorder. Typically, people with rapid cycling bipolar disorder experience more periods of pronounced depression than they do of manic or hypomanic episodes. The elevated mood episodes are infrequent and shorter than their depressive counterparts. One study showed that rapid cyclers are depressed 35 times more than they are manic or hypomanic. Often the manic episodes are simply mistaken as being in an unusually good mood. For this reason, the rapid cycler is often misdiagnosed as clinically depressed.

Though it can be dangerous for anyone with any form of bipolar disorder to ingest any type of mood altering substance, the nature of rapid cycling present such extreme and rapid changes that this may be the most dangerous of all disorders to mix mood altering substances with. The medications used to treat this disorder are among some of the most mentally dangerous ones to combine with substances like alcohol and may increase the chances of suicidal thoughts and other self-harming thoughts or actions.

Mixed Bipolar

Mixed Bipolar Disorder is unique from the other bipolar disorders. The usual pattern of alternating between elevated and depressed moods is exchanged for an experience where episodes of mania and depression occur either simultaneously or in rapid sequence.

Who Is at Risk

The risk factors for Mixed Bipolar Disorder are the same as for the previously mentioned types. It is common for someone who is diagnosed with bipolar disorder to experience mixed bipolar disorder. As many as 20% to 70% of all bipolar sufferers have mixed bipolar disorder. Statistics show that those individuals who develop bipolar disorder at a younger age are more apt to have mixed bipolar disorder.

What Are the Symptoms

Mixed bipolar shares many symptoms with what we think of as “regular” depression. Patients feel sadness, guilt, worthless and may lose interest in activities of any kind. They can have thoughts of suicide and experience loss of energy. Most mixed bipolar sufferers episodes of irritability, agitation, racing speech or thoughts and over activity. The symptoms can overlap, which is why this is called mixed bipolar.  It can be difficult to diagnose because it does not follow a predictable pattern. A person can be crying hysterically and claiming to be the happiest they have ever been all at the same time.

The episodes can last from a few days to years without proper treatment. The episodes of mixed bipolar tend to last longer than the

episodes of other bipolar disorders.

Of the greatest concern is the increased risk of suicide with mixed bipolar. It is 10 to 20 times more probable that people with any type of bipolar disorder will commit suicide than those without the illness. Of the people suffering with bipolar disorder, somewhere between 8% and 20% of them commit suicide. Those with mixed bipolar disorder are at a higher risk but statistics are not available in part because of the difficulty in recognizing the disorder for what it is.

Cyclothymia

Cyclothymia is the mildest form of bipolar disorder. Moods swings from mild depression to mild euphoria occur over at least a two year period with no more than a two-month symptom-free interval throughout that time. It begins early in life, possibly even in childhood and is equally common in man and women.

Bipolar disorders are fairly common and treatable once the proper diagnosis has been declared. Treatment may include medication and therapy to help patients recognize and cope with mood swings, learn to avoid triggers and develop other coping mechanisms. Though diet is very rarely, if ever to blame for the disorder, some dietary changes can also be included as part of the treatment plan.

Since a large part of proper diagnosis lies in identifying the extremes of mood as well as length of time during and between episodes, it’s critical that the individual concerned or a loved one keep track of time and behavior. Something important to note is that though bipolar disorders are based on chemical imbalances, those imbalances are now known to have the potential to be caused by environmental factors as well. This fact alone insinuates a potential for recovery in instances where environmental factors are contributors to the disorder.

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