Is Bipolar 1 or 2 Worse?

The manic episodes of bipolar 1 are typically worse than the hypomanic episodes of bipolar 2.

Bipolar disorders are a group of mental disorders that cause dramatic changes in a person's mood, activity level, and ability to function. People who have bipolar disorders have emotional states that are extreme and intense. These emotional states occur for specific times and are called mood episodes. They can be either manic, hypomanic, or depressive.

The average age when people with a bipolar disorder start showing symptoms is 25. However, it can develop in teenagers and even children, though that doesn't happen very often. Bipolar disorder affects men and women equally. In the United States, about 2.8% of the population is diagnosed with bipolar disorder. Of those, nearly 83 percent are severe.

People with bipolar also have times where they experience normal moods. Even though many diagnosed cases are classified as severe, with the right treatment, including medication and therapy, people who have bipolar can live productive lives.

All types of bipolar disorders involve changes in energy, activity levels, and mood. These moods can be very manic, which is energized, elated, or irritable, or depressive, which is sad, indifferent, or hopeless. People with bipolar can also have hypomanic episodes, which are similar to manic episodes but not as severe.

What is bipolar 1?

In bipolar 1, people have manic episodes that last at least seven days or are so severe they need to be hospitalized immediately. They also usually have depressive episodes that last at least two weeks as well. It's also possible for people to have episodes with features of both manic and depressive symptoms at the same time.

What is bipolar 2?

People with bipolar 2 have hypomanic episodes, which are similar to manic episodes but not as severe. People with bipolar 2 disorder usually return to normal function between episodes. They can have severe depressive symptoms, which is often why they first get treated.

Symptoms of bipolar 1 and 2 include manic and depressive episodes. The main difference between the two is the severity and length of symptoms.

Symptoms of bipolar 1

People with bipolar 1 have manic episodes that last at least seven days and include at least three of the following:

• A sense of grandiosity, which is exaggerated self-esteem
• Not needing much sleep
• Being easily distracted
• Talking loudly, quickly, and more than normal
• Risky behavior such as speeding, spending too much money, etc.
• Racing thoughts
• Trying to do a lot of activities at one time

People with bipolar 1 also have depressive episodes that last at least two weeks and include at least five of the following symptoms:

• Hopelessness, helplessness, worthlessness, sadness, and despair
• Not enjoying previous hobbies
• Feeling guilty
• Sleeping too much or too little
• Feeling agitated or restless
• Being tired, not have any energy
• Having a hard time concentrating or making decisions
• Frequently thinking about death or feeling suicidal

Symptoms of bipolar 2

If you have bipolar 2, you will have the symptoms of depressive episodes as above, but instead of a manic episode, you'll have hypomanic episodes, which are similar to manic episodes. They are not as severe as manic episodes. They last at least four days, but they don't cause the severe problems that manic episodes do.

You probably return to normal between episodes, though you may have other issues such as anxiety or substance abuse disorder.

Scientists don't know exactly what causes bipolar 1 or 2. They think several factors may contribute to both disorders, including:

Genes

If you have a parent or sibling with bipolar disorder, you have a greater chance of developing it. However, many people with a family history of bipolar never develop it themselves. There are even cases of identical twins where one twin has bipolar and the other doesn't. 

Stress

A stressful event can trigger a manic or depressive episode. If you're going through an event like a difficult divorce, having financial problems, or an illness, it can play a role in developing bipolar disorder.

Brain structure and function

Researchers have discovered subtle differences in the average size or activation of certain brain structures. You can't tell if someone has bipolar by looking at brain scans, though.

Your doctor will talk to you about your symptoms, your family history, and your medical history. You will have a physical exam and possibly some other tests such as blood tests to rule out other causes of your symptoms.

Your doctor will also do a mental health evaluation or may refer you to a specialist such as a psychiatrist who has experience in treating bipolar disorder.

Bipolar 1 disorder is diagnosed when you have had at least one manic episode. Bipolar 2 is diagnosed when you have had at least one hypomanic episode. The Diagnostic and Statistical Manual of Mental Disorders(DSM) is a reference book used by mental health professionals to diagnose the type of bipolar you may have.

If you are diagnosed with bipolar 1 or 2, it is a lifelong condition. Treatment will center on trying to control your symptoms and may include any of the following:

• Medications to balance your mood
• Psychotherapy treatment, including family therapy or cognitive behavioral therapy
• Substance abuse treatment if that is a problem for you
• Hospitalization to help stabilize you and keep you safe if you're feeling suicidal or behaving dangerously