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What are Bipolar Disorders I and II?

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Happy, sad, excited, angry—our moods swing like a pendulum, reflecting the everyday ups and downs in our lives and how we cope with them. It’s perfectly normal and healthy to experience a range of moods throughout the course of a day. For some people, though, the pendulum swings to extreme. Moods seesaw between profound lows and soaring highs. These symptoms signal the classic presentation of Bipolar Disorder.

What’s mania?

Mania is hard to miss. People in this state can’t focus. Their thoughts race, and they talk fast. They live on very little sleep and engage in risky behaviors like speeding, overspending, or hypersexuality. They may think they are invincible or possess an inflated sense of self, which leads to reckless decisions. Most are frequently impulsive and irritable, and are likely to hurt themselves or others. Unfortunately, people in this state are also very resistant to treatment. Mania is the hallmark symptom of Bipolar Disorder type I.

What’s hypomania?

Hypomania is a tamer form of mania and is not nearly as disabling. People in this state might function pretty well. They can be creative, energetic and goal-oriented—behavior easily characterized as normal. Hypomania and depression alternate in Bipolar Disorder type II. Depressive episodes mimic major depression with drained energy, low mood, altered sleep and appetite, and suicidal thoughts or behavior.

Although hypomania is a milder form of mania, Bipolar II is not a milder form of Bipolar I. In fact, in Bipolar II, the depressive symptoms are the most concerning and most disabling.  The depressive symptoms of Bipolar II create a more long-term type of impairment while the manias of Bipolar I lead to more periodic issues.

Bipolar I usually starts around age 18, while Bipolar II starts later, in the mid 20s. When parents suspect it their kids, they should also consider the possibility of Disruptive Mood Dysregulation Disorder. Bipolar I comes to light because of the manic episodes. However, depression is usually the first symptom of Bipolar II, and those patients are diagnosed with Major Depressive Disorder until a hypomanic episode occurs. In fact, 12% of people who are initially diagnosed with Major Depressive Disorder have their diagnosis changed to Bipolar Disorder II.

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References
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