What are the Different Types of Bipolar?

Contrary to popular belief, there are actually four types of bipolar disorder which will dictate how much someone’s life is affected by the condition:

Bipolar I

• At least one high or manic episode which has lasted for longer than one week.
• Individual may only have manic episodes, although most people with bipolar also have periods of depression.
• Untreated, a manic episode will generally last 3 to 6 months.
• Depressive episodes last rather longer – 6 to 12 months without treatment.

Bipolar II

• Characterised by more than one episode of severe depression, but only mild manic episodes – these are called ‘hypomania’

Rapid Cycling

• Characterised by more than four mood swings in a 12-month period. This affects around 1 in 10 people with bipolar disorder and can happen with both types I and II

Cyclothymia

• These mood swings are not as severe as those in full bipolar disorder but can be longer. This can develop into a full bipolar disorder.

What are the feelings associated with Bipolar Disorder

The feelings or symptoms that an individual who has a bipolar disorder will experience, are unique to them. Some may have one type of symptom and some individuals may never have one particular symptom that someone else may consistently have.

Whilst symptoms will vary, there are some that are characteristic of bipolar disorder which help health professionals to diagnose it accurately. When an accurate diagnosis is made, this can help to ensure that appropriate support and treatment is put into place to enable the individual to manage or recover from.

What are the main types of symptoms?

There are two main types of symptoms that individuals will feel when experiencing bipolar disorder: depression and mania. The symptoms of these two, as the name bipolar suggests, are very different. Symptoms of one or the other will usually be followed by a period of normality before a new episode occurs.

Depressive and manic symptoms cause changes in feelings and behaviour. We will first look at depressive symptoms.

Depressive Symptoms

Untreated, depressive episodes tend to last more than manic ones, typically averaging around 6-12 months. Depressive symptoms do not only occur in people with bipolar disorder but also in someone who has unipolar depression, which is where the individual does not have manic episodes. As such, their life is likely to be impacted in many ways, not just at home but possibly at work and in any other activity that they would normally carry out.

Firstly, an individual may find that they are eating more or less than usual to try and cope with their feelings. Food can be used as a comfort to get them through the phase, or they may feel unable to summon the energy to eat or prepare meals and, consequently, their energy levels may become lower still.

Not sleeping or sleeping too much are also common behavioural changes that may affect the individual’s daily routine.

Someone who has depressive symptoms can often find it difficult to get out of bed because they cannot face the day ahead, and so sleeping is a way of avoiding it. Conversely, someone who is depressed may also be experiencing an episode of severe anxiety and this will keep them awake because they are constantly worrying about everything in their life.

During this period, it is common that individuals who are prone to addictive behaviours may start to abuse drugs or alcohol, which is another self-coping mechanism to try and get through this period in their life. Whilst the individual may feel better in the short term, using drugs or alcohol to cope in the long term will likely have negative consequences because both are stimulants that can make feelings of stress and anxiety even worse.

Self-harm is also a possibility during a depressive episode where the individual feels as though they need to retain control over their life.

Some individuals feel that they cannot do this any other way than by hurting themselves. Others go through such a devastating depressive period that they hurt themselves just to try and feel some kind of emotion, even if it is pain.

Finally, a withdrawal from social occasions and not doing activities that were once pleasurable are also symptomatic of depression. Individuals sometimes do not want to socialise as they cannot face being with other people, perhaps because they do not have the energy to do so or because they are too embarrassed or ashamed to tell people about their condition. Not wanting to do activities is common because often it just feels like too much effort; alternatively, the individual may be in such a depressed state that they don’t feel anything is worth doing because nothing will lift their mood. This can severely affect their ability to form and maintain relationships and may also mean that they cannot attend work whilst experiencing a depressive episode.

How might the individual feel when experiencing depressive symptoms?

• Unhappy and tearful.
• Useless and worthless.
• Inadequate.
• Irritable and tense.
• Fatigued.
• Low in self-esteem and confidence.
• Unable to make decisions.
• Unable to concentrate.
• Unable to think positively or see hope for the future.
• Like a burden to others.
• Pessimistic and self-doubting.

How might the individual might behave?

• Eating more or less than usual.
• Not doing things that would normally bring enjoyment.
• Not sleeping (insomnia) or sleeping too much (hypersomnia).
• Withdrawing from social interactions.
• Abusing drugs or alcohol.
• Self-harming.

Manic Symptoms

If untreated, a manic episode is likely to last between 3 and 6 months.

When someone is experiencing a manic phase, their behaviour can appear very different to what it might normally be, especially when compared to the experience of a depressive phase.

Individuals are likely to be full of energy and will find it difficult to stay still. They may also talk rapidly, sometimes not making sense to anyone else. They may seem overly friendly towards others and are more inclined to indulge in risk-taking behaviours, which include risky sexual practices.

These types of behaviour during this phase occur because the individual’s mood is so elevated that they feel invincible, which can lead them to making grand plans, often with no regard for their physical or financial ability to carry them out.

Many individuals during this phase will spend money recklessly whether they can afford to or not and they may come across to others as rude and aggressive during this time as well.

In common with a depressive episode, the individual may be unable to sleep and may not eat. This is because they cannot concentrate for long enough to do so or because they are doing other things and do not consider sleeping and eating to be that important.

How might the individual feel when experiencing manic symptoms?

• Very happy, elated and overjoyed.
• Uncontrollably excited.
• Easily distracted and unable to concentrate.
• Full of energy.
• More important than they usually would.
• More confident and with higher self-esteem.
• Less inhibited.
• Adventurous.

How might the individual feel when experiencing manic symptoms?

• More active.
• Talking quickly and perhaps not making sense.
• Being overly friendly.
• Behaving out of character.
• Spending money recklessly.
• Making grand or unrealistic plans.
• Losing social inhibitions.
• Making risky decisions that compromise safety.
• Risky sexual behaviour.
• Being rude or aggressive.
• Not sleeping.