We all have ups and downs, but those with Bipolar Disorder experience them at extremes, for extended periods of time. These irregular shifts in mood are characterized by periods of mania and depression. There are four main types of Bipolar Disorder, each of which can be defined by the length, frequency, and pattern of episodes of mania and depression. In between these episodes, many people live typically “normal” lives.
Bipolar I: People with Bipolar I have had at least one manic episode in their lives. Though it is not required for diagnosis, most people with Bipolar I also experience depression. There is generally a pattern of cycling between mania and depression which is where the term “manic depression” comes from.
Bipolar II: People diagnosed with Bipolar II have had one or more major depressive episodes and at least one episode of hypomania. Hypomania is a less severe type of mania describing highs that do not quite reach “full” mania. Hypomanic episodes are usually met with disabling periods of significant depression.
Cyclocthymic Disorder (cyclothymia): Cyclothymia is a mild mood disorder, with symptoms similar to Bipolar Disorder. However, the low and high mood swings never quite reach the severity or duration of major depressive and full manic episodes. People with cyclothymia experience hypomania and mild depression for at least two years. The symptoms of cyclothymia while mild, may still interfere with daily life functioning and relationships.
Not Otherwise Specified: Those who experience depressive, manic, and hypomanic symptoms but do not fit the criteria for bipolar I, II, or cyclothymia may be diagnosed as Bipolar Disorder NOS.
You may hear people use the terms “rapid cycling,” “mixed episode,” or “mixed features” to describe an individual’s Bipolar Disorder; these are not diagnoses but rather course descriptors of the illness. Mental health professional use different specifiers to add more detail to a person’s Bipolar Disorder diagnosis.
A person is said to have rapid cycling when they experience four or more episodes of mania or depression in one year. Rapid cycling may occur in any kind of bipolar disorder and may come and go throughout the course of one’s life.
A mixed episode occurs when a person is experiencing symptoms of both depression and mania or hypomania at the same time or in rapid sequence with no recovery in between. Anyone with a bipolar diagnosis may be said to be “with mixed features.”