Types of bipolar

Psychiatrists sometimes diagnose people with a type of bipolar disorder. This will depend on their individual bipolar moods, patterns and symptoms. 

Not all doctors and researchers agree on how to categorise the different types of bipolar. 

Some people are told they have a different type of bipolar by different healthcare professionals. Others aren’t told which type of bipolar they have at all.

There are three common types of bipolar:

Bipolar type 1

A diagnosis of type bipolar 1 means someone has had at least one episode of mania (sometimes with psychosis) that lasts longer than a week. 

Nine in ten people with bipolar type 1 also go through periods of depression. Without treatment, manic episodes will generally last between three and six months, and depressive episodes will generally last between six and 12 months.

Bipolar type 2

A diagnosis of bipolar type 2 means someone has had at least one period of severe depression and at least one period of hypomania that lasted longer than four days, but not symptoms of mania. 

Someone with bipolar type 2 also tends to experience more frequent and longer episodes of low mood. Approximately two in five people with bipolar have bipolar type 2.

Cyclothymia

A diagnosis of cyclothymia, or cyclothymic disorder means someone has experienced regular episodes of hypomania and depression for at least two years. 

Although people diagnosed with cyclothymia are on the bipolar spectrum, they do not have a diagnosis of bipolar. Cyclothymia can, however, develop into bipolar. 

What is the difference between bipolar type 1 and bipolar type 2?

Many people think bipolar type 2 is just a milder form of bipolar type 1, but this is a myth. Here are the facts: 

1. While it’s true that people living with bipolar type 2 often have less severe symptoms and are hospitalised less often, research shows they tend to experience more episodes of both depression and hypomania.
2. Women with bipolar type 1 have about a 50% chance of experiencing perinatal mental illness – a range of mental health conditions that can affect women during pregnancy and up to two years after giving birth. 
3. Women with bipolar type 2 face a slightly lower risk of experiencing perinatal mental illness – around 40%. And when episodes do happen, they’re less likely to be triggered specifically by childbirth.
4. Both types of bipolar disorder carry a similar risk of suicidal thoughts and behaviours. 
5. Bipolar type 2 is more strongly linked to seasonal affective disorder (SAD) and anxiety disorders.

Subtypes of bipolar disorder

Doctors sometimes diagnose people with a subtype of bipolar disorder. The most common subtypes of bipolar are:

Bipolar type 1 or 2 with mixed features

Also known as a ‘mixed state’ or a ‘mixed bipolar state’, someone with mixed features can experience symptoms of mania or hypomania and depression at the same time. 

This can result in agitation, difficulty sleeping, significant changes in appetite and suicidal thoughts. 

To get diagnosis of ‘bipolar disorder with mixed features’, someone needs to experience the following symptoms most days during an episode:

• Three or more depressive symptoms during a manic/hypomanic episode

OR

• Three or more manic/hypomanic symptoms during a depressive episode

Bipolar type 1 or 2 with rapid cycling

Rapid cycling means someone has had four or more depressive, manic or hypomanic episodes in a 12-month period. Rapid cycling affects around one in ten people living with bipolar.

Bipolar type 1 or 2 with seasonal pattern

If someone has a seasonal pattern of bipolar, this means that their symptoms of depression, mania or hypomania are regularly affected by the changing seasons in the same way. 

For example, someone might experience a lower mood each winter and a higher mood each spring. 

Bipolar UK is here for you

Being diagnosed with bipolar, or waiting for a diagnosis, can be stressful and overwhelming. But you’re not on your own. 

We’re here for you with a range of support and resources, and a community that understands.