The 4 Types of Bipolar Disorder: What Treatment Options are Available?

Last Updated: Feb 8th 2020

Reviewed by Brittany Polansky

The 4 Types of Bipolar Disorder: What Treatment Options are Available?

In the United States, approximately 4.4 percent of adults experience bipolar disorder at some point. Bipolar disorder is something many people struggle with. That’s why it’s crucial to draw attention to the issue and encourage those struggling to seek help. 

Bipolar is a disorder that can be explained by moods marked by highs and lows, or periods of mania and depression. Mental health professionals can classify the four types of bipolar disorders by examining the duration and intensity of these episodes.

The four basic types of bipolar disorder all vary in symptoms. They can be classified by significant changes in mood, energy, thinking, concentration, and behavior. These changes consist of manic episodes, which are periods of feeling euphoric, and depressive episodes, which are periods of feeling hopeless and sad. Hypomanic episodes are a milder form of manic episodes.

Understanding the different types of bipolar disorders can help you or a loved one seek help, sooner rather than later. Addressing mental health concerns, as well as substance abuse, helps return the power into the individual’s hands. Fortunately, there are wonderful treatment options available for those struggling with any type of bipolar disorder.

Different Types of Bipolar Disorder

The disorder types are each identified by the pattern of episodes of mania and depression. Each type of bipolar disorder is unique in its pattern of episodes and intensity. 

Bipolar I Disorder

Bipolar I disorder can be classified by manic episodes that last at least seven days. These manic episodes may also coincide with certain symptoms of psychosis. In some cases, the manic symptoms are severe enough to require immediate hospitalization to prevent harm to oneself or others. 

Depressive episodes generally last at least two weeks. These types of episodes also occur often. An individual may have manic episodes including some depressive symptoms or depressive episodes accompanied by some manic features.

Bipolar II Disorder

Mania is not a part of bipolar II disorder. Instead, bipolar II disorder can be classified by recurring episodes of major depression and hypomania, a milder form of mania. A diagnosis of bipolar II disorder requires experiencing at least one hypomanic episode and one major depressive episode in your lifetime.

Compared to bipolar I disorder, although one or more major depressive episodes may occur, it is not a requirement. Bipolar II disorder consists of one or more major depressive episodes. 

General symptoms that take place in a major depressive episode include:

  • Insomnia or hypersomnia
  • Unexplained or uncontrollable crying
  • Severe fatigue
  • Loss of interest in things the person typically enjoys
  • Recurring thoughts of death or suicide

Cyclothymic Disorder

Cyclothymia symptoms differentiate between emotional highs and lows. The highs of cyclothymia include signs of an uplifted mood (hypomanic symptoms). The lows consist of mild or moderate depressive symptoms.

Cyclothymia symptoms are similar to those of bipolar I or II disorder. However, they’re significantly less severe. If diagnosed with cyclothymia, you can typically function on a day-to-day basis, though not always well. Changes in mood and behavior can get in the way of your stability if you never see it coming or don’t feel like you can control it. 

Cyclothymic disorder generally develops in adolescence. Those diagnosed with this disorder can be seen as simply difficult or moody to others, thus left untreated. If this occurs, cyclothymia can increase your chances of developing bipolar disorder.

Bipolar Disorder – Due to another medical or substance abuse disorder

Bipolar disorder that does not follow a particular pattern (for example, recurring episodes of hypomania episodes without depressive symptoms, or very rapid swings between some symptoms of mania and some symptoms of depression) is called bipolar disorder Not Otherwise Specified (NOS).

Typically, NOS can be diagnosed when the individual alternates between depression and short episodes of hypomania (a milder form of mania). Oftentimes, the mood swings are rapid, occurring within days of each other.

Bipolar Disorder: Recognizing the Signs 

The different types of bipolar disorders can be recognized by a variety of symptoms. These symptoms range from person to person, as each case is different. However, there are certain similarities that most people can search for when recognizing bipolar disorder.

Mania and hypomania can be generally identified by the following features:

  • An individual that displays intense, elevated, or irritable signs of changes in mood that are persistent and last for at least one week. If the person’s euphoric mood is so severe that it calls for hospitalization, then help should be sought after immediately. 
  • Additional signs and symptoms must also occur. If you’re mainly showing increased levels of energy or an expansive mood, you must also depict three of the following symptoms in order to be diagnosed with bipolar disorder. If you’re primarily showing signs of an irritable mood, you must display at least four of the following symptoms:
    • Inflated self-esteem or grandiosity
    • Being markedly more talkative than normal
    • A significant decrease in sleep or the need for sleep
    • Racing thoughts (this is often assessed by rapid speech patterns)
    • Extreme distractibility
    • A significant increase in goal-directed behavior, such as work-related activities or cleaning the house, or in non-goal-directed behavior, such as pacing
    • A significant increase in behavior that could be potentially dangerous or damaging, such as engaging in multiple sexual relationships, shopping binges, excessive investing, etc.

Depression in Different Types of Bipolar Disorders 

Experiencing periods of depression is a common symptom when diagnosing the different types of bipolar disorder. Depression is diagnosed when an individual displays at least 5 of 11 potential symptoms consistently over two weeks. 

These symptoms include:

  • Feeling sad for the majority of the day on a nearly daily basis
  • Displaying an inability to experience pleasure nearly every day
  • Sleeping excessively or not being able to sleep at all
  • Feeling guilty or worthless nearly every day
  • Problems with concentration, attention, remembering things, making decisions, etc.
  • Significant weight loss or gain in the absence of trying to intentionally lose or gain weight
  • Feeling extremely tired or fatigued nearly every day
  • Feeling restless and irritable almost every day
  • Moving as if in “slow-motion” most of the day nearly every day
  • Excessive thoughts about self-harm and/or suicide

Recognizing the signs of depression can help you decide to seek help sooner rather than later. Fortunately, there are many treatment options available that can alleviate these symptoms. Even more importantly, treatment teaches you the skills to work through these problems and guide you to a happier life.

Levels of Treatment for Different Types of Bipolar Disorder

When it comes to treatment at a rehab facility, there are varying levels of care offered. These levels of care each incorporate their own set of key components to help the patient recover. Our addiction and mental health specialists can help you determine where your needs are best addressed. These types of treatment include:

  • Outpatient treatmentOutpatient rehab is ideal for those who wish to reside in their communities but still treat their bipolar disorder. Patients will have the opportunity to create a schedule that best suits their unique needs. For example, you may have a child or you may need to attend night school classes. We can make it work to fit your circumstances.

The main advantage of outpatient care is convenience. Inpatient care may require too much commitment or a lack of flexibility. If that’s the case, don’t worry. You can still get the help you need.

  • Inpatient treatment – Inpatient treatment in a hospital or long-term care facility may be necessary when your mood is particularly unstable or if you are experiencing psychotic or suicidal thoughts or behaviors. This type of residential treatment will require patients to live at the treatment facility. Inpatient programs usually take 28 to 90 days to complete. 

Inpatient treatment is best for those struggling with severe bipolar disorder and/or coinciding substance abuse issues. Patients reside in a safe and secure environment.

  • Dual Diagnosis treatment – Did you know that about 56% of people with bipolar disorder also experience a drug or alcohol use disorder in their lifetime? Treatment that focuses on both substance use and bipolar symptoms is necessary for a lot of patients. Withdrawal symptoms of drugs or alcohol require immediate medical attention.

Dual diagnosis treatment addresses the addiction and disorder from the inside out. At 1st Step Behavioral Health, we believe in treating the person as a whole. Taking the time to understand the underlying roots behind a problem makes all the difference in finding a solution.

Components of Treatment for the Different Types of Bipolar Disorder

A treatment plan for any type of bipolar disorder must be comprehensive. Medical care and psychological care must be coinciding components. You may have a treatment team that includes a psychologist, a social worker, and a psychiatric nurse.

Bipolar disorder is a lifelong but treatable condition. Neglecting any part of the problem will only have the potential to cause more pain in the long run. Treatment is directed at managing and working through these symptoms. 

Depending on your needs, treatment may include:

  • Medications: Medications may be used to immediately balance moods. Our medical professional team will make sure to carefully assess you and monitor the use of medication throughout treatment.
  • Psychotherapy and psychoeducation: Also known as talk therapy or counseling, psychotherapy helps the individual learn and practice effective strategies for coping with the disorder, as well as managing symptoms. Cognitive-behavioral therapy can help an individual identify negative thinking patterns and the behaviors that follow. 

Family therapy can help family members learn to communicate calmly, in a productive manner. Thus, reducing overall stress in relationship systems. Psychotherapy can also provide valuable psychoeducation for problem-solving, developing self-care habits, and building resilience.

  • Substance abuse treatment: If you have problems with alcohol or drugs, you’ll also need substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder.
  • Continued treatment: Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. Skipping maintenance treatment puts you at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression. Maintenance treatment is all about preventing relapse. 

The main treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also generally include education and support groups.

Seek Help Today

If you’re struggling with any type of bipolar disorder, don’t shy away from getting help. Many people are in the same boat. Whether it’s you or a loved one that needs treatment, we’re here to guide you throughout the process. Bipolar disorder requires effort to change, as well as a thorough evidence-based plan. 

That’s where we come in. Our mission is to help you live the life you deserve. We’ll help you get the treatment you need. Contact us here at 1st Step Behavioral Health for more information about available programs.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.