A big difference in terms of medications is Bipolar 1s tend to get more antipyschotics and at higher dosages. Which makes sense when you think about it. Bipolar 1s often get psychotic, to reduce being pyschotic you take antipyschotics.

Of course it varies from person to person, some on Bipolar 1 can get by without the antipyschotics. And what Rambler said, paranoia, racing mind is often a reason a pdoc gives antipyschotics.