[Fontaine Moore]

I have been diagnosed as being bi-polar but suspect the psychiatrist listed this primarily for insurance purposes. I'm sure I'm not bi-polar I, however, because my predominant problem is depression, not mania. And when I do have manias, they're normally pretty mild, certainly compared to a number of folks I've known who are bi-polar I and can go off the wall. I can get quite animated but stay off the walls! LOL

I recently had a psychiatrist tell me that the difference between I and II was the duration, not the symptoms, but I didn't agree with his definition. (That's primarily because I'm an educational neuropsychologist and so do know a bit about mental illness from an academic as well as experiential perspective.)

I've suffered from pretty severe depression since '08 when my mother--my last remaining family member--to whom I was very close, died. This shrink did get me off Zoloft and onto Mirtazapine. It worked wonders for about 3 weeks and I felt back to my old self (prior to my mother's death) but that didn't last long, although it has definitely helped. Although I do still get pretty depressed, it's generally neither as deep or as long as before I began taking this Rx.

I'm interested in hearing what folks know about the difference between these two types of bi-polar illness, particularly anyone who's been diagnosed with bi-polar II.

[Victoria'smom]

The difference is who your pdoc is

[HALLIEBETH87]

Its confusing for my case. Ive been dxd with both I and II from different pdocs.

My psy d says he thinks I have type II because my mania isn't too bad. My pdoc says he thinks I have type I because it seriously disturbs my life ie multiple hospitalizations and crisis.

It depends on the doctor it seems to me.

[BipolaRNurse]

The severity of mania is how BP1 is distinguished from BP 2. At least, that's how it's supposed to be...one pdoc's 1 may be another's 2, and vice-versa.

[Edgar's Mom]

I'm BP II. I know that I'm very different from many of the type ones because the mania they describe is not mania I've ever experienced. When I read their posts, I feel more like I'm on the outside looking in, rather than relating to much of what they say.

I only get hypomania and have never had psychotic thinking. I even envy them sometimes when I read their posts when they are on a high, although I know that is silly and they pay dearly for them. But to experience that ride just once... I feel a little left out LOL, although I wouldn't want to pay the price for it.

Anyway, I've not been on that ride. My hypomania is productive and does not harm my life at all. In fact, I think it makes it better and I wish I could have more of it.

[BipolaRNurse]

Originally Posted by Edgar's Mom

I'm BP II. I know that I'm very different from many of the type ones because the mania they describe is not mania I've ever experienced. When I read their posts, I feel more like I'm on the outside looking in, rather than relating to much of what they say.

I only get hypomania and have never had psychotic thinking. I even envy them sometimes when I read their posts when they are on a high, although I know that is silly and they pay dearly for them. But to experience that ride just once... I feel a little left out LOL, although I wouldn't want to pay the price for it.

Anyway, I've not been on that ride. My hypomania is productive and does not harm my life at all. In fact, I think it makes it better and I wish I could have more of it.

Be thankful you haven't been on that ride. It can devastate one's finances, home life, and work. It destroyed my career and I spent my family into bankruptcy twice...no, I don't recommend full-blown mania.

[Edgar's Mom]

LOL, that's why I also said that I wouldn't want to pay the price.

[Curiosity77]

Diagnostically the difference is if a person has ever had a full mania, or only hypomania. One full manic episode is enough for the bipolar 1 diagnosis, with or without depression. Bipolar 2 has to have at least one major depressive episode, and at least one hypomanic episode, but no full manic episodes. Type 1 folks have more extreme manias, but type 2's tend to spend more time depressed. So severity isn't necessarily reflected by the 1 or 2 label, even though type 1 is usually considered more severe.

Drawing the line between mania and hypomania can be trickier, because it's not always obvious. One way to think about it is function - if the person can still function it's probably hypomania, but if they are past that point, probably mania. By definition if hospitalization is required it's considered mania.

Anyways, my label is type 2, although sometimes i think it should be 1 because things have gotten very crazy at times, including needing hospitilization, but i've spent way more time depressed than elevated through my life. But ultimately the label doesn't matter really.

[polesapart]

I think the reply above covers it pretty well, but I just had to reply because I'm also a neuropsychologist and there aren't that many of us!

It does come down to the mania vs hypomania question, nothing to do with duration. But it could well be that one pdoc will diagnose mania and another hypomania in the same patient. There are the clear cut examples of each, but the middle area is grey. For example I think I'm currently hypomanic, but pretty sure my pdoc thinks manic.

[wiretwister]

It also depends how you ask , as I was very "sick" he told me bpII , when I became a little "clearer" and noncomplient he said bpI (i think to scare me into complience ), I said where is the mania , he said ip "you were not yourself" is that now the definition of mania , as I have become very stable and demanded he prove what he dxed , he back peddled and said I was on "the bp spectrum" whatever the hell that means , I have been the same all along but the dx has changed all over the place .... go figure ...

[fishin fool]

I am bipolar 2 and the difference is the level of mania.
Much worse mania in bipolar 1. longer duration and more severe.
At least that's how I understand it.

[cloudyn808]

Interesting... I just came from a debate between two second-year psychiatrist residents regarding the difference. They agreed that the distinction was the severity of mania and if the patient has hypomania. They said the dx. can change dependent on the need for hospitalizations.

[CrazyLo]

Originally Posted by Edgar's Mom

I'm BP II. I know that I'm very different from many of the type ones because the mania they describe is not mania I've ever experienced. When I read their posts, I feel more like I'm on the outside looking in, rather than relating to much of what they say.

I only get hypomania and have never had psychotic thinking. I even envy them sometimes when I read their posts when they are on a high, although I know that is silly and they pay dearly for them. But to experience that ride just once... I feel a little left out LOL, although I wouldn't want to pay the price for it.

Anyway, I've not been on that ride. My hypomania is productive and does not harm my life at all. In fact, I think it makes it better and I wish I could have more of it.

I am schizo-affective type Bipolar I. I love hypomania...it is a good high, not too high and definitely not low. I am so productive and social and content with life. But once it escalates to manic, it is most unpleasant...partly because it inevitably leads to psychosis for me. Usually people only require hospitalization for either severe depression or severe mania or psychosis. So for those of you who have been hospitalized for "hypomania", I would consider taking a closer look at your diagnosis! Of course, it is possible for hypomania to be unpleasant. But most of the time...hypomania feels terrific.

[ozzy1313]

I am BPII and have never experienced true mania. My hypo shows itself in different ways. Mainly it is irritation, rage, and a constant buzzing/crawling out of my skin feeling. It has also been good at times, like when I painted an re-did my whole main level in a few weeks time. It has also been bad like when I have had times I drink too much (not in past few years thankfully), or flirt too much with people who aren't my husband, or get my whole back tattooed.

Medication really helps with the anger, but it flattens me too much sometimes. I tend toward the depressive side of things anyway.

[ozzy1313]

Originally Posted by CrazyLo

I am schizo-affective type Bipolar I. I love hypomania...it is a good high, not too high and definitely not low. I am so productive and social and content with life. But once it escalates to manic, it is most unpleasant...partly because it inevitably leads to psychosis for me. Usually people only require hospitalization for either severe depression or severe mania or psychosis. So for those of you who have been hospitalized for "hypomania", I would consider taking a closer look at your diagnosis! Of course, it is possible for hypomania to be unpleasant. But most of the time...hypomania feels terrific.

I wish my hypo felt terrific. When I am super productive that part is good but it is driven by a compulsive need to get it all done and that doesn't feel good. Or I do self-destructive things. I know I have this disease, pisses me off I don't have any of the "fun" parts of it! lol!

[fishin fool]

My hypomania is mostly flip flopping between irritability and laughing
its kinda strange. Like others have said irritability is a big one with type 2.

[CrazyLo]

Originally Posted by fishin fool

My hypomania is mostly flip flopping between irritability and laughing
its kinda strange. Like others have said irritability is a big one with type 2.

Irritability is common with type 1 as well. Sometimes I'm irritable but most of the time I'm really euphoric with high anxiety because I get so excited about everything. The irritable kind definitely sucks!

[LettinG0]

I, too, understand the difference to lie in the "mania" and that II's tend to have more depression........

Whatever the case may be...I have been diagnosed II and do not have full-blown mania....however my hypomania's are NOT good or fun.....very subtly destructive....I also suffer from severe depression more months than experience hypo's

[HALLIEBETH87]

Question...

Can you have mixed episodes in both 1 and 2? Because I have had two mixed episodes just this year (not counting my depressions/hypomania/mania)

[gemini_double]

As BP 1, my depression lasts longer than mania. Mania for me is uncontrollable paranoia and delusions, false memories, racing thoughts, strange emotions, just bad overall. BP 2 is a period of depression and then a week or more of a great, high mood, then back to depression. That's actually how mine started out but never got treatment for it.

Sent from my SM-N900V using Tapatalk

[Curiosity77]

Originally Posted by HALLIEBETH87

Question...


Can you have mixed episodes in both 1 and 2? Because I have had two mixed episodes just this year (not counting my depressions/hypomania/mania)

In DSM-IV mixed was only in BP1. In DSM-V it can be in either

[HALLIEBETH87]

Yeah that's what I thought. My pdoc says I have bp 1 and I think mixed episodes are the worst!