Bipolar 1 vs. Bipolar 2: Crucial Differences You Need to Know

Signs and Symptoms of Bipolar 2

Bipolar 2 mimics bipolar 1, but with a crucial difference in manic symptoms. Someone with bipolar 2 experiences hypomania⁴, which means their periods of mania are much less intense and less debilitating, often not affecting their safety, relationships, and work responsibilities nearly as much as mania. You can remember “hypo” means low or less, so low-mania.

Sometimes, people with bipolar 2 actually enjoy their hypomanic states. They often feel more energized, but not out of control, and happier, but not over energized. Perceiving hypomania as a “good mood”, especially following a depressive episode, can keep those with bipolar 2 from seeking treatment or realizing something’s amiss. 

Hypomania occurs more frequently than mania⁵ and can have negative consequences even if people perceive them as positive. Many people with bipolar 2 don’t feel comfortable with their actions and behaviors during a hypomanic episode, either. Symptoms of hypomania⁵ include

• Increased energy
• Less need for sleep
• Urge to socialize and talk about anything and everything
• Risky and promiscuous sexual behaviors
• Extreme irritability
• Intense anxiety

Notably, hypomania doesn’t cause psychosis, delusions, or hallucinations. People in a hypomanic state may not even notice it’s happened, whereas mania has much more pronounced signs and effects. Loved ones may notice hypomania, and they will certainly notice mania.

Bipolar 2 also includes periods of depression, often more so than bipolar 1⁶. Periods of depression can last months or years, while hypomania often lasts several days. 

Those with bipolar 2 face the highest likelihood of an incorrect diagnosis⁶. Since symptoms of mania are much less pronounced than bipolar 1, providers may misdiagnose patients with major depression, dysthymia (constant low-level depression), or borderline personality disorder (BPD). Hypomania can even present as extreme anxiety and irritability, which could be misdiagnosed as general anxiety disorder. Though these conditions can co-occur with bipolar 2, mistaking them for the primary diagnosis delays proper treatment.

Recognizing the cyclic nature of low/high moods can help patients and their providers arrive at an accurate diagnosis. Getting the right diagnosis means getting the most effective medications and therapy, which can be especially vital in treating bipolar disorders.

Key Differences

Key, overarching differences between bipolar 1 and 2 include

1. Mania vs. hypomania
2. Less vs. more frequent depressive episodes

Other differences vary person-to-person. Everyone will experience bipolar 1 or 2 differently. Doctors will often take a deep-dive to determine if you have bipolar 1 or 2, or an entirely different diagnosis.

Treatments for Bipolar 1 and 2

Medications

It’s true mood stabilizers like lithium can be life-changing medications for those with bipolar, especially bipolar 1. Mood stabilizers can manage mania (acute and long-term) and prevent mood cycling. 

Certain mood stabilizers and atypical antipsychotics center on reducing depression and suicidality, not mania. Those with bipolar 2 often benefit from these types of mood stabilizers, plus an antidepressant. 

Therapy

Therapy can help people manage and understand their symptoms. Cognitive behavioral therapy (CBT) focuses on changing thoughts and behaviors to positively alter mood, which can help in a depressive episode. Dialectical behavioral therapy (DBT) teaches practical strategies for managing distress, surviving crisis urges (like suicidal ideation), and interpersonal communication.

Those with bipolar often remain in therapy throughout their lifetime, as regular sessions can help manage stressors and other life events that could trigger a mood swing. Patients can learn personalized strategies for managing their symptoms and receive ongoing emotional support by working with a therapist.

Mood Tracking

Tracking mood serves as a vital tool for people with bipolar disorders. You can download apps designed exactly for this, or track it in a notebook. Keeping track of your mood and what’s happening in your life can clue you into the unique aspects of your mood cycles, helping you proactively manage highs and lows. This can help you feel more in control, not like your moods are happening to you.

Finding Your Cornerstone: Bipolar Maintenance

Figuring out your unique symptoms and expression of bipolar 1 or 2 can take time, but with accurate diagnoses, medications, therapy, and acceptance, you can learn to manage your bipolar as confidently as you might manage your diet or sleep. 

Regular appointments with therapists and psychiatrists can be key to long-term recovery. Let your loved ones know of your condition too, so they can offer their support when needed. And keep an open, non-judgemental mind as you navigate your symptoms—you’ve got this, and you’re in good company on the journey.
Use Recovery.com to find recovery centers offering bipolar treatment, with pictures, insurance information, reviews, and much more to help you find the best fit for you.