Bipolar Spectrum: The Four Categories of Bipolar Disorder


The complexity of bipolar disorder is not well known to the public eye. Bipolar disorder is not just about mood swings. Although most people experience mood changes from time to time, approximately 4.4 percent of adults in the United States experience some form of bipolar disorder in their lifetime. Additionally, according to the National Institute of Mental Health, 2.8 percent of the population are diagnosed with this disorder. Therefore, it is critical to draw attention to this issue and encourage individuals who are struggling with bipolar disorder to seek help and treatment. Mental health professionals have researched this mood disorder for several years and categorized bipolar disorder into four major types. It is important that people are informed about the intricacies behind bipolar disorder.

Bipolar disorder is a mental health condition that causes unusual mood shifts which include emotional highs and lows. Bipolar disorder was formerly known as manic-depressive illness or manic depression due to the severity of emotions examined in individuals who were struggling to cope with this disorder. The causes of this condition are quite puzzling for doctors; most research indicates genetic and environmental factors which contribute to the disorder onset. Mental health experts have categorized the types of bipolar disorder according to the duration and intensity of an episode (Polansky, 2020). 

Some mental health experts have further categorized bipolar disorder as a spectrum disorder (Higuera, 2019). The concept of the spectrum is to not only to categorize certain types of bipolar disorder, but to refer to other symptoms or conditions that may be contributing to the disorder, such as impulse control, personality, anxiety, or substance abuse. Symptoms alone are not enough to be diagnosed with bipolar disorder. Mental health professionals use the spectrum because some symptoms may loosely resemble certain types that lead to ineffective treatments. Bipolar disorder has distinctly shown elevations and fluctuations in mood which become severe to the point where it begins to affect all aspects of life. Negative changes in behavior, energy levels, concentration, ways of thinking, and disruption in sleep patterns are aspects that can be easily affected by bipolar disorder. The intensity of symptoms seen in manic or depressive episodes can make everyday life difficult to handle. Nonetheless, forms of mania, hypomania, and depressive symptoms are the commonalities that are all demonstrated in the different types of bipolar disorder.  

The emotional highs refers to mania which can be described as the “up” mood. A manic individual may experience an abnormally escalated, energetic, and hyperactive mood. The mania behavior can be exhibited by excessive talking, lack of sleep, increased likelihood to act impulsively, and delusions or hallucinations (Purse, 2020). During a manic episode, an individual is more likely to engage in risky behaviors and make irrational decisions. Some potential behaviors include spending large sums of money that they cannot afford or participating in sexual indiscretions while being in a committed relationship. Manic episodes can last up to seven days and some episodes may be intense to the point of hospitalization. In comparison to mania, hypomania can be described as less severe compared to a manic episode (Roland, 2019). Both manic and hypomanic episodes cannot be considered as such episodes if influenced by alcohol or drugs. 

The depressive symptoms that are commonly shown in bipolar disorder can be regarded as the “low” mood. Depressive episodes can be defined as lengthy periods of sadness or hopelessness. Symptoms consist of tiredness, emptiness, loss of interest in activities that used to bring pleasure, fatigue, decreased energy levels, and suicidal thoughts. During a depressive episode, an individual can also experience physical symptoms such as body aches and pains (Purse, 2020). Other physical symptoms could be either weight gain or loss. It is common for people with bipolar disorder to struggle with eating if they are feeling down, while others turn to food for comfort.

 Bipolar disorder can be further categorized into four different types: bipolar 1, bipolar 2, cyclothymia, and unspecified disorders that do not match the other three types (Hayes, 2020). However, the types that are most commonly diagnosed are bipolar 1 and bipolar 2 (Roland, 2019). The main difference between bipolar 1 and bipolar 2 is the severity of manic episodes. A person diagnosed with bipolar 1 will experience a full manic episode, while a person with bipolar 2 may only experience a hypomanic episode. Mania is described as the main characteristic of bipolar 1 disorder. 

Another difference between a person with bipolar 1 and bipolar 2 is a person with bipolar 1 may or may not experience a major depressive episode, while a person with bipolar 2 is known to experience a major depressive episode (Roland, 2019). People with bipolar 2 tend to seek help when they enter the major depressive state and are often misdiagnosed with clinical depression. Unlike individuals with bipolar 1, individuals with bipolar 2 experience a hypomanic episode and a major depression state that can last up to two weeks (Roland, 2019). There is a strong chance the severity of the hypomanic episode does not require hospitalization, unlike manic episodes characterized in bipolar 1. 

The third known form of bipolar disorder is called cyclothymia, a milder mood disorder that has symptoms similar to bipolar 2 (Kerr, 2018). Cyclothymia fluctuates between low level forms of depressive symptoms and periods of hypomania. The changes in mood of high and low appear in cycles. In between these mood cycles, an individual with cyclothymia will feel stable and like their usual self. In order to be diagnosed with cyclothymia, symptoms need to be persistent for a range of two years for adults, and at least one year in children. Cyclothymia commonly appears at the adolescent stage. Since the mood swings exhibited in cyclothymia are not as severe in bipolar 1 or 2, people appear to function normally. Therefore, teenagers and younger children will be misdiagnosed and considered to be going through stages of puberty. Adolescents will be wrongly seen as “difficult” or “moody,” which can result in not seeking treatment (Kerr, 2018). 

If left untreated for cyclothymia, people have increased chances of developing bipolar disorder by a 15 to 50 percent rate (Cagliostro, 2020). In regards to the other types of bipolar disorder, cyclothymia misses the main criteria of this mood disorder which is manic or depressive episodes. In fact, most people diagnosed with cyclothymia may appear more productive or active in their work which leads others to believe they are functioning fine. 

The last type of bipolar disorder can be due to a medical or substance abuse disorder (Hayes, 2020). This type is harder to diagnose as it does not have a specific pattern of symptoms. The fluctuations in mood will be considered to meet the standards of abnormal mood behavior. Compared to cyclothymia, an individual with this form of bipolar disorder will display symptoms of hypomania and mild depression that may not be persistent for two years. During depressive episodes, the mood elevations will be less than mild to be considered a form of mania or hypomania. These set of symptoms can lead to many individuals being misdiagnosed, which can be due to the lack of awareness of this form of bipolar disorder. Small levels of manic and hypomanic episodes can occur from taking antidepressant medication (Northpoint, 2019). Depending on the individual and their treatment plan, antidepressants can trigger an episode to occur. The lack of awareness normalizes the use of substance and alcohol for individuals with bipolar disorder as a coping method instead of seeking treatment.

Bipolar disorder is considered to be a chronic mental health disorder that does not have a cure. The public needs to be aware of the complexities of this mood disorder and empower others so they can live their lives the way they want to. People should not feel controlled or limited by bipolar disorder. Many individuals who do seek out treatment should be aware that this disorder does not have a quick fix. It will take time for an individual to find the right medication and mental health professional to guide them to have a stable life, but it is not impossible for someone with bipolar disorder to have a healthy life. 

 

References

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Cagliostro, D. (2020, September 28). Cyclothymia Personality, Symptoms, Causes, and Treatment. Psycom.Net – Mental Health Treatment Resource Since 1986. https://www.psycom.net/depression.central.cyclothymia.html

Hayes, L. N. (2020, September 1). 4 Different Types of Bipolar Disorder, and How They’re Treated. Talkspace. https://www.talkspace.com/blog/types-of-bipolar-disorder/#:%7E:text=According%20to%20the%20American%20Psychiatric,medical%20or%20substance%20abuse%20disorder.

Higuera, V. (2019, February 21). Bipolar spectrum: Types, diagnosis, and treatment. https://www.medicalnewstoday.com/articles/314829

Kerr, M. (2018, August 20). Cyclothymia. Healthline. https://www.healthline.com/health/depression/cyclothymia

NIMH » Bipolar Disorder. (2020, October 9). Nimh.Nih.Gov. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

Polansky, B. (2020, February 08). 4 Types of Bipolar Disorder: Treatment Options.  https://firststepbh.com/blog/the-4-types-of-bipolar-disorder-what-treatment-options-are-available/

Purse, M. (2020, March 24). These Are the Most Common Symptoms of Bipolar Disorder. Verywell Mind. https://www.verywellmind.com/bipolar-disorder-symptoms-and-diagnosis-379962

Roland, J. (2019, January 10). Bipolar 1 Disorder and Bipolar 2 Disorder: What Are the Differences? Healthline. https://www.healthline.com/health/bipolar-disorder/bipolar-1-vs-bipolar-2#symptoms

Staff, N. (2019, October 25). Comparing and Contrasting: The 4 Types of Bipolar Disorder. Northpoint Recovery’s Blog. https://www.northpointrecovery.com/blog/comparing-contrasting-4-types-bipolar-disorder/

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