Similarities Between Bipolar 1 and Bipolar 2
We understand by now that there are similarities between bipolar 1 and bipolar 2.
For one, the symptoms are similar, as we discussed – with the differences in mania and hypomania.
For another, diagnostic criteria are also similar. “…to diagnose bipolar II disorder, one or more major depressive episodes must occur. In bipolar I disorder, a major depressive episode (one or more) usually occurs, but it is not required.”
Euthymia is also present in both mental health conditions. Euthymia is what we can consider “middle ground,” when the condition is adequately controlled, and symptom-free. This is when mania, hypomania, and depression is not present, and the person suffering is in their “normal” state.
Also, both types of bipolar are considered disabling. It is a common misconception that bipolar 1 is more disabling than bipolar 2 as the manic episodes are more severe. While this is indeed true, evidence suggests that bipolar 2 is characterized by more severe episodes of depression.
One study suggested that “people with bipolar II become less likely to return to fully normal functioning between episodes.” Yet another stated, “bipolar type II was linked to a poorer health-related quality of life compared to type I – this remained true even during long periods of euthymia.”
Diagnosis of Bipolar Disorder
The Depression and Bipolar Support Alliance (DBSA) notes that, “seven of every ten people with bipolar disorder are misdiagnosed at least once, and that the average length of time from a person's first bipolar symptoms to correct diagnosis and treatment is ten years.”
Why is this happening? Surprisingly, the DBSA blames the patient.
Here’s what they have to say: “One of the reasons for this is that many people don't report all of their symptoms. It is important for people to share all symptoms, even those not present during a health care appointment, as well as their family history to help health care providers make a correct diagnosis.”
What does this mean for you, if you have bipolar disorder, or suspect that you have bipolar disorder?
Report every symptom. Even symptoms that occurred a week ago, a month ago, a year ago. Does your mother have bipolar disorder? Your grandmother? Your estranged brother? This is all important.
Is this hard to discuss? Yes.
Getting the right diagnosis is important for the right treatment.
Treatment of Bipolar Disorder
Treatment of bipolar disorder typically involves medication management from at least one medication from one of the following drug classes: mood stabilizers, antipsychotics, and antidepressants.
- Mood stabilizers may include lithium carbonate and valproic acid. Lithium has been highly effective at reducing mania, as well as reducing the recurrence of depression. It is often given in conjunction with antidepressants. Valproic acid has been shown to be effective in treating mania and mixed phases of bipolar disorder.
- Antipsychotic drugs are often given to people who do not respond to mood stabilizers, or during acute phases of mania. Examples include haloperidol, olanzapine, risperidone. Latuda is a newer antipsychotic that has been FDA-approved to treat bipolar 1 disorder specifically.
- Antidepressants are widely prescribed for the treatment of bipolar disorder, but they have not been adequately studied in patients with bipolar disorder to know if they are truly effective. In fact, antidepressants may trigger a manic episode. They should only be continued if they are shown to be effective.
The Bottom Line…
It is important to understand that when someone says they have bipolar disorder, there are multiple different types of bipolar disorder – bipolar 1, bipolar 2, cyclothymic disorder, mixed features, and rapid-cycling bipolar disorder. All have different features and treatments, and all can be disabling.