Bipolar one versus two which is worse I'm Dr. Tracey Marks, a psychiatrist and I
publish weekly videos on mental health and self-improvement. Today I'm going to
be talking about the difference between bipolar one disorder and bipolar two
disorder and address the common misconception that bipolar two is a
milder form of bipolar one and therefore probably less of a problem. Bipolar
disorder is a mood disorder and it has two states: depressive episodes and
hypomanic or manic episodes. And manic episodes are defined as the following
and I'm going to read this because it's just too many words and it's taken from
our Diagnostic and Statistical Manual of Mental Disorders the fifth edition. Here
we go. A period of abnormally and persistent, elevated, expansive or
irritable mood and abnormally and persistently increased activity lasting
one week and present for most of the day, nearly every day. And then you have to
have three of the following or four if your mood is irritable instead of
elevated. Number one is inflated self-esteem or grandiosity - decreased
need for sleep, more talkative than usual or pressure to keep talking.
Number four flight of ideas or racing thoughts, distractibility, increase in
goal-directed activity or psychomotor agitation. You just can't stop doing
things. Excessive involvement in activities that have a high potential
for painful consequences such as things like going on buying sprees or getting
involved in business investments. Sometimes people become hyper sexual.
Also the symptoms caused clinically significant distress or impairment in
various areas of your life not just one little area. Hypomania has the same
symptoms except they only need to last for four days instead of a whole week.
Another main difference is that with hypomania
the symptoms don't cause any real impairment and in other words you're
still pretty high-functioning. Now the second part of bipolar disorder would be
to have depression or depressive episodes and I've talked in previous
videos about depression and I'll put a link in the corner for you to reference
Ii you want to watch that video. So bipolar one would be having episodes of
mania and depression. Bipolar 2 would be episodes of depression and hypomania.
If a person has delusions or any other psychotic symptoms, it's automatically
considered mania versus hypomania because with hypomania there's no
impairment. There's a good chance that if you have bipolar two disorder that you
can go all of your life and never have never be put in the hospital because of
your bipolar disorder. But with bipolar one, it's very hard, pretty uncommon for
someone with bipolar one to never have a hospitalization because the manic
episodes tend to be pretty destructive. Now knowing that, it's easy to conclude
that bipolar one disorder is much worse than bipolar two because the manic
episodes can cause a lot of problems. it's kind of like a tornado ripping
through and then you've got to clean up all the damage. But the reason bipolar 2
is not merely a milder form of bipolar one disorder is because people with
bipolar 2 tend to have a more chronic course to their illness. They also tend
to spend more time depressed than the people with bipolar 1 so bipolar 1 may
be more intense but bipolar 2 can be more chronic and persistent. Also the
number of lifetime episodes of hypomania and depression tend to be more for the
person with bipolar 2 then the person with bipolar 1. So did you get that?
People with bipolar 2 tend to have a more recurring episodes of
depression than the person with unipolar depression even. So in many ways although
bipolar two disorder may be less intense when it
comes to the mania at least, it can just create more overall dysfunction in the
person's life because of the lingering and recurring depressive episodes. Now I
said all this because I think in the past we as clinicians have tended to
think of bipolar two disorder is not really that bad and that's kind of
trickled down to patients in the way that they even think about their illness
and may even feel like you don't really need to get treatment for it because
it's just not that bad. And I think this is because we tend to focus on the
intensity of the mania and seeing that as more the thing to keep under control
but depression can be pretty debilitating and we're not talking about
like a hypo depression there's no such thing. The person with bipolar disorder
will have not as severe of a manic episode but they can have very severe
depressive episodes so the depression is still can be a big problem. And a reason
to continue in treatment and to maintain regular treatment to prevent
the bottoming out episodes with a depression. And a good medication regimen
can help reduce the overall burden of the illness by lessening the symptoms
and maybe even decreasing the number of recurring episodes that you have over
time. Thanks for watching. Leave me a comment if you have any questions or
even if you don't have any questions leave me a comment just to say "hi."