We all have ups and downs, but those with bipolar disorder experience them at extremes, for extended periods of time. These irregular shifts in mood are characterized by periods of mania and depression. There are four main types of bipolar disorder. The main differences are in the intensity of the manic and depressive episodes. In between these episodes, people with bipolar disorder usually feel “normal.”
People with bipolar I have had at least one manic episode in their lives. Most people with bipolar I also experience depression. There is generally a pattern of cycling between mania and depression, which is where the term “manic depressive” comes from.
People diagnosed with bipolar II have had one or more major depressive episodes and at least one episode of hypomania. Hypomania is a less severe type of mania, with highs that do not quite reach “full” mania.
Cyclothymia is similar to bipolar disorder, but less severe. The low and high mood swings never quite reach the intensity or duration of manic or depressive episodes. People with cyclothymia cycle between hypomania and mild depression for at least two years. While mild, the symptoms of cyclothymia may still interfere with daily life and relationships.
Not otherwise specified (NOS)
Those who experience symptoms of depression, mania, and hypomania but do not fit the criteria for bipolar I, bipolar II, or cyclothymia may be diagnosed as bipolar disorder NOS.
Other terms related to bipolar disorder
You may hear people use the terms “rapid cycling,” “mixed episode,” or “mixed features” to describe an individual’s bipolar disorder. These are not separate types of bipolar disorder. They are symptoms that may appear in any type of bipolar disorder.
Rapid cycling is when a person experiences four or more episodes of mania or depression in one year. Rapid cycling may occur in any kind of bipolar disorder and may come and go throughout the course of one’s life.
It’s also possible to experience mania and depression at the same time. This is called a mixed episode, or an episode with mixed features.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
- American Psychiatric Association. (2017). What Are Bipolar Disorders? Retrieved from https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders