What types of bipolar are there?
Depending on the way you experience different bipolar moods and symptoms, and how severely they affect you, your doctor may diagnose you with a particular type of bipolar disorder. The table below explains some terms your doctor might use.
You may be told you have bipolar I if you have experienced:
- at least one episode of mania which has lasted longer than a week
- You might also have experienced depressive episodes, although not everyone does.
You may get a diagnosis of bipolar II if you have experienced both:
You may get a diagnosis of cyclothymia if:
- you have experienced both hypomanic and depressive mood states over the course of two years or more
- your symptoms aren’t severe enough to meet the criteria for a diagnosis of bipolar I or bipolar II
This can be a difficult diagnosis to receive, because you may feel that you are being told your symptoms are ‘not serious enough’, but this is not the case. Mental health is a spectrum that encompasses lots of different experiences and cyclothymia can have a serious impact on your life.
Using these terms can help both you and health professionals discuss your diagnosis and treatment more specifically. If your doctor ever uses words or phrases you don’t understand, you can ask them to explain.
“[I have] cyclothymia. It can make you feel more like it must be all in your head as the symptoms are often not as extreme as bipolar.”
How often do bipolar episodes occur?
This can depend on a lot of things, such as:
- your exact diagnosis
- how well you’re able to manage your symptoms
- whether certain situations or experiences can trigger your episodes (for example, you might find that getting very little sleep while going through a stressful life event could trigger an episode of mania)
- how you define an episode personally
What’s normal for you can also change over time. However, many people find that:
- mania can start suddenly and last between two weeks and four or five months
- depressive episodes can last longer – sometimes for several months
You may be told your bipolar is rapid cycling if you have experienced four or more depressive, manic, hypomanic or mixed episodes within a year.
This might mean you feel stable for a few weeks between episodes, or that your mood can change as quickly as within the same day, or even the same hour.
Currently, rapid cycling is not officially considered a separate type of bipolar disorder, but more research is needed to know for sure or to better understand it. (For more information on rapid cycling, see the Bipolar UK website.)
It’s also common to have stable or neutral periods in between episodes. This doesn’t mean that you have no emotions during this time – just that you’re not currently experiencing mania, hypomania or depression, or that you’re managing your symptoms effectively. You might find you feel stable for years in between episodes, although for some people periods of stability can be much shorter.
“It’s a lot harder coming to terms with being stable […] than I could have imagined. I’ve had to struggle with a ‘new’ identity and way of life after spending so many years thinking the ups and downs of bipolar are ‘normal’.”