The Differences Between Bipolar 1 and Bipolar 2

Patient Expert

Bipolar 1 and Bipolar 2 disorders have a lot in common. Both, of course, are characterized by mood swings. Both respond to the same types of medications. In both conditions, one end of the spectrum is depression that can range from moderate to crippling. So what are the differences between Bipolar 1 and 2?

One difference lies in the upper end of the mood swing scale. People with Bipolar 1 experience mania; those with bipolar 2 have hypomanic episodes. And while mania and hypomania share many of the same symptoms, certain aspects of mania don't happen in hypomania.

  • If you are having psychotic symptoms - hallucinations and/or delusions - you are experiencing mania.
  • Symptoms that cause significant disruption of your day-to-day life indicate mania. In hypomania, symptoms are often problematic from day to day but daily life is manageable.
  • If your high-end symptoms are so severe that they require hospitalization, you're in a manic episode, not a hypomanic episode.

The presence of any one of the above situations is enough to diagnose Bipolar 1 rather than Bipolar 2, according to the official diagnostic criteria.

There's another difference that is less well-known. People with Bipolar 2 Disorder tend to have longer depressive episodes and more of them, and also tend not to function as well between episodes as those with Bipolar 1. In particular, some symptoms of depression may linger during a period of relative stability. This difference is marked enough to make Bipolar 2 an equally severe condition with Bipolar 1.