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Monday, 01 Jul 2019

Correctly Diagnosing Your Bipolar Symptoms: Are you Type I or Type II?

By Dr Becky Spelman

Bipolar (BPD), or manic depression as it is sometimes known, is a mood disorder incorporating both depressive and manic episodes that appear independently of one another over a sustained period. Due to the broad spectrum it exists on, it can be quite tricky for the untrained observer to discern, accurately. So broad is the spectrum, in fact, it’s seen the designation of a Type I and Type II diagnosis. Although, both exhibit the same patterns of extreme elation followed by crushing lows.

The effects of depression are fairly self-explanatory, but the mania associated with BPD is a little less clear. A passage from the ‘Diagnostic and Statistical Manual for Mental Health Disorders’ defines manic episodes as being, “a period of abnormally and persistent, elevated, expansive or irritable mood and abnormally and persistently increased activity lasting at least one week and present most of the day, nearly every day.”

The main difference between BP I and BP II, is how these episodes of mania are experienced. For the person with BP I, their manic episodes are classed are ‘mania,’ while the BP II sufferer’s version is referred to as, ‘hypomania.’ Both will display inflated self-esteem, (grandiosity), decreased sleep, talkativeness, inspired creativity, racing thoughts, and an increase in goal-oriented activities.

The difference largely comes in how these manic periods are experienced. In type I, there is an increased detachment from the world, marked by an indulgence in fantasy, suspicion and paranoia. These sorts of heightened mood states are much harder to manage, sometimes necessitating hopsitalisation, meaning the sufferer can be more reliant on medication than those suffering with type II. Type I sufferers often find it hard leading a functional life, due to the cognitive impairment they endure while in their manic state. This can, and often does, lead to them becoming isolated, living on the fringes of society unable to fit in.

Type II sufferers, on the other hand, experience higher functioning hypomania. While they’re still prone to the same symptoms associated with type I, the intensity is significantly reduced, meaning they’re ‘more’ in tune with reality. The flights of fancy and grandiosity will still be present, as well as the lack of choice in when these episodes take place, but they’re much more manageable. Episodes of hypomania are distracting but occur without any lasting impairment.

However, this doesn’t make a diagnosis of type II BPD any easier to live with, as some people mistakenly believe. It’s thought due to the higher-functioning hypomania, a relatively normal life can be led, which in that respect at least, it can. But the unfortunate consequence of type II is with being more of a chronic condition compared with type I.

Periods of depression last for much longer and with greater frequency, making it harder to engage in daily activities, due to the underlying sense of apathy – similar to unipolar depression. And in fact, it has been reported type II’s experience far more low points even those with unipolar depression. Type II may be less intense, but creates more dysfunction over the long-term.

*** If you think you may be exhibiting the signs of either bipolar type I or II, or have an existing diagnosis requiring support, one of our specialists would be happy to provide you with a FREE 15 MINUTE CONSULTATION.

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