Bipolar disorder, sometimes known as bipolar spectrum disorder, is a complex mental health condition characterized by extreme mood swings that range from manic highs to depressive lows.
There are three main types of bipolar disorder — bipolar I, bipolar II, and cyclothymic disorder. While all three types share similarities, they differ in severity and frequency of symptoms and often require different treatment methods.
Bipolar I and bipolar II are the most common types of bipolar disorder — they also cause the most debilitating symptoms. Let’s explore the definitions of bipolar I and II and break down the specific ways these disorders can impact a person’s mood, energy levels, and behavior.
What is Bipolar Disorder?
Bipolar disorder is a mental health condition that involves shifts in mood, energy, and activity levels. These shifts are more substantial than ordinary ups and downs and can impact work, relationships, and daily life.
The condition can be either episodic or chronic, depending on the person. The bipolar spectrum includes several types:
- Bipolar I – Defined by at least one manic episode lasting a week or requiring hospitalization, often followed by periods of depression.
- Bipolar II – Defined by at least one hypomanic episode (less intense than mania) and one major depressive episode.
- Cyclothymic disorder – Defined by frequent but milder mood swings with hypomanic and depressive symptoms that last for years.
What is the Difference Between Bipolar I + Bipolar II?
The main difference is that bipolar I is defined by mania, and bipolar II is characterized by depression with milder highs. However, it’s helpful to look closer than the simple definition. The differences affect how symptoms manifest on a day-to-day basis, their level of disruption, and which treatment is most effective.
Manic vs. Hypomanic Episodes
The main difference between the two types lies in the intensity of the “high” episodes. For someone living with it, mania in bipolar 1 can feel like “I’m unstoppable, nothing can touch me,” while hypomania in bipolar II might feel more like “I’m on a roll, everything seems to click.”
Bipolar I: Mania is intense and disruptive.
People may experience an extreme surge of energy, require very little sleep, and behave in impulsive or risky ways. Mania can last a week or longer and may lead to hospitalization if safety becomes a concern. Loved ones often notice significant personality shifts, rapid speech, and behaviors that feel out of character or unsafe.
Bipolar II: Hypomania is noticeable but less severe.
People may feel more energetic, social, or productive than usual and may experience less sleep. However, they can often continue to function at work or school. Hypomania lasts at least four days and usually doesn’t cause hospitalization. Loved ones might notice quicker speech, more confidence, or bursts of new projects and ideas.
The Role of Depression
Depression is another key way the two conditions differ.
Bipolar I: Depression ISN’T central to the disorder.
Depressive episodes often occur, but they are not required for diagnosis. When they do happen, they can be severe and follow directly after a manic episode.
Bipolar II: Depression IS central to the disorder.
To be diagnosed, a person must experience at least one major depressive episode, which usually lasts at least two weeks. These depressive episodes tend to be more common and longer-lasting than the periods of hypomania, and they are often the main reason individuals seek help.
During these lows, individuals may feel drained, hopeless, or unable to enjoy things they usually like. For loved ones, it may look like withdrawal, fatigue, or a sharp drop in motivation that lasts well beyond a typical bad mood.
Functional Impact + Safety
The level of disruption is another way bipolar I and II differ. For families and friends, it helps to know that safety risks are higher during mania in bipolar I, while the greater burden in bipolar II usually comes from recurring depression.
Bipolar I: Manic episodes have a significant influence on behavior.
Manic episodes can overwhelm a person’s ability to function. Work, school, finances, and relationships may all be affected, and hospitalization may be necessary if judgment or safety is compromised. Loved ones may see behavior that feels alarming or completely out of character.
Bipolar II: Hypomanic episodes can disrupt, but don’t derail.
Hypomanic episodes typically don’t cause the same level of crisis as manic episodes do for the person with bipolar I. In fact, some people find themselves more productive or outgoing during these times. That said, the benefit is short-lived because depressive episodes are frequent and often much heavier, leaving day-to-day life just as disrupted in different ways.
How They Look in Daily Life
The symptoms of bipolar I vs. II show up differently in real-world situations. Loved ones might notice bipolar I as dramatic swings that disrupt everything at once, while bipolar II can look more like “hidden depression” punctuated by short bursts of energy.
Bipolar I: Impulsive, high-risk behaviors are evident.
A person may suddenly spend large amounts of money, stay up for nights in a row, binge drink, or make impulsive decisions that put them at risk. Their energy may feel uncontainable, and in some cases, they may believe things that aren’t true (psychosis).
Bipolar II: Shifts in energy and activity seem out of character.
A person with bipolar II may seem “high-functioning” during hypomania. This can manifest as starting new projects, being more social, or operating on little sleep. Often, though, this is followed by long stretches of depression where energy, motivation, and interest are hard to find.
The Role of Self-Image
How someone sees themselves can also differ between the two conditions, and a distorted self-image shows up in both bipolar I and II, but in very different ways.
Bipolar I: Self-image may be inflated during mania.
Manic episodes often bring grandiosity, giving the individual a heightened or exaggerated sense of self. They may feel more powerful, talented, or important than they really are, sometimes to the point of believing things that aren’t true.
This inflated self-view can fuel risky decisions and strain relationships, as loved ones may notice behavior that feels disconnected from reality.
Bipolar II: Self-image is often damaged by depression.
With depression at the center of bipolar II, many people struggle with harsh self-criticism, guilt, or feelings of worthlessness. Even though hypomania can temporarily boost energy, it doesn’t usually bring the same distorted self-confidence seen in bipolar I. Instead, self-image often declines over time because of the weight and frequency of depressive episodes, leaving the person feeling undeserving or “less than” in their daily life.
Diagnosing Bipolar I vs. Bipolar II
Getting an accurate diagnosis can be a challenge, as bipolar symptoms often overlap with other mental health conditions. Many people first seek help when they’re in a depressive episode, which can look a lot like major depression. If past manic or hypomanic episodes aren’t mentioned or recognized as symptoms, both bipolar I and II become more challenging to diagnose.
Basic Criteria for Diagnosis
Here’s a reminder of the main criteria that set the two types apart:
- Bipolar I – At least one full manic episode lasting around a week or requiring hospitalization. Depression may also occur, but it isn’t necessary for diagnosis.
- Bipolar II – At least one hypomanic episode lasting four days or more and one major depressive episode, with no history of full mania.
Why Bipolar Disorder Can Be Hard to Recognize
One of the biggest challenges is that hypomania — which is part of bipolar II — can sometimes feel like a “good” phase. Extra energy, confidence, and productivity may seem positive rather than concerning, so it doesn’t always get reported. This is why bipolar II is often mistaken for depression alone.
Misdiagnosis of Conditions With Similar Symptoms
Another layer of confusion comes from overlap with conditions like ADHD, anxiety, or trauma, which can share some of the same symptoms. On top of that, some people fall in between the classic patterns of bipolar I and bipolar II, which is why you’ll hear the term “bipolar spectrum.”
Getting the Right Diagnosis
Because the signs aren’t always obvious, diagnosis typically involves piecing together your entire medical history. This includes patterns of mood, energy, sleep, and behavior over time. The good news is that once the correct diagnosis is made, treatment can be tailored to what you’re actually experiencing, which makes recovery more effective and sustainable.
Treating Bipolar 1 vs Bipolar 2
Both bipolar 1 and 2 are highly treatable, but the approach can look a little different depending on the type. Effective treatment usually combines medication, therapy, and lifestyle support.
Medication
With bipolar I, mood stabilizers and antipsychotic medications are often used to manage manic episodes and prevent them from returning. If depression occurs, medication may also target those symptoms, but the primary focus is on keeping the mania under control.
For bipolar II, treatment often emphasizes easing depressive episodes while preventing hypomania from spiraling into mania. Antidepressants may sometimes be used, but only alongside mood stabilizers to avoid triggering hypomanic symptoms.
Therapy
With bipolar I, therapy often centers on relapse prevention. People learn to spot the early signs of mania and put safeguards in place before symptoms escalate.
For bipolar II, therapy tends to focus more on managing recurring depression while also teaching strategies for identifying hypomania. Tracking mood changes is especially useful in catching shifts early.
For both conditions, therapeutic modalities such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychoeducation help individuals reframe their thoughts, build coping skills, and strengthen their relationships.
Lifestyle + Support
With bipolar I, sticking to consistent routines — especially around sleep — is crucial since disruptions can trigger mania. Support from family or a care team may be needed during episodes to maintain safety.
For bipolar II, lifestyle support often emphasizes managing depression. Regular exercise, healthy sleep, and supportive connections can help buffer against prolonged periods of low mood. Tracking moods also helps catch the subtler signs of hypomania.
Find the Right Support for Bipolar Disorder
Whether it’s bipolar I or bipolar II, healing is possible. Effective treatment can help alleviate the mood swings, strengthen coping skills, and pave the way for a more stable and fulfilling life.
At Clearview Treatment Programs — a leading behavioral healthcare provider in Southern California — we deliver individualized care for bipolar disorder that helps manage mood swings, build coping strategies, and regain confidence in daily life.
Our programs combine evidence-based therapies, medication support when appropriate, and a compassionate environment where healing feels possible. With a treatment plan tailored to each client’s needs, it’s possible to move forward with steadiness and hope.
Contact us or visit one of our locations online today to learn more about how our bipolar treatment programs can help you or your loved one take the next step.
