╰┈➤ Well, there are two forms of bipolar disorder, which include Bipolar I and Bipolar II. However, the main difference lies in the elevated mood experience. In Bipolar I disorder, an individual experiences at least one episode of mania. Nevertheless, for Bipolar II disorder, an individual will have a history of experiencing hypomania and depression, without a history of mania. Mania is a more severe condition that results in hospitalization or psychosis, while hypomania is less severe. Both will have an effect on a teenager’s mood, sleep, energy levels, relationships, academic performance, and other aspects of life.
In this article, we will learn to distinguish between bipolar I and bipolar II disorder and how teens and adolescents can overcome them.
Bipolar 1 vs 2: Quick Comparison
Let’s have an overview of the characteristics of Bipolar I and Bipolar II disorder.
| Feature | Bipolar I | Bipolar II |
| Main elevated mood episode | Mania | Hypomania |
| Depression | May occur, but is not required for diagnosis | Major depressive episodes are part of the diagnosis |
| Severity of elevated episode | More severe | Less severe than mania |
| Hospitalization | May be required during mania | Hypomania does not require hospitalization |
| Psychosis | Can occur during severe mania | Hypomania itself does not include psychosis |
| Effect on daily life | Can be severe | Hypomania causes less obvious impairment |
| Can teens experience it? | Yes | Yes, although diagnosis in young people requires careful assessment |
| Treatment | Medication, psychotherapy, lifestyle and family support | Medication, psychotherapy, lifestyle and family support |
Quick insight:
It is wrong to think that Bipolar I is just more “bipolar” than Bipolar II. The conditions differ by the type of mood swing cycles rather than by the general mood level.
People suffering from Bipolar II may have severe depression and impairment. However, their struggles are real and significant. However, Bipolar II should not be seen as a less severe version of bipolar disorder. It is a mental health condition on its own.
What Is Bipolar Disorder?
Bipolar disorder is a mental disorder whose defining features are mood swings as well as changes in levels of energy, behavior, activities, sleep, and thinking patterns.
Besides, people suffering from bipolar disorder have mood swings that include symptoms such as mania, hypomania, depression, or any combination thereof.
Every person experiences great days as well as bad days during adolescence.
At the onset of puberty, young people experience changes in their moods due to pressures at school, making friends, and being independent.
This disorder is another thing.
It involves mood swings that are more intense and happen alongside shifts in energy, activity, sleep patterns, thoughts, and actions. Such episodes can have an effect on academic life, relationships, and even routine activities.
Moreover, this disorder usually starts in late teenage years or early adulthood, although it can develop before this stage as well.
What Is Bipolar I Disorder?
The symptoms of Bipolar I include having one or more manic episodes.
Manic episodes include an unambiguous period of unusually elevated, expansive, or irritable mood accompanied by increased activity or energy.
This usually lasts for at least seven days or requires hospitalization because of its severity. However, a person can experience a depressive episode usually but it is not necessary that he is suffering from Bipolar I disorder.
Symptoms of Mania in Teens:
A teen with mania can:
- Speak much faster than usual
- Have racing thoughts
- Switch from one topic to another quickly
- Get little sleep and not feel tired from that
- Be more energetic than usual
- Feel very confident or powerful
- Feel irritable
- Act impulsively and engage in dangerous behavior
- Spending money without thinking about consequences
- Become very sociable or hyperactive
- Begin many projects at once
- Get distracted easily
- Make bad decisions
- Have psychotic symptoms in some cases
According to the National Institute of Mental Health (NIMH), fast talking, racing thoughts, decreased need for sleep, increased activity, irritability, grandiosity, and impulsiveness are some examples of possible mania symptoms in children and adolescents.
Example:
For instance, think of a usually quiet 16-year-old teenager who now sleeps just three hours at night but claims to be totally energized. So, all day he is always talking, starting many new ventures, and acting overly confident in addition to being impulsive.
This type of behavior needs professional attention because it is quite different from a few days of being energetic.
What Is Bipolar II Disorder?
Bipolar II disorder is characterized by hypomanic episodes as well as major depressive episodes.
Hypomania resembles mania but is not quite so severe.
Thus, a teenager becomes more energetic, talkative, productive, confident, or active than normal. They have less need for sleep and have racing thoughts.
But the hypomania does not become so severe as to qualify as a manic episode.
Signs of Hypomania in Teens:
Teenagers having hypomania will:
- Be more talkative than normal
- Have less need for sleep
- Be very energetic
- Become more productive
- Feel more confident than normal
- Come up with many new ideas
- Become more social than normal
- Become easily distracted
- Take certain kinds of risks
- Be cheerfully or irritably happy
Thus, these experiences might even be pleasant for the teenager.
The teenager might think:
“This is the most productive I have ever been.”
So, this makes Bipolar II hard to diagnose.
In the end, the teenager may get help due to depression and not due to hypomania.
Bipolar I vs Bipolar II: The Main Difference
A simple rule to help remember the differences is:
Bipolar I Disorder = Mania
Bipolar II Disorder = Hypomania and Major Depression
So, the distinction between the two is clinically relevant because:
Mania could be serious enough to affect a teen’s functionality both at school and at home to the point that they would need to be hospitalized.
Hypomania is not quite as serious but can still affect behavior and can result in severe depression.
Why Does the Difference Matters?
Consider two Adolescents:
Adolescent A: Adolescent A goes through a phase of intense energy, lack of sleep, gets seriously impaired, acts impulsively, and ultimately needs medical care.
This sequence might meet the diagnosis of Bipolar I if all the symptoms of mania are fulfilled.
Adolescent B: Adolescent B has some days with an increased level of energy, lack of sleep, fast talking, increased self-confidence, but is still able to work without any impairment. Thus, following these symptoms, the adolescent experiences an episode of depression.
This sequence might fit the diagnosis of Bipolar II if a clinician confirms all the required criteria are met.
Bipolar I vs Bipolar II Depression
Depression occurs in both conditions; however, it is especially significant in Bipolar II.
A depressive episode in Bipolar II may include:
- Prolonged sadness
- Hopelessness
- Reduced energy
- Lack of interest
- Social isolation
- Lack of appetite
- Excessive sleeping or insomnia
- Attention difficulties
- Worthlessness
- Thinking about self-harm or suicide
NIMH reports that adolescents with bipolar disorder experience depressive episodes interfering with interpersonal relations, learning, energy levels, communication skills, and functioning.
It becomes a crucial diagnostic problem.
So, a teenager who suffers from bipolar II disorder will first show symptoms of major depressive disorder because it is the symptoms that bring him to the psychiatrist.
And if the patient was having hypomanic episodes previously, the psychiatrist will miss the diagnosis of bipolar disorder.
This is why psychiatrists always want to know about past episodes where the person showed increased energy, slept less, and talked too much.
Bipolar I vs Bipolar II Symptoms in Teens
Well, symptoms of bipolar disorder may differ between teenagers and adults, thus making diagnosis difficult.
For instance, irritability may be more evident in teens than happiness when he experiences episodes of being in a high mood.
This means that a teen becomes very argumentative, restless, short-tempered, and frustrated instead of simply looking happy.
As stated by NIMH, the symptoms of bipolar disorder among children and adolescents are similar to those of ADHD, anxiety disorders, major depression, and disruptive disorders.
Most importantly, the similarity of symptoms is one of the reasons why parents should not diagnose their teens using the internet.
Symptoms That Can Look Similar:
Bipolar I and Bipolar II have similar symptoms like:
- Changes in mood
- Changes in sleep
- Increases or decreases in energy levels
- Racing thoughts
- Concentration issues
- Irritability
- Depression
- Activity level changes
- Impulsivity
- Academic troubles
- Social relationship troubles
The important thing to note is the type and severity of the episode of elevation of mood.
Bipolar I vs II and School Performance
Effects of symptoms of Bipolar on learning are diverse.
In cases where the individual is experiencing a hypomanic condition, he is likely to have problems paying attention in class and complying with assignments given because his mind wanders away.
However, in cases where the individual is undergoing a depressive condition, he is likely to have problems owing to a lack of energy, motivation, and hopefulness.
Thus, this will make the individual perform inconsistently.
The learner may be performing very well for some time but all of a sudden stops doing assignments or attending classes.
However, this would not necessarily be associated with bipolar disorder.
Conditions such as ADHD, anxiety, depression, insomnia, substance abuse, learning disabilities, and trauma, among others, can lead to similar symptoms.
In the end, it takes a full evaluation to diagnose bipolar disorder.
Bipolar I vs II and Sleep Changes
Well, need for sleep is among the most helpful indicators in assessing the symptoms of bipolar disorder.
In cases of mania or hypomania, the adolescent may experience a decreased need for sleep.
However, don’t confuse it with insomnia. It is another thing.
In the case of insomnia, one would want to sleep but would be unable to.
In the state of mania or hypomania, an individual requires far less sleep while feeling highly energized at the same time.
For instance, an adolescent who usually gets eight hours of sleep may suddenly get only three or four hours of sleep and feel well-rested.
So, decreased need for sleep along with elevated energy levels can indicate a problem.
According to NIMH, decreased need for sleep is a common characteristic of manic states among teenagers.
Is Bipolar I More Serious Than Bipolar II?
The possibility of having severe manias is indeed higher in Bipolar I than in Bipolar II, but this does not mean that Bipolar II is not as severe.
So, this difference is crucial.
Whereas Bipolar I can result in severe impairment, hospitalization, or even psychosis, Bipolar II does not have manias, and the depressions can be severe enough to affect education, social functioning, and even endanger the patient’s safety.
For these reasons, it will be better to see them as two separate disorders or clinical variations, not as “bad” or “less bad” ones.
Is It Possible for Teenagers to Have Bipolar I or Bipolar II?
Yes. Bipolar disorder can develop in teenagers; however, there is a need for special caution when evaluating bipolar disorder in young people.
Teenagers undergo mood fluctuations naturally, but these are not the same as those of bipolar disorder. These are mostly at the onset of puberty.
According to NIMH, mood changes in bipolar disorder are marked by excessive mood swings in addition to alterations in sleep, energy, activities, thinking, or behavior.
What Complicates the Diagnosis?
Various disorders look similar to bipolar disorder in teens. This makes the diagnosis difficult.
These disorders include:
- ADHD
- Major depressive disorder
- Anxiety disorders
- Disruptive behavior disorders
- Substance-related disorders
- Trauma-related disorders
- Sleep disorders
According to the American Academy of Child and Adolescent Psychiatry (AACAP), the identification of bipolar disorder among children and adolescents poses difficulties as the symptoms are similar to that of other behavioral and mood disorders.
It is hence likely for a mental health practitioner to inquire about behavior over weeks, months, or even years from the parents or teenager.
How Is Bipolar Disorder Diagnosed in Teens?
Well, there is currently no blood test or brain scan that can be used to diagnose bipolar disorder.
Therefore, the diagnosis is based on symptoms, their severity and duration, the individual’s history, and how the symptoms impact daily functioning. Professionals can run other tests to rule out other possible causes for symptoms.
An evaluation may include:
- Mood changes
- Changes in sleep
- Energy changes
- Changes in speech
- Thinking processes
- Risky behaviors
- Scholastic performance
- Interpersonal relationship with family
- Past experiences of depression
- Past episodes of elevated moods
- Medications
- Substance abuse
- Family psychiatric history
How can parents help professionals in assessment?
Parents should document any noticeable changes rather than just going on what they remember.
The mood chart will record sleep, energy, mood, behaviors, and important life events.
Bipolar I vs Bipolar II Treatment
Well, management of both types typically involves the treatment of mood episodes, preventing any future episodes, and enhancing overall functionality.
Management includes:
- Medication
- Psychotherapy
- Family-focused psychotherapy
- Educating people about bipolar disorder
- Sleep and routine management
- School intervention
- Follow-up care
Medications:
Doctors may choose to prescribe drugs like mood stabilizers or specific atypical antipsychotics.
It will depend on the person’s symptoms, age, medical history, medication history, and reaction to the drug. Young people can have different reactions to medications. Therefore, doctors observe positive and negative effects carefully. According to research, patients shouldn’t refuse the prescribed medication without consulting their healthcare provider first.
Psychotherapy:
Therapy can assist teenagers in identifying their mood patterns and developing helpful techniques.
They include:
- Interpersonal and social rhythm therapy
- Psychoeducation
Therapy can assist teenagers in identifying their triggers, coping with stress, building positive relationships, and sticking to their routines.
According to NIMH, family-based therapy can be beneficial for adolescents and adults if used together with mood stabilizer therapy.
How Can Parents Support a Teen With Bipolar Symptoms?
Parents can help their teens by observing changes and facilitating access to help from professionals.
1. Watch for Patterns:
Parents can keep track of:
- Sleep
- Energy levels
- Mood
- Speech
- School attendance
- Risk-taking
- Social behavior
- Changes in medication
- Patterns can be more helpful than single incidents.
2. Ensure Regular Sleep:
Regularity of sleep and other routines might facilitate mood stabilization.
If a teenager drastically reduces their sleep at a time of high energy or unusual behavior, it is definitely worth paying attention.
3. Don’t Blame:
A teenager going through a mood episode cannot fully control themselves.
Don’t say:
“Why can’t you just control yourself?”
Instead, try saying:
“I see some major changes happening lately. Let’s discuss your experience.”
As a result, this will keep lines of communication open.
So, when symptoms affect daily activities and include harmful behaviors, professional assistance for bipolar disorder becomes especially crucial.
Only a pediatrician, psychologist, psychiatrist, or child and adolescent mental health care specialist will be able to determine what is going on.
The Bottom Line: Bipolar 1 vs. 2
In conclusion, the simplest thing to remember about these is that:
Bipolar I features mania. Bipolar II features hypomania and major depressive episodes, but no true mania.
Mania can become very serious, even requiring hospital treatment, and can include psychosis. Hypomania is not quite as serious but does still mark a significant shift from a person’s baseline state. Bipolar II cannot just be thought of as a less severe form of bipolar disorder, since episodes of depression can seriously impair someone.
So, special care must be taken in assessing teens, due to overlap with normal development and other disorders. The key is not labeling any mood shifts. The key is spotting problematic patterns before proper assessment can be done.
