Bipolar 1 Disorder or Bipolar 2 Disorder – Which is Worse?


Bipolar one versus two which is worse
I’m dr. Tracey Marks, a psychiatrist and I publish weekly videos on mental health
and self-improvement. Today I’m going to be talking about the difference between
bipolar one disorder and bipolar two disorder and address the common
misconception that bipolar two is a milder form of bipolar one and therefore
probably less of a problem. Bipolar disorder is a mood disorder and it has
two states: depressive episodes and hypomanic or manic episodes. And manic
episodes are defined as the following and I’m going to read this because it’s
just too many words and it’s taken from our Diagnostic and Statistical Manual of
Mental Disorders the fifth edition. Here we go. A period of abnormally and
persistent, elevated, expansive or irritable mood and abnormally and
persistently increased activity lasting one week and present for most of the day,
nearly every day. And then you have to have three of the following or four if
your mood is irritable instead of elevated. Number one is inflated
self-esteem or grandiosity – decreased need for sleep, more talkative than usual
or pressure to keep talking. Number four flight of ideas or racing
thoughts, distractibility, increase in goal-directed activity or psychomotor
agitation. You just can’t stop doing things. Excessive involvement in
activities that have a high potential for painful consequences such as things
like going on buying sprees or getting involved in business investments.
Sometimes people become hyper sexual. Also the symptoms caused clinically
significant distress or impairment in various areas of your life not just one
little area. Hypomania has the same symptoms except they only need to last
for four days instead of a whole week. Another
main difference is that with hypomania the symptoms don’t cause any real
impairment and in other words you’re still pretty high-functioning. Now the
second part of bipolar disorder would be to have depression or depressive
episodes and I’ve talked in previous videos about depression and I’ll put a
link in the corner for you to reference Ii you want to watch that video. So
bipolar one would be having episodes of mania and depression. Bipolar 2 would be
episodes of depression and hypomania. If a person has delusions or any other
psychotic symptoms, it’s automatically considered mania versus hypomania
because with hypomania there’s no impairment. There’s a good chance that if
you have bipolar two disorder that you can go all of your life and never have
never be put in the hospital because of your bipolar disorder. But with bipolar
one, it’s very hard, pretty uncommon for someone with bipolar one to never have a
hospitalization because the manic episodes tend to be pretty destructive.
Now knowing that, it’s easy to conclude that bipolar one disorder is much worse
than bipolar two because the manic episodes can cause a lot of problems.
it’s kind of like a tornado ripping through and then you’ve got to clean up
all the damage. But the reason bipolar 2 is not merely a milder form of bipolar
one disorder is because people with bipolar 2 tend to have a more chronic
course to their illness. They also tend to spend more time depressed than the
people with bipolar 1 so bipolar 1 may be more intense but bipolar 2 can be
more chronic and persistent. Also the number of lifetime episodes of hypomania
and depression tend to be more for the person with bipolar 2 then the person
with bipolar 1. So did you get that? People with bipolar 2 tend to have a
more recurring episodes of depression than the person with unipolar
depression even. So in many ways although bipolar
two disorder may be less intense when it comes to the mania at least, it can just
create more overall dysfunction in the person’s life because of the lingering
and recurring depressive episodes. Now I said all this because I think in the
past we as clinicians have tended to think of bipolar two disorder is not
really that bad and that’s kind of trickled down to patients in the way
that they even think about their illness and may even feel like you don’t really
need to get treatment for it because it’s just not that bad. And I think this
is because we tend to focus on the intensity of the mania and seeing that
as more the thing to keep under control but depression can be pretty
debilitating and we’re not talking about like a hypo depression there’s no such
thing. The person with bipolar disorder will have not as severe of a manic
episode but they can have very severe depressive episodes so the depression is
still can be a big problem. And a reason to continue in treatment and to
maintain regular treatment to prevent the bottoming out episodes with a
depression. And a good medication regimen can help reduce the overall burden of
the illness by lessening the symptoms and maybe even decreasing the number of
recurring episodes that you have over time. Thanks for watching. Leave me a
comment if you have any questions or even if you don’t have any questions
leave me a comment just to say “hi.”

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