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



Bipolar disorder 1 vs 2, which is worse? There is a common misconception that bipolar 2 is a milder form of bipolar 1 and therefore probably less of a problem. This can lead to people feeling as though they don’t need to get treatment if they have bipolar disorder. In this video I give you the definitions of bipolar 1 and bipolar 2 disorders.

Bipolar disorder is a mood disorder that has two states. Depressive episodes and manic or hypomanic episodes. Manic episodes are defined as the following according to the diagnostic and statistical manual fifth edition
A period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day.

And then you have 3 of the following: or 4 if your mood is irritable instead of elevated
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or racing thoughts
5. Distractibility
6. Increase in goal-directed activity or psychomotor agitation
7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

Hypomania is the same thing has the same symptoms except that they only need to last for four days. Also a second main difference with hypomania is that the symptoms don’t cause real impairment in your functioning.

The reason bipolar 2 is not really a milder form of bipolar 1 is because people with bipolar 2 disorder tend to have a more chronic course to their illness. They tend to spend more time depressed than 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 tends to be more for bipolar 2 disorder than for bipolar 1 disorder or major depression.

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25 Comments

  • cellogirl11RW

    I have heard that I have Bipolar 1, and I have also heard Bipolar 2 because I have experienced full-blown mania, where I was in the hospital, and I have also experienced the rapid cycling of type 2. Is it possible to go back and forth between the two types?

  • LisiLisichan

    I have Bipolar 2 with rapid cycling. I take medication for it. The hypomania is like riding a wave for me, yes it can be exhausting but also fun. I have rules for that time to at least stop me from spending all my money. I don't own a credit card (not necessary in germany). And I tell my partner and leave most of my money at home. Also my bankcard stays home and hidden, till it wears off. The depressions are hard.

  • Cassandra Humphreys

    Hi there, can you please help with a discussion around work? I have been diagnosed with bipolar and I am struggling with work, I had quit a very good job just at the start of this year now only a few months into another good position I want to quit I feel it is a trigger as I am feeling trapped by the limits of the job and I don’t know what to do.

  • Samantha James

    Hi! I’m not sure how often you read comments, especially from videos so long ago, but I’m wondering about talking about diagnoses generally. So if I’m diagnosed with BIPOLAR II and BPD, do I still say I have major depressive disorder too? I’m wondering for things such as participating on a small panel etc.

  • Dominique René Bounds

    Yea I had 2 manic episode 10 years ago when I was 19 and I’ve been stuck with the diagnosis since. I was even in full remission for the last four years now partial remission. 2 episodes of mania earned me a lifetime diagnosis. Ugh. Becoming a psychiatrist or psychologist is going to be interesting with the huddle jumping.

  • Gled Wood

    The best way I've heard it put (re the depression) is that bipolar 1 depression is more like a broken leg — it's really bad but it goes away. Bipolar 2 depression is more like chronic arthritis — maybe not as bad but it's there so much more of the time.

  • jayehawk88

    I was diagnosed 5 years ago with Bipolar Ii, OCD, Generalized Anxiety Disorder and Social Anxiety Disorder. I believe I have rapid cycling bipolar as well. My question is this, what does it mean when my depression is soooo bad every time to the point I’m suicidal? I’m currently on lamictal as a mood stabilizer and my doc wants to add lithium. I’m scared of the side effects (mostly weight gain and thyroid/kidney issues)! Is it worth trying to help with the depressions?

  • Britta Olson

    Can criminal behavior be part of the “behavior with high potential for negative consequences?” In my manic episodes I have decided I don’t have to do the things others have to do to find success and that I should be a “hustler.” When I am more rational and less grandiose and do not have elevated mood, it is easy to see the error of criminal thinking. Then I feel like a fool. With time and treatment, I have learned to avoid these pitfalls more and more of the time. Am I correct in thinking my criminal behavior (for which I certainly suffered consequences, let me tell you) could be a manifestation of My Bipolar 1 Disorder? Have you seen this in other patients?

    Edit: I have, through a dual diagnosis CD treatment, received an accurate diagnosis and treatment since 2015. I have since returned to school (part time) and some employment, and have been building stability and understanding of my disorder. Knowledge and treatment has set my life, and thinking, on another course, and my ego is no longer inflated by getting away with something. I want to earn respect, and have learned you can’t steal it or hustle it up! And the most empowering thing is knowing I don’t HAVE to. Folks, never give up on yourself (and engaging in criminal behavior is giving up on yourself or, at least, putting yourself at unnecessary risk). We are all worth more than that, whatever our obstacles. By seeking out help and guidance. I’ve gained a lot…and had not much to lose.

  • A Fate So Twisted

    I have been diagnosed with Bipolar 1, but I have severe depressive episodes. I don't think you can really put anybody in a specific category. Everybody is different. I lost my husband to a car accident in 2011 and it has been hard to hold myself together since then. He kept me on solid ground for years. When he died, I knew I wasn't going to be okay for very long.

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