Types of Bipolar Disorder — Bipolar I, II & Cyclothymia

Overview of Bipolar Types

Bipolar disorder exists on a spectrum. The three main types are distinguished primarily by the severity and duration of manic and depressive episodes.

Feature	Bipolar I	Bipolar II	Cyclothymia
Mania	Full manic episodes (≥7 days)	Hypomania only (≥4 days)	Hypomanic symptoms
Depression	Common but not required	Required (≥2 weeks)	Depressive symptoms
Duration	Episodes, not chronic	Episodes, not chronic	Chronic (≥2 years)
Severity	Most severe mania	Milder highs, severe lows	Less severe throughout
Psychosis	Possible during mania	Not in hypomania	No

Bipolar I Disorder

Bipolar I disorder is defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that immediate hospital care is needed. Depressive episodes occur as well, typically lasting at least 2 weeks.

Diagnostic Criteria (DSM-5)

At least one manic episode lasting ≥7 days (or any duration if hospitalization required)
Manic episode not better explained by schizoaffective disorder
May include hypomanic or major depressive episodes

Key Features

Manic episodes may include psychotic features (delusions, hallucinations)
Episodes often severe enough to cause significant impairment
May require hospitalization to prevent harm
Affects men and women equally

Bipolar II Disorder

Bipolar II disorder is defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes characteristic of Bipolar I. It is not a "milder" form of bipolar disorder—the depression is often more frequent and longer-lasting.

Diagnostic Criteria (DSM-5)

At least one hypomanic episode lasting ≥4 consecutive days
At least one major depressive episode lasting ≥2 weeks
No history of manic episodes

Key Features

Hypomania may feel good and boost productivity
Depression is typically the predominant mood state
Higher risk of suicide attempts than Bipolar I
Often misdiagnosed as unipolar depression
More common in women

Cyclothymic Disorder (Cyclothymia)

Cyclothymia is a milder form of bipolar disorder involving chronic fluctuating mood with periods of hypomanic and depressive symptoms. Symptoms don't meet the full criteria for hypomanic or depressive episodes.

Diagnostic Criteria (DSM-5)

Periods of hypomanic symptoms and depressive symptoms for at least 2 years (1 year in children/adolescents)
Symptoms present at least half the time
Never without symptoms for more than 2 months
Symptoms never meet criteria for major depressive, manic, or hypomanic episode

Key Features

Chronic, persistent mood instability
Risk of developing Bipolar I or II (15-50%)
Often goes undiagnosed or dismissed as "moodiness"
Can significantly impact quality of life

Other Specified and Unspecified Bipolar Disorders

Some people experience bipolar symptoms that don't fit neatly into the three main categories. The DSM-5 includes:

Other Specified Bipolar Disorder

This diagnosis applies when symptoms cause significant distress but don't meet full criteria for any specific bipolar type. Examples include:

Short-duration hypomanic episodes (2-3 days) with major depression
Hypomanic episodes without prior major depression
Short-duration cyclothymia (less than 24 months)

Unspecified Bipolar Disorder

Used when there's insufficient information for a specific diagnosis, but clear bipolar symptoms are present.

Which Type Do I Have?

Only a qualified mental health professional can diagnose bipolar disorder. Diagnosis is based on:

Comprehensive psychiatric evaluation
Detailed history of mood episodes
Duration and severity of symptoms
Ruling out other conditions

💡 Important Note

Many people with Bipolar II are initially misdiagnosed with unipolar depression because they seek help during depressive episodes. Always tell your doctor about any periods of elevated mood, increased energy, or decreased need for sleep—even if they felt productive or "good."