Experiencing Bipolar I and Bipolar II
Definitions, Symptoms and Experiences With the Mental Illness
Bipolar Disorder is a serious and potentially crippling disease that causes extreme mood swings in the sufferer. Although the differences in severity and symptoms of Bipolar make the disease more of a spectrum than a concrete illness, the illness is separated into four categories for sake of study and treatment.
The four categories of Bipolar Disorder are:
- Bipolar I
- Bipolar II
- Cyclothymia
- Bipolar Not Otherwise Specified (NOS)
J.D., a diagnosed Bipolar sufferer, says "Bipolar Syndrome is the ruling factor in every part of my life. Everything I do, I have to second guess because I don't know if it is me or my emotions acting."
J.D. was diagnosed with Bipolar II at age 14, eventually becoming re-diagnosed with Bipolar I. Since his diagnosis, this Bipolar patient has studied the disease since then, both from the inside and outside, that he might better understand his own experiences, which he has shared in an attempt to educate others about the psychological disorder. He has agreed to share his unique experiences in an attempt to help others understand how Bipolar Disorder affects the patient's life, while shedding light on the individuality of each incident of Biploar Disorder.
Bipolar I Involves At Least One Manic Episode
Bipolar I is the classic Bipolar Disorder that people imagine when thinking of the disease. According to The Diagnostic and Statistical Manual of Mental Disorders (DSM), the criteria for Bipolar I Disorder includes:
- One to multiple manic episodes at the time of diagnosis.
- Zero to multiple hypomanic episodes at the time of diagnosis.
- Zero to multiple major depressive episodes at the time of diagnosis.
Although Bipolar I often contains both depressive episodes and manic episodes, it is the presence of manic episodes that separates Bipolar I from Bipolar II. According to the National Institute of Mental Health (NIMH), some symptoms of a manic episodes include:
- A prolonged feeling of being “high,” or abnormally happy;
- A prolonged feeling of being irritable, anxious, or “wired;”
- Racing thoughts;
- Distractibility;
- Impulsive behavior such as stealing or PICA;
- Uncontrolled anger; and
- Irrational thought and paranoia.
J.D. experienced his first manic episode as a teen, and has had a few since. He characterizes the sensation as “being locked completely in your own mind. You follow a thought down the rabbit hole, unable to catch it, and you become lost inside the maze of your own mind.”
Extreme cases of Bipolar I can also include “mixed states.” According to WebMD, a "mixed state" involves the rapid cycling of moods; the patient will shift back and forth between manic and depressive states, and at times, the Bipolar patient may experience these states simultaneously. It's believed the "mixed state" is experienced by about 10% to 20% of Bipolar sufferers.
J.D. says he has never suffered a true mixed state episode, though he reports fairly rapid cycling at times. He explained, "I've seen people with mixed state cycling before, and it's nightmarish. I wouldn't wish that upon anyone."
Bipolar II Involves at Least One Major Depressive Episode
Bipolar II is similar to Bipolar I in that the patient will experience periodic mood swings – high highs and low lows. The difference is that, in the case of Bipolar II patients, the highs are not as severe. The DSM's criteria for Bipolar II includes:
- Zero manic episodes at the time of diagnosis;
- One to multiple hypomanic episodes at the time of diagnosis; and
- One to multiple major depressive episodes at the time of diagnosis.
Hypomania is a minor manic episode. According to the DSM, it is “A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least four days, that is clearly different from the usual non depressed mood.” The intensity is not as bad as with an manic episode.
J.D. usually has one or two hypomanic episodes during the year. For some reason, he almost always has one around the end of May. He finds that they are also caused by stress or external incidents, which WebMD confirms as fairly common saying, "Environmental stressors also play a role in triggering bipolar episodes in those who are genetically predisposed."
Bipolar II also contains major depressive episodes. Because of the presence of depression and the lack of mania, Bipolar II is often misdiagnosed as Major Depression.
J.D. says that he experiences two or three depressive episodes during the year. In fact, J.D. explained that he always experiences a depressive episode in mid-November; he believes these depressive episodes are triggered by stress and sometimes, by physical ailments. He described the episodes as “a crushing weight upon your body and head, and the more you struggle to lift it, the heavier it gets.”
Bipolar I and Bipolar II are not the only classifications of Bipolar Disorder. Bipolar Disorder should be understood as a spectrum, with each the disorder manifesting differently in each person. This is why Bipolar Disorder is sometimes so difficult to diagnose and treat: Each patient and their challenges are as different as the individual.
The Many Colors of the Bipolar Spectrum
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