Types of bipolar disorder
Find out about the different types of bipolar disorder and the symptoms to look out for.
Bipolar disorder can affect people in different ways. Rather than being a single, uniform condition, it includes several recognised types, each involving its own pattern of mood changes.
All types of bipolar disorder involve shifts in mood, energy and behaviour. Some people experience very intense highs or lows, while others experience milder but still disruptive changes in mood.
Understanding the different types of bipolar disorder can help you make sense of what you’re experiencing and what support may be helpful. Effective treatment options are available for every type of bipolar disorder.
What is bipolar disorder?
Bipolar disorder is a mental health condition that affects your mood. People with bipolar disorder experience periods where their mood becomes unusually elevated or energised, known as mania or hypomania, as well as periods of depression.
These mood episodes can affect how you think, feel and behave. They may influence your sleep, energy levels, concentration and decision-making.
Everyone’s experience of bipolar disorder is different. Doctors typically look at the pattern of mood changes over time to make a diagnosis. While symptoms vary between individuals, a key feature of bipolar disorder is experiencing episodes of mania or hypomania. This is what distinguishes bipolar disorder from depression on its own.
The four main types of bipolar disorder
The type of bipolar disorder you’re diagnosed with depends on the pattern and intensity of the mood episodes you experience.
Bipolar 1 disorder
You may be diagnosed with bipolar type 1 if you’ve experienced at least one episode of mania lasting longer than one week, or an episode severe enough to require hospital treatment.
- Symptoms of mania may include:
- Extremely elevated or irritable mood
- Increased energy and reduced need for sleep
- Rapid speech and racing thoughts
- Grandiose ideas or unrealistic beliefs about your abilities
- Impulsive or risky behaviour
- In some cases, psychosis such as hallucinations or delusions
Depressive episodes can also occur in bipolar 1 disorder, although they are not required for diagnosis. Mania in bipolar 1 is typically more severe and can significantly disrupt daily life.
Bipolar 2 disorder
Bipolar type 2 is diagnosed when someone has experienced at least one hypomanic episode and one major depressive episode.
Hypomania is similar to mania but less severe. It usually does not require hospitalisation and does not involve psychosis. Symptoms may include increased energy, confidence and productivity, but without the level of impairment seen in full mania.
In bipolar 2 disorder, depressive episodes are often more frequent, prolonged or severe. Because hypomania may feel less disruptive, bipolar type 2 is sometimes initially misdiagnosed as depression.
Cyclothymia (cyclothymic disorder)
Cyclothymia is a long-term condition that involves ongoing mood instability.
You may be diagnosed with cyclothymia if you’ve experienced repeated periods of hypomanic and depressive symptoms over at least two years. However, these symptoms are not severe enough to meet the diagnostic criteria for bipolar 1 or bipolar 2 disorder.
Although cyclothymia is sometimes considered a milder form of bipolar disorder, it can still significantly affect relationships, work and overall wellbeing.
Rapid cycling bipolar disorder
Rapid cycling is not a separate diagnosis but a pattern that can occur in bipolar type 1 or bipolar type 2 disorder.
It is defined as experiencing four or more mood episodes within a 12-month period. These episodes may be manic, hypomanic or depressive.
Rapid cycling can feel unpredictable and exhausting and often requires careful treatment planning and monitoring.
Other specified or unspecified bipolar disorder
Some people experience symptoms of mania, hypomania or depression but do not meet the full diagnostic criteria for bipolar 1 disorder, bipolar 2 disorder or cyclothymia.
In these situations, clinicians may use the terms other specified bipolar disorder or unspecified bipolar disorder.
Although the diagnostic criteria differ, the symptoms can still have a significant impact on daily life and may benefit from treatment and support.
What are the most common types of bipolar disorder?
Out of the four types of bipolar disorder, the most common diagnoses are bipolar type 1 and bipolar type 2. We explore these in more detail below.
What is the difference between mania and hypomania?
Understanding the difference between mania and hypomania helps explain how different bipolar diagnoses are made.
Mania
- Severe mood elevation or irritability
- Lasts at least seven days, or requires hospital treatment
- May include psychosis
- Often causes significant disruption to work, relationships or safety
Hypomania
- Milder elevation in mood and energy
- Lasts at least four days
- Does not involve psychosis
- Less likely to cause severe impairment
Both mania and hypomania involve noticeable changes in mood and behaviour. You may feel unusually energised, require less sleep than usual or feel more active and driven than normal.
The key difference is intensity. Mania tends to be more severe and disruptive, while hypomania is milder but still represents a clear shift from your usual mood.
How bipolar disorder is diagnosed
To receive a diagnosis of bipolar disorder, you will usually have a comprehensive psychiatric assessment. A specialist may explore:
- Your mood history and patterns of episodes
- The duration and severity of symptoms
- Whether there is a family history of mental health conditions
- Whether other conditions could explain your symptoms
Diagnosis is based on a detailed assessment rather than a single test. Although it can be tempting to self-diagnose, several mental health conditions can involve mood changes, so speaking with a qualified professional is important.
Treatment for different types of bipolar disorder
Treatment is tailored to the individual rather than based solely on the type of bipolar disorder diagnosed. The aim is to help stabilise mood, reduce the likelihood of future episodes and support overall wellbeing.
Medication
Medication is often an important part of treatment. Options may include:
- Mood stabilisers such as lithium
- Antipsychotic medication for mania or psychosis
- Antidepressants, sometimes used for depressive symptoms alongside a mood stabiliser
Your doctor will work with you to find the most appropriate medication plan and may adjust treatment over time.
Psychological therapies
Therapy can help you understand your mood patterns and develop practical coping strategies. Approaches may include:
- Cognitive behavioural therapy (CBT)
- Psychoeducation about bipolar disorder
- Relapse prevention planning
- Family-focused therapy to improve communication and support
For many people, therapy works alongside medication to support longer-term mood stability.
Inpatient support
In some situations, symptoms of bipolar disorder can become severe, particularly during episodes of mania, psychosis or deep depression. In these cases, a higher level of support may be recommended.
Inpatient treatment provides a safe and structured environment where you can receive round-the-clock support from a team of mental health professionals. This may include medication management and therapeutic support to help stabilise symptoms during more acute periods.
Ongoing management
Managing bipolar disorder is usually an ongoing process focused on maintaining stability and reducing the risk of future episodes. This may include:
- Regular check-ins with a psychiatrist
- Recognising early warning signs that your mood may be changing
- Developing consistent daily routines
- Prioritising healthy sleep habits
With the right support and strategies in place, many people with bipolar disorder are able to maintain stable and fulfilling lives.
When to seek help
It may be helpful to speak to a professional if:
- Changes in your mood are affecting your relationships, work or safety
- You experience symptoms of mania or severe depression
- You notice a repeating pattern of mood highs and lows over time
If you are experiencing suicidal thoughts or symptoms of psychosis, seek urgent support by calling 999 or going to your nearest A&E department.
Getting support early can help you access appropriate treatment and manage symptoms more effectively.
Get support for bipolar disorder at Priory
At Priory, we provide specialist assessment and treatment for all types of bipolar disorder.
Your care begins with a comprehensive mental health assessment, where we explore your symptoms and history in detail.
Treatment options may include outpatient therapy, online sessions, day care programmes or inpatient support, depending on your needs.
Our experienced psychiatrists and therapists work together to create personalised care plans focused on stabilising mood and supporting your long-term wellbeing.
If you are concerned about bipolar disorder, speak to our team today to explore your treatment options.
