FAQ: Bipolar I vs. Bipolar II — What’s the Difference?
By Growth Era Counseling & Wellness
Understanding the Spectrum of Bipolar Disorder
If you or a loved one has been diagnosed with bipolar disorder, you might be trying to make sense of the terminology:
Bipolar I? Bipolar II? What do those even mean?
Although both fall under the umbrella of bipolar spectrum disorders, Bipolar I and Bipolar II are not the same — and understanding the differences can help you better navigate symptoms, treatment options, and healing paths.
At Growth Era Counseling & Wellness, we offer therapy services for individuals living with either Bipolar I or Bipolar II, and we’re here to walk with you — or your loved one — through diagnosis, treatment, and recovery.
Let’s break it down in a way that makes sense.
What Is Bipolar Disorder, Broadly?
Bipolar disorder is a mood disorder characterized by significant shifts in a person’s mood, energy levels, and ability to function. These shifts include episodes of:
Depression: deep sadness, low energy, hopelessness, loss of interest
Mania or hypomania: elevated or irritable mood, increased energy, impulsivity
The type of bipolar disorder a person is diagnosed with depends on the intensity and duration of these episodes — particularly the manic symptoms.
What Is Bipolar I?
Bipolar I is defined by the presence of at least one full manic episode. This may or may not be accompanied by depressive episodes.
Characteristics of a manic episode:
Elevated or irritable mood lasting at least 7 days (or less if hospitalization is required)
Increased energy or activity levels
Inflated self-esteem or grandiosity
Decreased need for sleep (e.g., feeling rested after only a few hours)
Racing thoughts, distractibility, or rapid speech
Risky or impulsive behaviors (e.g., spending sprees, risky sex, substance use)
Mania can significantly impair functioning and may require hospitalization — particularly if it includes psychotic features or leads to unsafe behavior.
Important note: People with Bipolar I may also experience depressive episodes, but these are not required for the diagnosis.
What Is Bipolar II?
Bipolar II involves at least one major depressive episode and at least one hypomanic episode, but no full manic episodes.
Hypomania (a milder form of mania):
Lasts at least 4 consecutive days
Involves increased energy, confidence, or productivity
Still noticeable to others but does not cause significant impairment
No psychosis, no need for hospitalization
While hypomania may feel productive or even enjoyable, it can still lead to risky decisions and emotional burnout. The depressive episodes in Bipolar II are often longer and more severe than those in Bipolar I.
Can People Be Misdiagnosed Between the Two?
Yes — this happens often.
Since hypomania can appear as high-functioning or go unnoticed, Bipolar II is frequently misdiagnosed as major depression. On the other hand, someone in a severe manic episode may not recall the full extent of their behavior, making accurate diagnosis difficult without thorough assessment and history-taking.
That’s why ongoing, supportive therapy can be such a powerful tool — to monitor symptoms over time and adjust treatment accordingly.
Treatment Options for Bipolar I and II
Both forms of bipolar disorder benefit from a combination of therapy, medication, and lifestyle support. Here’s what that can look like:
Medication (managed by a psychiatrist or medical provider):
Mood stabilizers (e.g., lithium, lamotrigine)
Antipsychotics (especially for Bipolar I)
Antidepressants (used carefully and typically alongside mood stabilizers)
Therapy (offered at Growth Era Counseling & Wellness):
Identifying early warning signs of mood episodes
Developing mood tracking and self-awareness tools
Learning emotion regulation, boundary-setting, and self-care practices
Navigating shame, relationships, or identity issues that may arise
Addressing trauma or grief, which may co-occur with bipolar symptoms
What We Offer at Growth Era Counseling & Wellness
While we do not prescribe medication, our therapists work closely with clients living with Bipolar I and Bipolar II to provide:
Evidence-based therapy tailored to mood disorders
Collaboration with medical providers and psychiatrists for coordinated care
Trauma-informed support
A space where your diagnosis doesn’t define you — it empowers your self-understanding
We believe that living with bipolar disorder is not a life sentence — it’s a part of your story, and therapy can help you write the next chapter with more clarity, confidence, and support.
Have Questions or Need Support?
- Serving clients across the state of Connecticut
- Therapists experienced in treating both Bipolar I and Bipolar II
- Learn more about us and our approach