People with bipolar I disorder experience mania differently than those with bipolar II disorder. People with bipolar I disorder may also not have major depressive episodes, while all people with bipolar II disorder do.

Most people have emotional ups and downs from time to time. But if you have bipolar disorder, your moods can reach very high or low levels.

Sometimes, you may feel immensely excited or energetic. Other times, you may find yourself sinking into depression. Some of these emotional peaks and valleys can last for weeks or months.

There are four basic types of bipolar disorder:

Bipolar I and II disorders are more common than the other types of bipolar disorder. Read on to learn how these two types are alike and different.

Mood episodes are the hallmark of both types of bipolar disorder. The highs are known as manic episodes. The lows are known as depressive episodes.

Not all types of bipolar disorder have episodes of depression.

The main difference between bipolar I and bipolar II disorders is in the severity of the manic episodes.

A person with bipolar I will experience an episode of mania, while a person with bipolar II will experience a hypomanic episode (a period less severe than a full manic episode).

A person with bipolar I may or may not experience a depressive episode, while someone with bipolar II will experience a major depressive episode.

What is bipolar I disorder?

You must have had at least one manic episode lasting 7 days or more to receive a bipolar I disorder diagnosis. A person with bipolar I disorder may or may not have a major depressive episode. The symptoms of a manic episode may require hospital care.

Manic episodes are usually characterized by the following:

What is bipolar II disorder?

Bipolar II disorder involves a major depressive episode lasting at least 2 weeks and at least one hypomanic episode. People with bipolar II disorder typically don’t experience manic episodes intense enough to require hospitalization.

Doctors sometimes misdiagnose bipolar II disorder as depression since depressive symptoms may be the primary symptom when the person seeks medical attention. When there are no manic episodes to suggest bipolar disorder, the depressive symptoms become the focus.

Which is more serious — bipolar I or bipolar II?

Most people think of bipolar I as the more severe condition since manic episodes can be more intense and require hospitalization. Bipolar I may often be more challenging to treat, too.

However, research suggests that depressive episodes in bipolar II may be more frequent and longer than in bipolar I and persist longer through life.

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As mentioned above, bipolar I disorder involves episodes of mania and may involve depression, while bipolar II disorder includes hypomania and depression. Here’s what these symptoms mean:


A manic episode is more than just a feeling of elation, high energy, or distraction. During a manic episode, mania can interfere with daily activities.

People having an episode of mania may make some “irrational” decisions, such as spending large amounts of money they can’t afford. They may also engage in behaviors that could have harmful consequences.

An episode is not considered manic if caused by outside influences such as alcohol, drugs, or another health condition.


A hypomanic episode is a period of mania less severe than a manic episode. However, in a hypomanic episode, behaviors still differ from your usual state. The differences will be extreme enough that people around you may notice.

Officially, an episode isn’t considered hypomania if it’s influenced by drugs or alcohol.


Depressive symptoms in someone with bipolar disorder are like those of someone with major depressive disorder. They may include extended periods of sadness and hopelessness. You may also experience a loss of interest in people you once enjoyed spending time with and activities you used to like.

Other symptoms include:

  • tiredness
  • irritability
  • trouble concentrating
  • changes in sleeping habits
  • changes in eating habits
  • thoughts of suicide

Cyclothymia is another type of bipolar disorder. People with cyclothymia also experience high and low moods, though they are not often as severe. Your moods may be high or low, but they don’t meet the criteria for a full hypomanic or depressive episode.

The following chart summarizes the key differences in symptoms:

Bipolar I disorderyesmaybemaybe
Bipolar II disordernoyesyes
Cyclothymianomild; not full episodemild; not full epsidoe

A psychiatrist or other mental health professional typically diagnoses bipolar disorder. The diagnosis will include a review of both your medical history and any symptoms you have that are related to mania and depression. A trained professional will know what questions to ask.

It can be very helpful to bring a partner or close friend with you during the doctor’s visit. They may be able to answer questions about your behavior that you may not answer easily or accurately.

If you have symptoms of bipolar I or bipolar II, you can always start by telling your doctor. Your doctor may refer you to a mental health specialist if your symptoms appear serious.

A blood test may also be part of the diagnostic process. There are no markers for bipolar disorder in the blood, but a blood test and a comprehensive physical exam may help rule out other possible causes for your behaviors.

Doctors usually treat bipolar disorder with a combination of medications and psychotherapy.

Medications may include:

Doctors may also prescribe antipsychotics to treat manic episodes or psychosis. While people with either type of bipolar disorder can experience psychosis, it’s more common in bipolar I disorder.

Your doctor may start you on a low dose of whichever medication you both decide to use to see how you respond. You may eventually need a stronger dose than what they initially prescribe. You may also need a combination of medications or different medications to manage symptoms.

All medications have potential side effects and interactions with other drugs. If you’re pregnant or taking other medications, be sure to tell your doctor before taking any new medications.

Writing in a diary can be an especially helpful part of your treatment. Keeping track of your moods, sleeping and eating patterns, and significant life events can help you and your doctor understand if therapy and medications are working.

If your symptoms worsen or don’t improve, your doctor may order a change in your medications or a different type of psychotherapy.

Online therapy options

Read our review of the best online therapy options to find the right fit.

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With proper treatment and support from family and friends, you can manage bipolar disorder symptoms and maintain your quality of life.

It’s important to follow your doctor’s instructions regarding medications and other lifestyle choices. This includes guidance related to:

Including your friends and family members in your care can be especially helpful.

Resources for support

Support groups, both online and in person, can be helpful for people with bipolar disorder. They can also be beneficial for your friends and relatives. Learning about others’ struggles and triumphs may help you overcome challenges.

Options for support include:

You can also discover materials for caregivers and loved ones of those with bipolar disorder.

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The main difference between bipolar I and II is the severity of symptoms.

People with bipolar I disorder experience more severe highs (mania) and may not have depressive episodes. While people with bipolar II experience a less severe high (hypomania), their diagnosis includes depressive episodes.

The following chart summarizes the key differences:

Bipolar IBipolar II
PsychosisMore likelyLess likely
HospitalizationYes, especially during manic episodesPossible during depressive episodes
TreatmentMood stabilizers, therapy, antipsychoticsMood stabilizers, therapy

If you have a diagnosis of bipolar I or bipolar II, remember that this is a condition you can manage. You aren’t alone. Talk with your doctor or call a local healthcare center to find out about support groups or other local resources.