What is the difference between Biphasic Type I and Biphasic Type II disorders?

What is bipolar disorder?

Bipolar disorder is characterized by periods of extreme mood swings, including manic or hypomanic episodes, and usually involves periods of depression. Although a parent or sibling with bipolar disorder does not guarantee that someone will have these symptoms, this diagnosis has a strong genetic component.

Bipolar disorder is a treatable disease. Some therapies and drugs can reduce symptoms and improve quality of life. However, being diagnosed with bipolar disorder can be frightening and confusing. Knowing the different types can help determine the treatment path that is best for you.

This article describes the differences between Bipolar Type I and Bipolar Type II disorders, and discusses the available treatment options for each disease.

Biphasic I and Biphasic II disorders

Let’s take a look at some of the main differences between Biphasic Type I and Biphasic Type II disorders. Although everyone can be debilitating, each of them has unique symptoms. This article will further explain more detailed information about these symptoms.

Bipolar Type I Disorder

  • Include at least one complete history of manic episodes

  • Usually related to depressive episodes

  • May include psychotic features in the context of mood episodes

What is bipolar disorder type I?

According to the “Diagnostic and Statistical Manual of Mental Disorders, 5th Edition” (DSM-5), to be diagnosed with type I bipolar disorder, they must have at least one history of manic episodes.

Manic episodes consist of at least one week and involve three or more of the following:

  • Inflated self-esteem or arrogance
  • Reduce sleep needs
  • A more talkative or stressful speech than usual
  • Racing idea or the flight of ideas
  • Increase concentration
  • Exciting sports or increasing goal-oriented activities
  • Engaging in dangerous activities, including physically dangerous choices, impulsive buying frenzy, or unsafe sex

The incident must cause damage and may require hospitalization due to unsafe behavior. People who experience a manic episode due to bipolar I disorder may experience hallucinations or delusions.

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What is bipolar type II disorder?

Bipolar type II disorder is usually associated with a major depressive episode and at least one hypomanic episode. According to DSM-5, a hypomanic episode consists of three or more symptoms of a manic episode that lasts four days or longer.

Hypomanic episodes are not as severe as manic episodes because of their shorter duration. Hypomanic episodes do not include delusions or hallucinations.

Bipolar II disorder is not as severe as bipolar I disorder because hypomanic episodes are not as strong as manic episodes and cause less damage. However, any diagnosis can lead to dysfunction. Both of these conditions are treatable, and evidence-based interventions can be selected.

Depressive symptoms and bipolar disorder

Although most people diagnosed with bipolar disorder will experience depressive symptoms, if a person has experienced a complete manic episode, the diagnosis of bipolar I disorder does not require a history of major depressive episodes.

The diagnosis of bipolar II disorder requires a history of at least one depressive episode.

A major depressive episode consists of five or more symptoms lasting two weeks or longer, including depression or loss of interest:

  • Daily or almost daily depression lasts most of the day
  • Decreased or disappeared interest in activities
  • Significant weight loss or loss of appetite
  • Difficulty sleeping or increased sleep needs
  • Body restlessness
  • Fatigue or low energy almost every day
  • Feelings of worthlessness or guilt
  • Difficulty concentrating or indecision
  • Thoughts of death or suicidal ideation


Both bipolar type I and bipolar type II disorders are mood disorders characterized by extreme highs and lows. You and your treatment team will work together to develop a treatment plan that suits your unique needs.

Although there are some differences in the recommendations for bipolar type I and bipolar type II disorders, the recommendations for the two diagnoses are similar. Treatment options include:

  • Medication: The manic symptoms of bipolar type I and bipolar type II bipolar disorder are treated with a class of medications called mood stabilizers. Because the use of SSRI antidepressants may cause hypomania in bipolar patients, they should only be prescribed after a person has taken an effective, stable dose of mood stabilizer. In addition, patients with bipolar I disorder with psychotic symptoms may require antipsychotic drugs. Doctors usually prescribe multiple drugs to treat different symptoms of bipolar disorder.
  • Psychotherapy: Individual or group therapy services can help patients with bipolar disorder learn skills to cope with emotional symptoms, improve their interpersonal communication, and better understand their experiences with this disorder.Evidence-based therapies for bipolar disorder include cognitive behavioral therapy As well as interpersonal relationship and social rhythm therapy.
  • Hospitalization: Both mania and depressive episodes can trigger suicidal ideation or behavior. Hospitalization may be required to stabilize medications or to keep someone safe when they are in a suicide crisis. Bipolar II does not require hospitalization.

Bipolar disorder usually requires long-term treatment. Even if the emotional symptoms stabilize, continuous treatment is essential to prevent recurrence. Medication management can reduce the risk of future mania, hypomania, or depressive episodes.

In addition, treatment is most effective when the client does not have an immediate crisis. Treatment services provided when the individual’s condition is stable are important for long-term improvement.

Prevention is an important treatment for these two diseases. There is evidence that manic episodes damage the gray matter in the brain, destroy brain cells, and affect the temporal lobe and cerebellum (the part of the brain that is related to memory and coordination).

Clients must submit any issues related to ongoing medications or treatments to their treatment team and must not change or stop medications without the supervision of a prescribing doctor.

Cyclic Disorder: Biphasic Type III Disorder

In addition to bipolar I and bipolar II disorders, circulatory disorders also include hypomania and depressive symptoms. In layman’s terms, cyclic mental disorder is sometimes referred to as “bipolar type III disorder.” The diagnosis includes persistent hypomanic and depressive symptoms, but does not meet the diagnostic criteria for hypomanic or depressive episodes.

For the diagnosis of circulatory disorder, individuals may have some depressive symptoms, such as low mood or loss of interest in activities, but these symptoms do not meet the diagnostic criteria for major depressive episodes. They may also experience symptoms of hypomania, such as a rush of thoughts or reduced sleep requirements, but they will not experience a complete hypomanic episode. This may be because the number of symptoms does not meet the criteria or the duration of the onset is too short to be diagnosed as bipolar type I or bipolar type II disorder.

Coping with bipolar disorder

Normally, people with bipolar disorder experience one or two episodes a year, but those who experience “rapid cycles” experience four or more episodes within 12 months.

Being consistent with how you feel and recognizing whether symptoms are increasing is an important part of life with bipolar disorder. Noting that a seizure may be imminent, controlling stress levels, and identifying and avoiding what triggers the seizure can help control symptoms and maintain stability.

Having a treatment team composed of professionals you trust is important to control symptoms. Candid communication about your symptoms and stressors is an important part of treatment.

Mood disorders, including bipolar I and bipolar II disorders, are stigmatized, but both conditions are highly treatable. People suffering from these diseases can get effective treatment, stabilize and lead a fulfilling life.