Types of Bipolar Disorder

I think most people don’t know much about Bipolar Disorder, let alone that there may be variant themes and different sorts of the disease. The usual concept, I believe, is of a person who loses control of themselves and commits acts that are in stark contrast to what society thinks is acceptable or “normal” behaviour and often must be hospitalized in order to help them and keep them segregated from society. This is what is typically called Bipolar I the one most people think of when they do it at all. It’s the lurid story in the headlines that gets the attention of the media and usually involves something illegal or immoral and truly frightening. This is far from the truth. Most people with Bipolar of any sort are regular people who have a severe illness but may be your friends and neighbors. So give us a chance.

There are many ways in which to have a Bipolar Disorder and there are many people who are now considering the concept of a Spectrum of Illnesses that make up Bipolar and they’re not all so shocking, but are all devastating. In the upcoming Diagnostic and Statistical Manual V I believe that some attention will be paid to this spectrum  and things will shake out a bit differently than the usual. As it stands you can usually be diagnosed with either Bipolar I or Bipolar  II and there are some possibilities of Bipolar NOS, or Not Otherwise Specified or perhaps Cyclothymia, a sort of the illness that is more focused on depression than manias, as I understand it. But the new thinkers also allow for blends of these disorders and find that not all of us fit neatly into a single category of one or the other.

I myself was first diagnosed with Bipolar II with Rapid Cycling and Mixed States. Now this is somewhat odd because in order to have Mixed States you have to have a situation where you are both Manic and depressed at the same time, something with which I am most familiar. However the DSM says that this means I must be Bipolar I, a designation that some psychiatrists have also given me. I was also diagnosed with Bipolar NOS at a hospital that didn’t know what to do with me. But I think I fit best with Bipolar II. Some people refer to us as the “less serious ” form of Bipolar or as “Soft Bipolar “, a position I take strong issue with. Any illness that totally turns lives upside down is anything but Soft or Lesser than another one that is so similar.

The difference seems to be in the matter of Manias. I have indeed had periods where if I had been “caught out” in my manias, I would have been hospitalized and given a diagnosis of Bipolar I. But I’ve never been caught, so I’ve been given the one of Bipolar II instead, because that could be seen by the attending Psychiatrist who saw me.  When I tried to kill myself in 1980 they just called it depression and didn’t even keep me in the hospital for the requisite 3 days. Sheesh! I’ve been lucky I guess, or have I? If it’s so iffy why the big differences?

Because what I do have is what’s called Hypomania, where you are flying just below the radar of Mania. That’s why I feel accepting of the Bipolar II as my diagnosis. I haven’t flown too high to get caught. Though I’ve crashed often and hard at times. Before the Mixed State Episode where I finally crashed for good in 1995 I would find that I was frequently intensely creative and sometimes brilliant, and I’m not trying to blow my horn, just facing facts that others have told me about. I’d have tons of energy and still am highly sexual and feel like I can move the world and accomplish anything I set out to do and often I have. I’ve created a number of businesses and venues that have been very successful, tho I’ve never done well at making money because I’ve worked for community service organizations mostly and they don’t pay well I’m afraid. But that’s been my choice and I don’t regret it. I’ve been very lucky in that I’ve had these opportunities and in many ways am a  typical entrepreneur. All this could be true of someone with Bipolar I as well tho and I’m trying to show some differences. I guess it’s that I’ve chosen to be hospitalized and never forced into it by lack of control. I’ve had just the right luck and situations to stay below that radar I talked about.

But there are other factors in Bipolar II that we suffer from differently than Bipolar I. Mostly we have much more severe and frequent depressions than Bipolar I and that’s where I really  find my niche. I slide down into suicidal ideation and depression at the drop of a hat. The rapid cycling I was talking about earlier means that I cycle from hypo/mania to depression in the blink of an eye at times and can do nothing to stop it. So I suffer the degradations of severe depression and have come close to dying and have been hospitalized because of it. I have lost many of my friends too because of it and it’s ruined my life in many ways and I am lucky to be alive now and writing this blog to you.

I think Bipolar II is also sneakier than Bipolar I. It’s not as obvious and we have symptoms that are more elusive and that are hard to pin down, like anxiety and nervousness and panic attacks and agoraphobia and feelings of impending doom and the like. Subtle stuff sometimes. Lots of very subtle stuff. It’s a hard disease to live with and harder still to survive with. Not everyone even believes it’s real, including a lot of doctors. They fob us off as simply depressive, and deny our symptoms whereas a full blown mania is pretty hard to ignore. So we get the short end of the stick.

I should also mention that many many people with Bipolar of all types Don’t have the intense creativity that has marked so much of my time with it. Many of us suffer with lives that are mostly filled with distress and never have the bright shining times of hypomanic intensity that allows us to rise beyond the suffering and I don’t mean to forget them or how they live. I’ve heard people in support groups who suffer like this and they dislike people like me to characterize the illness as so wonderful at times. It’s simply Not true for them and I’m not meaning to imply otherwise.  Sorry if this was too top heavy with lightness. It’s not meant to be.

But there’s a lot we can do to deal with it and I’ve covered that in an earlier post on Surviving Bipolar Disorder. I originally combined the two but decided it was too long and unwieldly  so I split it apart. I hope this makes more sense to you now. Please realize that I am simply a person who suffers from this difficult disease and not a medical professional. I write about what I’ve learned in my time with this illness. And it’s valid I think for what I know. But others may have different stories and I’d love to hear them if you will share. Please feel free to contact me with what you have to say about this and let me know if I’ve educated you about this awful disease or gone astray. It needs more attention and we need to come out of the closet about it and that’s what I’m trying to do. I hope it helps someone somewhere.

In a Mixed State at present,


One comment on “Types of Bipolar Disorder

  1. Pingback: Mel Gibson Bipolar | Is Bipolar Hereditary

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