The DSM-IV, a diagnostic manual prevalent in the medical community for the diagnosis of mental conditions, divides bipolar disorder into several categories. Of these, bipolar I and II disorder are the most prevalent. While both share similarities, there are some key differences that are important to understand when making medical decisions concerning this mental health condition.
Bipolar I Disorder
According to the DSM-IV, bipolar 1 (bipolar I) disorder should be diagnosed when a patient experiences manic or mixed episodes (manic and depression) that last a minimum of seven days, or if the depressive episode is so severe the person needs to be hospitalized. Depressive episodes of most patients with bipolar I disorder last at least two weeks, according to the mental-health-today.com. A depression episode linked to substance abuse or caused by another medical condition is not considered cause to apply the bipolar I label.
Bipolar II Disorder
Patients are diagnosed with bipolar II disorder when they experience "one or more major depressive episodes accompanied by one hypomanic episode," according to mental-health-today.com. Manic-depression.net defines hypomania when a person is persistently elated or irritable for at least four days, accompanied by a decreased need for sleep, racing thoughts, talkativeness, distractibility, increased goal-directed activity and excessive involvement in risky activities without regard for consequences.
Key Diagnostic Differences
The major differentiator between bipolar I and II is the episodes of mania. A bipolar I patient can have manic episodes, whereas the bipolar II patient's experiences will be hypomanic in nature. Bipolar I disorder may also include psychotic components like delusions and hallucinations, which do not appear in bipolar II. A hypomanic episode is considered slightly less severe than a full manic episode, and those with bipolar II disorder remain at risk for experiencing mania in its most severe form. Should a bipolar II patient experience a manic episode, his diagnosis would then change to bipolar I.
Gender Differences Bipolar I
Mental-health-today.com states that bipolar I disorder appears equally in men and women in the United States. Gender does appear to play a role, however, in the order of appearance with regards to depression and mania. Males are more likely to experience a manic episode prior to a major depression, whereas the reverse is more likely to be true with women. The website also points out that the onset of bipolar I is more common during a postpartum period.
Gender Differences Bipolar II
According to a 1999 study by Dr. Franco Benazzi, a senior psychiatrist at an Italian public hospital, bipolar II women are more likely than bipolar II men to experience atypical features of the condition. Titled "Gender Differences in Bipolar II and Unipolar Depressed Outpatients-- a 557-case study," the research was published in the Annals of Clinical Psychiatry. In particular, the study showed that anxiety-related conditions, including phobias and obsessive-compulsive features, are seen more often in women.
Furthermore, Dr. Benazzi's later findings concluded that women experience an earlier onset of symptoms than do men diagnosed with bipolar II disorder. These findings are detailed in his study titled "Gender Differences in Bipolar-II Disorder," which appeared in the March 2006 edition of the European Archives of Psychiatry and Clinical Neuroscience.
References
- Mental-health-today.com: Bipolar I Disorder DSM IV Criteria
- Mental-health-today.com: Bipolar II Disorder DSM IV Criteria
- European Archives of Psychiatry and Clinical Neuroscience: Gender Differences in Bipolar-II Disorder
- Annals of Clinical Psychiatry: Gender Differences in Bipolar II and Unipolar Depressed Outpatients
- ManicDepression.net: Bipolar II Disorder
