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Writer's pictureBrandilyn Hallcroft

Understanding Bipolar Disorder: The Difference Between Bipolar I and Bipolar II

Updated: Nov 19

Let’s rewind to a memory from my childhood that stuck with me: I was at a friend’s house, just another day of playtime when her dad suddenly came out of his room in a military hat, dancing and singing around the house. This was… unusual. Most of the time, he stayed quiet and secluded in his room. That day, my friend leaned over and whispered, “My dad has bipolar.” At the time, I had no idea what that meant. All I knew was that sometimes, something was different with him, and as a kid, it was both fascinating and confusing.

Bipolar Disorder

It wasn’t until years later that I gained a deeper understanding of what “bipolar” really means. I met a wonderful young woman whose journey with bipolar disorder showed me just how complex this mental health condition can be. She was funny, intelligent, and spiritually aware—someone I immediately connected with. During her manic episodes, she would make sudden, spontaneous decisions like booking a flight to another state or setting off on a six-mile walk because someone casually suggested she take a walk. Watching her try to navigate these moments, I realized how much compassion and understanding she—and others like her—needed.

What is Bipolar Disorder, Really?

Bipolar disorder is a mood disorder that affects a person’s emotional and physical state in profound ways. According to the DSM-5, the key characteristics of bipolar disorder are drastic shifts in mood, energy, and activity levels. These shifts can cause episodes of depression on one end of the spectrum and episodes of mania (in Bipolar I) or hypomania (in Bipolar II) on the other. The disorder doesn’t just involve “mood swings,” as people often say—it’s a condition that affects a person’s life in deeply impactful ways, influencing everything from relationships to personal safety.

One important thing to understand is that bipolar disorder is not a casual term to throw around or use to describe someone’s emotions. We often hear people saying things like “Oh, they’re so bipolar” whenever someone seems overly emotional or switches moods quickly. But bipolar disorder is a serious condition that can be both physically and mentally exhausting for the person experiencing it. This disorder deserves understanding, not stigma or judgment.

The Difference Between Bipolar I and Bipolar II

While both Bipolar I and Bipolar II are forms of bipolar disorder, they differ in their symptoms and severity.

Bipolar I: The “High-Intensity” Version

Bipolar I disorder is often considered the more intense form. People with Bipolar I experience manic episodes—periods of extremely elevated mood, energy, and behavior that last at least a week. During these manic episodes, a person might feel euphoric, irritable, or even invincible. They may have racing thoughts, talk rapidly, sleep very little, or engage in risky activities like excessive spending, unprotected sex, or impulsive decisions that could put their safety or well-being at risk. These manic episodes can become so severe that hospitalization is sometimes required, and they often disrupt a person’s day-to-day life in significant ways.

Thinking back to my friend’s dad, I can now see that his sudden burst of energy, singing, and dancing may have been part of a manic episode. His behavior was so out of character compared to the quiet, withdrawn person I was used to seeing. This is often how mania can present itself—seemingly unpredictable and intense, almost like a rollercoaster that the person can’t easily get off. It’s not just an “up” mood; it’s a high-stakes experience that can disorient the person and those around them.

Bipolar II: Hypomania and the Cycle of Depression

Bipolar II is often misunderstood as a “milder” form of bipolar disorder, but that’s not accurate. Instead of full manic episodes, people with Bipolar II experience hypomanic episodes—a less intense but still elevated state of mood and activity. Hypomania can lead to impulsivity, high energy, and increased sociability, but it doesn’t reach the level of full mania. In some ways, hypomania can feel like an exhilarating high, but it’s also unpredictable, and it often cycles into depressive episodes.

In Bipolar II, the depressive episodes tend to be more frequent and severe than in Bipolar I, and they can make daily life very challenging. These depressive episodes are not just “feeling down” but are intense lows that make it hard for a person to even get out of bed or find the motivation to do the things they usually enjoy. 

How the Current System Fails People with Bipolar Disorder

With the young woman I know, I saw firsthand how frustrating the system can be when you are dealing with a severe mental health crisis. I watched her mother get emotionally drained by the experiences that were happening with her daughter. I saw how fast she would enter the hospital, cycle out, and return. I know from all the years I have been obsessed with psychology that there are proper ways to treat these things now, but the system makes it harder, not easier. Everyone involved suffers. The patient suffers the most, but there are the family members and friends. The doctors know more to be done, but insurance companies tie their hands. 

Statistics highlight the gap in care for people with bipolar disorder. According to the National Institute of Mental Health (NIMH), bipolar disorder affects nearly 2.8% of U.S. adults. However, only around 40% of those diagnosed receive adequate treatment. For people experiencing manic episodes, emergency intervention is often the first step in the treatment cycle, but it rarely leads to lasting support. Here’s what typically happens:

  1. Crisis Intervention: A person with Bipolar I in a manic episode may be brought to a hospital or mental health facility. During this short stay, the goal is stabilization—usually through medication and observation.

  2. Short-Term Care and Release: Once the person appears stable, they are typically discharged with minimal follow-up plans. This approach often leaves the individual needing more adequate support to maintain stability outside the facility.

  3. Limited Access to Outpatient Resources: Many mental health facilities and hospitals are overburdened, leading to limited resources for follow-up care. In addition, insurance limitations often restrict access to outpatient services and counseling, especially for those who may need long-term support. The result is a high likelihood of cycling back into another manic or depressive episode.

This system creates a cycle of crisis management rather than long-term care. Without a solid follow-up plan, patients are left without the resources or support they need, leaving families to struggle with their loved one’s mental health challenges alone.

The Human Cost of an Inadequate System

For those experiencing bipolar disorder, this broken system not only impacts their mental health but also affects their personal lives and relationships. Family and friends often feel helpless, seeing their loved ones discharged from care without a long-term plan in place. The constant cycle of hospitalization and release can lead to feelings of hopelessness and frustration, not just for the person experiencing bipolar disorder but also for those who support them.

For my young friend with Bipolar I, this lack of a consistent support system meant she was often left vulnerable, especially during manic episodes that could last for weeks. Friends and family stepped in when possible, but without a reliable healthcare structure, her journey is a lonely and challenging one.

How We Can Do Better: Possible Solutions

While mental healthcare reform is complex, several strategies could help improve support for those with bipolar disorder. Here are a few possibilities:

  1. Personalized Discharge Plans and Follow-Up: Before discharging someone from inpatient care, facilities should be required to create a customized discharge plan that includes follow-up appointments with therapists, psychiatrists, and support groups. Ideally, these plans would be adjusted based on each person’s needs and include resources such as medication management and social support.

  2. Integrated Care Teams: Rather than treating bipolar disorder as a series of isolated episodes, hospitals and clinics could provide patients with an integrated care team, including a therapist, psychiatrist, and social worker, who can work together to provide holistic, ongoing support.

  3. Insurance Reform to Support Mental Health Care: Currently, many insurance policies limit coverage for long-term mental health treatment, even though conditions like bipolar disorder often require ongoing care. Advocating for better insurance policies that include long-term coverage for therapy, medication, and follow-up care is critical to breaking the cycle of crisis intervention.

  4. Community-Based Mental Health Programs: Local and community-based programs can provide an invaluable support network for people with bipolar disorder. By offering services like regular check-ins, group therapy, and educational programs, communities can help reduce the need for emergency interventions and provide patients with resources to manage their condition before it reaches a crisis point.

  5. Education and Support for Families and Caregivers: Many families don’t know how to effectively support their loved ones after being discharged from inpatient care. Providing families with resources, training, and ongoing support would help them feel more equipped to provide assistance and reduce the burden on emergency services.

  6. Peer Support Networks: Many people with bipolar disorder benefit from connecting with others who have lived experience with the condition. Expanding access to peer support groups through healthcare facilities or community programs would give patients additional support.

Why Compassion and Understanding Matter

For many people living with bipolar disorder, one of the most challenging aspects isn’t just the disorder itself—it’s the stigma and misunderstandings that surround it. Too often, people throw around “bipolar” as a term for erratic or overly emotional behavior, not realizing that real bipolar disorder is far more complex and painful than occasional mood swings. Using the term casually only adds to the stigma, making it harder for people with bipolar disorder to feel accepted or understood.

People with bipolar disorder are not defined by their diagnosis. They are people with dreams, hopes, and lives they want to live fully, just like anyone else. Bipolar disorder doesn’t make someone less worthy of love, friendship, or acceptance. What people with bipolar disorder need most is compassion—friends and family who are willing to learn about their experience and support them in a way that respects their unique needs.

Breaking Down Stigma: Supporting Loved Ones with Bipolar Disorder

If you know someone with bipolar disorder, here are a few ways to be supportive:

  • Educate Yourself: Understanding the difference between Bipolar I and Bipolar II can help you be a more compassionate friend or family member. By learning about their condition, you can better understand what they might be going through and respond to their needs without judgment.

  • Offer Steady Support: People with bipolar disorder often struggle to maintain consistent routines; whether helping them with day-to-day tasks or simply being there to listen, offering support without judgment can make a huge difference.

  • Create a Non-Judgmental Space: Remember that people with bipolar disorder may have behaviors that seem unusual or unpredictable, but these behaviors are part of their experience. Giving them a safe space to express themselves without fear of being judged is invaluable.

  • Encourage Professional Help When Needed: Bipolar disorder is best managed with the help of professionals, whether through therapy, medication, or both. If someone you care about is struggling, encouraging them to seek help can be one of the most supportive things you can do.

Living with bipolar disorder can be isolating, but the power of compassion, acceptance, and understanding can make a huge difference. For those with bipolar disorder, having people in their lives who see beyond their diagnosis and appreciate them for who they are helps them feel connected and loved. They are not “too emotional” or “too complicated.” They navigate a different experience and deserve love and acceptance like anyone else.

By moving beyond the stigma and choosing to show empathy, we create a world where people with bipolar disorder can live openly without fear of judgment. Let’s leave behind the stereotypes, stop using “bipolar” as a throwaway term for someone’s mood, and embrace compassion instead. Every person deserves to be seen, understood, and loved—especially those who face the unique challenges of bipolar disorder.


Disclaimer: Journaling is a powerful tool to support your healing process. The CBT exercises in Journals to Healing journals are intended to help you analyze and reframe your thoughts as part of a personal growth journey. However, these journals do not replace therapy or professional help. If you are experiencing intense emotions or feelings beyond your control, please seek professional assistance. Resources such as the National Suicide Prevention Lifeline (988) and Crisis Text Line (Text HOME to 741741) are available 24/7 for support. Remember, reaching out for help is a strength, and healing is a process.

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