Bipolar Disorder Community
4.99k Members
1167245 tn?1353882100

Bipolar II to Bipolar I?

Yesterday, I dropped in for an emergency appointment at my school's mental health office to discuss my increasingly serious suicidal ideation and what seems to be rapid cycling induced by an anti-depressant. The doctor was concerned enough that she made a full length follow-up for this morning. During this meeting, I gave her a detailed history of my mood disturbances, symptoms, and episodes, and she suggested that I definitely have a bipolar disorder, and that I have "more than bipolar II" (ie. BP I). This surprised me, although several of the mixed episodes that I have experienced since I last saw a psychiatrist (October 2009 or so) have been absolute, out-of-control hell, with distinct and crippling paranoia. One led to an overdose and a consequent hospitalization. I'm still on the fence about it, but we're meeting two more times in the next few days to complete the evaluation, and hopefully things will begin to make sense.

Anyway, my questions are: (a) has anyone experienced a change of their illness from BP II/ BP NOS to BP I, or cyclothymia to BP I/II, etc.?
(b) does anyone out there question their diagnosis, and why? Have you had conflicting diagnoses from pdocs?

The treatment is essentially the same, that is, medications to manage whatever particular symptoms one struggles with. I know the diagnoses are really just "labels", but with the label comes a sense of hope, sometimes.
20 Responses
Avatar universal
Were you in the hospital for mania?

If you end up being hosptialized for a severe manic episode then it is usually Bipolar 1.  I have bipolar 1 and have been hospitalized for extreme manic episodes with psychosis.  I can go years and years (4-5) without a manic episode unless I go off my meds.  I have had periods of depression usually after my manic episodes that have left me feeling suicidal.  

Usually in bipolar 2 the mania comes but not as extreme.  Some people cycle from depression to hypomania almost daily.  

Personally I'm glad I have bipolar 1 because the cycles are more spread apart.  My friends with bipolar 2 have a hard time with medication because one day they can be manic and the next day depressed.  The bad part about having bipolar 1 is the hospitalizations are long.  My 5 have been at least 3 weeks.  If I would have stayed on my meds then I wouldn't have had the hosptializations.  

Whatever your diagnosis there are alot of people here to help you and you will feel better once you get a clear diagnosis.  I know it gets overwhelming and confusing. Keep me posted on how things are and what the docs determine.

603015 tn?1329866573
I am Bipolar II and this means that I suffer more from depression/hypomania than mania, when I am manic it is hypomanic which is less extreme than pure mania, I have however had an extreme manic episode but my diagnosis was kept at BP II because the mania was triggerred by an anti depressant, really as long as you are getting the right treatment the lable doesnt matter. I have had many periods of denial since being diagnosed a year ago but I am just learning to accept the diagnosis for good and make sure I dont get as sick as I did last year. This site has seen me through some really tough times and im almost addicted to it but the support you get is outstanding, I have learnt alot by reading and contributing to posts on here. Good luck with your assesment and I hope you get the treatment you need.
574118 tn?1305138884
your post is interesting in how to differentiate between BP1 and BP2. I agree with you that like all the sites that say in 1 you get mania whereas in 2 just hypomania. Further they say in mania you have psychosis and in hypomania you don't except that many said they still do

I have been in this disorder years and still i can't tell the difference between a mania and a hypomania. If you see my profile it says "can anyone guess" and actually this tortures me in a way because although i know all the meds their doses and many things about this disorder but still i can't decide to what type i belong, neither the pdocs. this doesn't mean i am NOS. I was even thinking to post this question so as the folks in this forum ask me a set of questions and let them decide.

One of the pdocs said i am BP1.5 (incidentally don't laugh i read it more than often) why he said that is because i didn't enter the hospital. In Mania he said i must be hospitalized. But this can be a family decision. For example in one of the episodes, I tried to commit suicide my mother was abroad with my sister and i was left alone with my father. I tried to jump from the window and he was preventing me and we had a fierce fight and i injured him in the face many times and we continued fighting for a period until i was exhausted and the man too. It was one of my mixed states. Now something like this shouldn't have passed smoothly i believe the hospital is a MUST. Likewise many other incidences occured (not committing suicide, but hurting others) occurred and i was never hospitalized. Perhaps the reason was that my family never trust hospitals fearing they will put me on some drugs or narcotics or the like to keep me exploited later sort of blackmail. So really i can be 1. But again depression is my main concern and unless i take an AD i stop functioning. I am under the impression that my mania is due only to the AD i take, so if i can find a way to stop depression without an AD (lamictal i didn't tolerate it, didn't try abilify) then my problem is solved and i could even be BP3.

Again the meds are the same really, unless lithium is for 1 not for 2, but i have seen 2 taking it, etc...

coming to your post, it's really enlightening when you said

"My friends with bipolar 2 have a hard time with medication because one day they can be manic and the next day depressed. Usually in bipolar 2 the mania comes but not as extreme.  Some people cycle from depression to hypomania almost daily."

Do i understand that in BP1 there is no rapid cycling. If this is so then i am BP2, because i cycle and my main concern is depression and i graduated from a university, i.e. less probability of frequent psychosis. Again when do you call a mania "extreme" I really can't tell

finally as to whether when unmedicated 2 turns into 1 i also read it, but this is illogic too either you are genetically 1 or 2.

at last don't neglect the phenomenon of "kindling" i.e. more frequency and worsening rather than the metamorphosis from 2 onto 1

have a good day

1234832 tn?1288215488
Conflicting diagnosis are common. It is really hard to know what is going on in someones head.
As Athena said there is this 1.5 category. As my doctor said in BP 1 usually the person loses almost complete control in a manic state.
Im just coming down from a 3 to 4 week mixed manic attack. The attack that resulted in me joining this site and a lot like what you described.
I'm in school too. One thing I did that seemed to help was... well first I had to stop going to classes, I could not function properly or even sit down for more then an hour... but I got into this schedule of doing half an hour of work then taking a walk, then half an hour of work, then walk, ect. ect. It was hard at first, but after a while I got into the routine and it helped a lot. Just do everything a little bit at a time. Also I have some pretty good room mates who put up with my increasingly erratic behavior (like closing all the blinds in the house in a bought of paranoia)
Also remember, it wont last forever. Good luck!
574118 tn?1305138884
>>>I could not function properly or even sit down for more then an hour..but I got into this schedule of doing half an hour of work then taking a walk, then half an hour of work, then walk, ect. ect.

you are describing me. All bipolars do this. The problem with me is that my patience became narrower and narrower, so reading less no of paragraphs, sit less ammount of time, restlessness. This is an authentic BP behaviour LOL
Avatar universal
Hi Adel_ezz,

Based on what you wrote I would "guess" you have Bipolar 2.  

In bipolar 1 the problem is usually with the manic episodes being so extreme that hospitalization is usually forced by court order or the police come to take you into the hospital.  There is usually no option for family deciding to not hospitalize.  Also the mania from lack of sleeping for weeks turns into psychosis.  Where the person hallucinates and has delusions and false beliefs.  I once thought I was MARY the mother of Jesus and then one time I thought I was Michael Jackson's mother. LOL.
In mania the speech is extremely fast.  The thoughts and ideas are for inventions and all types of strange ideas.  The person will be singing in a theatrical way.  (Which is why I was put in the isolation room, I kept singing really loud when all the other patients were sleeping).  What's funny about that is that I did take Theater singing before I was diagnosed.  The person stops sleeping maybe getting one hour a night and it could be that way for weeks.  The person becomes a danger to themself and others.  Once I was so manic I started dancing in the middle of the street with cars honking at me.  I thought I was an angel-everyone thought I was gonna prove it by jumping off a building. So, I was hospitalized. I had my keys and credit cards taken away from me by my husband.  I almost lost my job.  

In bipolar 1 there is usually no cycling.  The medication is to control the mania from occuring.  The medicine can lead to depression.  

Whereas in bipolar 2 the medication is to control the depression and can cause hypomania. Hypomania is just like mania only less severe and does not normally require hospitalization.  

I'm so glad your father stopped you from jumping out of the window.  That must have been a horrible time for you.  

If you get your medical reports I am sure there is something written down that says whether you have bipolar 1 or bipolar 2.  

I have seen too that the meds for both are somewhat the same.  

There are things you could do to help lighten the depression that I have done.

Sleep at night - if we stay up late our brains don't make enough serotonin
Get sunlight for 30 minutes before noon.
Eat bread - it has something in it that helps make serotonin
Eat one or two pieces of dark chocolate 60-70%
Try Omega 3 with Fish oil capsules
Take a dance class- Dancing is so good for us that have "mental illnesses" or watch dancing

Good luck Adel.  

I think it would be a good post for people to guess which bipolar you have.

Take care
Have an Answer?
Top Mood Disorders Answerers
Avatar universal
Arlington, VA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
15 signs that it’s more than just the blues
Discover the common symptoms of and treatment options for depression.
We've got five strategies to foster happiness in your everyday life.
Don’t let the winter chill send your smile into deep hibernation. Try these 10 mood-boosting tips to get your happy back
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Here’s how your baby’s growing in your body each week.