The Difference Between Bipolar I and Bipolar II in Teens and Young Adults
An adolescent might wake up in the morning with such a low level of dopamine that he or she feels severely depressed, and then by late afternoon, his or her mood has shifted to such an elevated degree that nothing short of psychotropic drugs will provide stability.
Bipolar Disorder is an illness of the mind that affects an adolescent’s mood. While most people are familiar with depression and its associated experience of low energy, many teens and their parents don’t understand the complex nature of Bipolar Disorder – and for good reason. It’s a psychological illness that is multifaceted.
Bipolar disorder is characterized by the swing of moods between mania and depression, moving between both poles. In addition to the symptoms of depression, such as having a low mood, losing interest in favorite activities, and frequently feeling guilt or shame, a teen might also experience:
- Increased energy, activity, and restlessness
- Excessively “high”, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one idea to the other
- Distractibility – an inability to concentrate
- Unrealistic beliefs about one’s abilities
- Poor judgment
- Spending sprees
- Increased sex drive
- Little sleep
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
To provide a clearer description of this teen disorder, the biochemistry of a teen with Bipolar Disorder is so extreme that a morning run or cup of coffee isn’t going to facilitate balance, as it can for others. A teen with Bipolar Disorder has levels of dopamine, serotonin, and norepinephine that are at chaotic levels, making it difficult to find what will restore a feeling of ease. An adolescent might wake up in the morning with such a low level of dopamine that he or she feels severely depressed, and then by late afternoon, his or her mood has shifted to such an elevated degree that nothing short of psychotropic drugs will provide stability.
Type I and Type II
Typically, Bipolar Disorder is classified in two ways. An adolescent with Bipolar Disorder will be diagnosed as having either Type 1 or Type 2. The first type of Bipolar, also known as Bipolar I, includes one or more distinct periods of mania, and could also include a mixed period. For instance, if there is a period of mania, there might also be features of depression and if there is a period of depression, there might also be features of mania. The second type of Bipolar is characterized by at least one episode of hypomania and at least one episode of depression. This diagnosis can be made only if a teen has not ever experienced a period of mania.
To be clear, hypomania is an episode of that is less severe than a full episode of mania. For instance, mania is an experience of euphoria, high energy, impulsivity, irritability, and less need for sleep. However, hypomania is an elevated mood that is not quite full mania but does include increased energy, less sleep, clarity of vision, and strong creativity. According to The Diagnostic and Statistical Manual of Mental Disorders (DSM), the standardized text used by psychologists and therapists to diagnose their clients, “in contrast to a Manic Episode, a Hypomanic Episode is not severe enough to cause marked impairment in social, educational, or occupational functioning or to require hospitalization.”
Bipolar will develop in about 1-5% of children and adolescents. When Bipolar Disorder develops in childhood or early adolescence, it is known as an early-onset form of the mental illness. In these cases, it is often more severe with frequent mood swings and physical sickness. It’s true that Bipolar Disorder is difficult for anyone at any age, but its challenges become more acute for teenagers.
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Lucy Nguyen is the Executive Director at Paradigm Treatment, overseeing all clinical treatment programs across the organization’s southwestern region. Her extensive experience includes working with young adults in private practice, serving as a therapist for children and teens with emotional and behavioral needs, and acting as a behavior interventionist for teens with developmental disorders. Lucy integrates cognitive-behavioral approaches with mindfulness and compassion in her work, and she is also EMDR-trained. She holds a Master of Science in Counseling from California State University, Fullerton, and a Bachelor’s degree in Psychology and Social Behavior from the University of California, Irvine.
