Is Bipolar I Worse Than Bipolar II?

The following article, in its entirety is by Marcia Purse, Health Guide for Ms. Purse is an informative writer. I hope you enjoy.


Is Bipolar I  Worse Than Bipolar II?

Marcia Purse
Health GuideWednesday, March 28, 2012

People tend to think of Bipolar I as being “worse” than Bipolar II. In discussions about this, people diagnosed with Bipolar I have sometimes said, “I wish I only had Bipolar II.”


I’m not here to tell you people with BP I don’t have a rough time – they do. But what those who said they wished they had BP II, and the public in general, don’t realize is that Bipolar II is profoundly different from Bipolar I.


If you have ever had soaring mania, perhaps with hallucinations or delusions; if your mania has ever been so out of control that you had to be hospitalized; indeed, if you’ve ever had a manic episode at all, you have Bipolar I Disorder. Mania and the hypomania of Bipolar II and Cyclothymia (also known as Bipolar III) share some characteristics, but the severity of mania makes a great deal of difference. (See Mania vs. Hypomania)


But people who have Bipolar II have a miserable time at the opposite pole: depression. In general, these people have far more depressive than hypomanic episodes. Those depressive episodes last longer and are more frequent than in people with BP I. Again, this isn’t to say that people with BP I can’t have very bad depressive episodes. They just aren’t likely to have them as frequently, or for as long as, people with BP II.


And there is one more key difference between the two disorders – the one that sometimes makes me wish I had Bipolar I, believe it or not. That is the fact that people with BP II are very likely to feel at least slightly depressed almost all the time that they aren’t hypomanic.


It’s true for me. In fact, my psychiatrist told me that on the 1-10 scale he uses for rating mood, 6 is normal, and most of his patients with BP II hardly ever get above 5 (having to push yourself some), and 4 (having to push yourself often) is more common.


That’s where I live most of the time – between 4 and 5, with days I’d rate as 3 at least twice a week. And at those levels, my symptoms don’t even qualify as a diagnosable depressive episode! Yet I’m struggling all the time to a greater or lesser degree. “Up” periods generally don’t last for more than a few hours.


So don’t let anybody tell you that because you have Bipolar II Disorder you “aren’t that sick.” Both Bipolar I and Bipolar II are serious disorders. It’s just important to understand that they are so different that they can’t be compared.



Mantere, O., et al. (2008). Differences in outcome of dsm-iv bipolar i and ii disorders. Bipolar Disorders, 10(3), 413-25. Abstract retrieved from


Maina, G., et al. (2007). Health-related quality of life in euthymic bipolar disorder patients: differences between bipolar i and ii subtypes. Journal of Clinical Psychiatry, 68(2), 207-12. Abstract retrieved from


3 thoughts on “Is Bipolar I Worse Than Bipolar II?

  1. As someone with type 2 Bipolar Disorder I find it insulting when people insinuate my disease is less than because my manias aren’t as rough. I have know type 1 people with very severe manic episodes, & I wouldn’t change places with them. That does not diminish the real affect my depressions have had on my life.

    I have lost several good jobs, my career, & my professional licensure (by letting it lapse & I can’t get it back till I can be declared mentally fit to return to work). I have gone so deep for so long I have had psychotic breaks. There was a time in my life when I quit my job, hid inside my house refusing to answer the phone until my mother sent the police to my house. I had become convinced I wasn’t a human. I was either a ghost who hadn’t realized they were dead till now, or an alien posing as a human. I didn’t know what I was, but I did know I was not a human any longer. Fast forward & I had to move home, can no longer live by myself, & I am living on disability instead of using the master’s degree I worked so hard for. I have not had it easy just because I haven’t had any out of control manias.

    I am not a competitive person by nature, & it I really don’t understand the need for one person to feel like they are sicker than another, but it’s either part of the illness or just the good ol’ American way.

    Okay, /rant Thanks for sharing this! I enjoyed reading it. I didn’t know that about type 2 spending most of their time in the depressive state, but I certainly do feel like that.

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