Question:
I am bipolar. I thought I was somewhat
knowledgable about this illness but have noticed many making reference
to bipolar 1,2 or 3. Can anyone differentiate between these three?
Answer:
Bipolar I is "classic" Bipolar Disorder... periodic, long-lasting
episodes of mania and depression, typically with periods of
normalcy intervening. Bipolar II is like Bipolar I, except that the person is "hypomanic"
(the mania is milder) instead of "manic," but also experiences
depression. "Bipolar III" is a proposed diagnosis; it seems to be
basically cyclothymia (a form of cyclical mood disorder in which
mood cycles occur but the criteria for a manic episode or
major depressive episode are never fully met.) So... it's like this: Bipolar I: Major depressive episodes + manic episodes
Bipolar II: Major depressive episodes + hypomanic episodes
"Bipolar III"/Cyclothymia: Depression without meeting all criteria for major
depressive episode + hypomania Oh, and to further complicate matters, one may be a "rapid cycler"--
someone who completes four or more mood cycles within the space of
a year... and one can experienced "mixed states," a state with some
of the features of depression and some of mania. Originally, about 10 years ago, it was this type of presentation
that was proposed to be ascribed the nosological Type III. When
I saw the stuff Barry has written regarding III, I was a bit taken
back - but realized that things change. I was actually glad to see
cyclothymia occupy such a prominent position in a diagnostic
structure so that it may perhaps be more adequately treated. The new FAQ (1.2, which I'm still rewriting and pending Barry's final
thumbs-up) is going to treat cyclothymia somewhat more prominently. This
theory might also make it in, might not, depends if I can find the
reference. So might kindling theory, if I have the time. Oh, and I was imprecise when describing type IV IV: depression with mania/hypomania activated by pharmaceuticals only is the more precise definition.
