Bipolar Disorder 1

Disclaimer: This article is for informational and educational purposes only, and does not replace expert medical or mental health advice. Bipolar I disorder requires a comprehensive psychiatric and physical evaluation. So, always refer to a board-certified physician or mental health specialist for a proper diagnosis and treatment. In case of emergencies, call 9-1-1 in the U.S. or your local emergency number immediately.

Bipolar I disorder is estimated to impact up to 1.5% of the population in the U.S., and it is the most severe type of bipolar disorder. Unlike other types, bipolar I is defined by the presence of at least one full manic episode, one that can be intense enough to require hospitalization. Understanding what sets bipolar I apart is key to getting the right diagnosis and treatment.

Bipolar I disorder (BD-I) is a mental health condition classified under "Bipolar and Related Disorders" in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). The National Institute of Mental Health (NIMH) says that it is defined by manic episodes lasting at least seven days, or manic symptoms severe enough to require immediate medical care. Most with bipolar I also experience depressive episodes; however, a depressive episode is not required for diagnosis.

Bipolar I is often what many of us picture when we think of bipolar disorder, as the manic episodes are so pronounced. But it is also a highly treatable condition. With the right combination of medication and therapy, many go on to live stable, fulfilling lives.

Manic Episode Symptoms

A manic episode involves atypically heightened or irritable mood along with increased energy, lasting at least a week. Common symptoms are:

• Extreme talkativeness or racing thoughts
• Irritability and distractibility
• Inflated self-esteem or grandiosity
• Decreased need for sleep
• Increased goal-directed activity or agitation
• Risky behavior, such as excessive spending or impulsive decisions
• In severe cases, psychosis, including delusions or hallucinations.

A manic episode is severe enough to significantly disrupt daily functioning, relationships, or career, and it is not the outcome of substance use or another medical condition.

Depressive Episode Symptoms

While not required for diagnosis, most with bipolar I also experience depressive episodes, typically lasting two weeks or longer. These can be characterized by persistent sadness, low energy, changes in sleep or appetite, difficulty concentrating, and, in some cases, suicidal thoughts.

If you or someone you know is struggling with suicidal thoughts, please contact 9-8-8 in the U.S. or your national helpline number immediately. This can be a life-saving move.

Mixed Episode Symptoms

Some experience mixed features, meaning manic and depressive symptoms occur at the same time. For instance, one can experience feeling energized and agitated while also feeling hopeless or empty.

Bipolar I is frequently misdiagnosed, often mistaken for major depressive disorder, especially when a depressive episode precedes a manic one. An accurate diagnosis typically requires:

• A comprehensive psychiatric evaluation
• A review of personal and family mental health history
• Input from close relatives when possible, to track mood patterns over time
• Medical tests to rule out other conditions
• Use of the DSM-5-TR criteria to confirm the diagnosis.

As symptoms can overlap with other conditions, working with a licensed and experienced mental health practitioner who is experienced in mood disorders makes a meaningful difference in getting a proper and timely diagnosis.

The key difference comes down to the severity of the manic episodes. Bipolar I diagnosis requires at least one full manic episode, which can involve hospitalization or psychosis.

Bipolar II involves hypomania, a less intense and shorter version of mania that does not require hospitalization, along with depressive episodes. People with bipolar II never experience a full manic episode.

Bipolar I is a chronic condition, but it is highly manageable with the right treatment plan. Effective care typically entails:

• Medication: Mood stabilizers like lithium, atypical antipsychotics, and sometimes antidepressants
• Psychotherapy: Ongoing cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy, and family-focused treatment
• Psychoeducation: To identify personal triggers and early warning signs of an episode
• Lifestyle Modifications: Consistent sleep, stress management, and avoiding alcohol or drug use
• Higher Levels of Care: Hospitalization, partial hospitalization, or intensive outpatient programs, during more severe episodes
• Dual Diagnosis Treatment: Integrated behavioral health treatment when substance use disorder co-occurs, which is relatively common among those with bipolar I.

Early intervention makes a real difference with bipolar I. The sooner someone gets a proper diagnosis and begins treatment, the better their long-term outlook tends to be.

At the NuView Treatment Center, we personalize bipolar I treatment around your symptoms, history, and life circumstances rather than relying on a one-size-fits-all pathway to healing. Our partial hospitalization programs and flexible intensive outpatient programs offer a full continuum of outpatient treatment to provide the right level of care at every stage of recovery.

Call (323) 307-7997.