Understanding Bipolar Disorder: Bipolar I, Bipolar II, and Related Types

And where to get support and help in Singapore

Bipolar disorder is a mood disorder characterised by significant changes in mood, energy, and activity levels.

Rather than a single condition, it includes several types, each defined by distinct patterns of mood episodes. Psychological and psychiatric diagnostic systems (like the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition — DSM-5) recognise these differences to guide accurate diagnosis and appropriate treatment.

What Bipolar Disorder Is

Bipolar disorders involve alternating periods of:

• Elevated mood and energy (mania or hypomania), and

• Depressive episodes (low mood and loss of interest).

These swings are more intense, prolonged, and functionally impairing than typical mood changes experienced by most people.

There are three main categories that fall under this.

1. Bipolar I Disorder

Bipolar I is defined by at least one manic episode in a person’s lifetime.

Key clinical features:

• Manic episodes are intense periods of abnormally elevated or irritable mood, increased energy, and activity that last at least 7 days (or any duration if hospitalization is required).

• Mania can include:

  • Very high energy

  • Impulsivity and risky behavior

  • Decreased need for sleep

  • Impaired judgment

  • Psychotic symptoms (e.g., delusions or hallucinations) in some cases

• Major depressive episodes may occur before or after mania, but are not required for diagnosis.

Because manic episodes can severely disrupt functioning and sometimes require hospitalization, bipolar I is often considered the most classic form of bipolar disorder.

2. Bipolar II Disorder

Bipolar II differs primarily in the severity of elevated mood episodes.

Key differences from Bipolar I:

• In bipolar II, elevated mood episodes are hypomanic, not full mania.

• Hypomania involves elevated or irritable mood and increased energy but is less intense than mania and does not cause major impairment or require hospitalization.

• People with bipolar II must also experience one or more major depressive episodes to receive the diagnosis.

• Bipolar II can be chronic and debilitating due to frequent and longer periods of depression, even though the elevated phases are less severe.

So, while bipolar II does not include full manic episodes, the depressive component can be especially impactful.

3. Cyclothymic Disorder

A related subtype is cyclothymic disorder (sometimes called cyclothymia).

Cyclothymic disorder involves:

• Numerous periods of hypomanic symptoms and depressive symptoms that don’t meet full criteria for hypomania or major depression.

• These symptoms persist for at least 2 years in adults (1 year in young people) with no long symptom-free periods.

Cyclothymia causes chronic mood fluctuations and can be distressing and disruptive, even though the episodes are less intense than in bipolar I or II.

4. Other Specified and Unspecified Bipolar and Related Disorders

The DSM-5 also includes categories such as:

• Substance- or medication-induced bipolar disorder

• Bipolar disorder due to another medical condition

• Other specified bipolar disorder

• Unspecified bipolar disorder

These are used when an individual has bipolar-like mood disturbances but doesn’t fully meet the symptom or duration criteria for types I, II, or cyclothymic disorder.

So What’s the Core Difference Between Bipolar I and II?

Here’s a scientific breakdown:

Feature	Bipolar I	Bipolar II
Elevated mood type	Mania (full intensity)	Hypomania (less intense)
Hospitalization risk	Often	Rare (unless for depression or another reason)
Psychosis (hallucinations/delusions)	Can occur in mania	Does not occur in hypomania
Depressive episodes	May occur	Required for diagnosis
Functional impact	Often severe	Depression often drives impairment

Important Notes from Research

Recent studies support the idea that bipolar I and bipolar II are distinct syndromes with specific clinical profiles, not just “milder” or “severe” versions of the same illness. For example, bipolar II often involves longer and more frequent depressive episodes, even though its elevated phases are less intense.

Why This Matters

Understanding the types of bipolar disorder helps in:

• Accurate diagnosis

• Tailored treatment planning

• Supporting people and families with clearer expectations

Each type presents differently and affects daily life in unique ways, so recognising these differences is not just academic — it can be life-shaping.

Wrapping Up

Bipolar disorder is a diverse spectrum of mood conditions, each with specific criteria and challenges.At its core:

• Bipolar I is defined by manic episodes

• Bipolar II involves hypomania + depression

• Cyclothymic and other related types capture different patterns of mood instability

Understanding these distinctions — grounded in the DSM-5 and psychological research — can help reduce confusion and support compassionate, informed dialogue about mood disorders.

Where to get help in Singapore?

In Singapore, help is available across medical, psychological, and community settings.

Specialist Assessment & Treatment

Bipolar disorder is typically assessed and diagnosed by a psychiatrist, often with ongoing care involving both medication and psychotherapy.

• Institute of Mental Health (IMH) Singapore’s national psychiatric hospital, with specialist mood disorder services, outpatient clinics, and emergency support.

• Public hospitals with psychiatric departments (e.g. NUH, SGH, KKH, CGH) — accessible via polyclinic or GP referral.

• Private psychiatric clinics Many psychiatrists in private practice in Singapore provide assessment, diagnosis, medication management, and long-term follow-up for bipolar disorder.

Psychological Therapy & Psychoeducation

While medication is often central to bipolar treatment, therapy can help with:

• Understanding mood patterns

• Early warning signs of relapse

• Managing routines, sleep, and stress

• Coping with the emotional impact of the diagnosis

Look for clinical psychologists or counsellors experienced in mood disorders or working alongside psychiatric care.

Community & Ongoing Support

Living with bipolar disorder can feel isolating. Community-based support can help with stability and connection between medical appointments.

• Community mental health teams (CREST)Provide psychosocial support, monitoring, and linkage to services.

• Peer support and support groupsSome organisations and clinics offer peer-led or professionally facilitated groups for people with mood disorders.

If You’re in Crisis

If someone is experiencing:

• Severe mania

• Psychotic symptoms

• Suicidal thoughts

• Loss of sleep with escalating mood or impulsivity

Please seek urgent help:

• IMH Mental Health Helpline: 6389 2222

• National Mindline: 1771 (24/7)

• Or go to the nearest A&E immediately

A Hopeful Reminder

Bipolar disorder is treatable, and many people live meaningful, stable lives with the right combination of support. Getting help early — especially during mood changes — can reduce relapse and improve long-term wellbeing.

If you’re unsure where to start, a GP, polyclinic, or mental health helpline can help guide you to the right next step.

Or just reach out to us too - we'd be happy to guide more too :)

Team iash.sg