What are the different types of bipolar disorders?

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There are three main types of bipolar disorders (see Table 7):

  • Bipolar I disorder.
  • Bipolar II disorder.
  • Cyclothymic disorder.

It is also possible for a person to have mixed episodes, whereby a person experiences several manic and several depressive symptoms simultaneously, or rapidly alternates between them, either day-to-day, or even within the same day.

A case study example of how a person experiencing co-occurring bipolar and AOD use disorder may present is illustrated in Box 3.

Table 7: Types of bipolar disorders

Disorder Symptoms
Bipolar I disorder Bipolar I is characterised by one or more manic episodes, which can be preceded or followed by hypomanic or major depressive episodes.
Bipolar II disorder Bipolar II is characterised by recurring mood episodes, consisting of at least one or more major depressive episodes and at least one hypomanic episode.
Cyclothymic disorder Cyclothymic disorder is characterised by chronic (at least two years), fluctuating disturbances in mood involving numerous periods of hypomanic and depressive symptoms. The symptoms do not meet the criteria for a manic or major depressive episode.

Box 3: Case study C: What does co-occurring bipolar disorder and AOD use look like? Scott’s story

Case study C: Scott’s story

Scott, a 25-year-old who identified as male, presented to an AOD service on the recommendation of his manager. Scott worked on a remote mining site in a ‘fly-in-fly-out’ capacity, where he worked in cycles consisting of 14 consecutive days of 12-hour shifts, followed by 14 days of leave. In a random drug test, Scott screened positive for amphetamine-type stimulants, and he was advised by his supervisor, who was very supportive, to take leave to address this in his home city. Scott’s girlfriend accompanied him to his assessment at his local AOD service.

On assessment, Scott told the AOD worker that he loved his job but found the cycles of long shifts and long periods of leave incredibly difficult. He had recently been using stimulants more often to help him get through the long shifts, but knew it was a risk with the random drug testing that sometimes takes place. Scott told the AOD worker that he started smoking pot when he was about 13 years old and remembers drinking a lot of alcohol at high school parties, though he didn’t remember drinking much apart from at social gatherings. At university, Scott used cocaine and MDMA recreationally.

Scott had not told his GP about his AOD use but had seen him in the past about several periods of depression that he first experienced in his teens. He said that during these times, he had experienced very low mood, had no energy or interest in anything, and spent all of his time in his bedroom watching TV or sleeping. Scott said that although he had at times thought that life wasn’t worth living when he was feeling extremely low, he had never seriously considered killing himself. He said he had previously been prescribed two different types of antidepressants but couldn’t remember what they were – he stopped taking them because he thought they helped for a little while, but then stopped working. He had never seen a psychologist.

When not feeling low, Scott said he considered himself as a ‘party guy’, and the type of guy that people enjoyed being around – he loved to have fun at work. Because of the nature of his work, Scott earned a lot of money but had been spending beyond his means on extravagant purchases and getting into debt. He told the AOD worker that recently, he was called into his manager’s office because a couple of his coworkers had complained about him, saying they didn’t want to work on the same shift as him, because they thought he was behaving recklessly and dangerously, compromising their safety. Scott said he was shocked by this and thought they were over-reacting – he didn’t think there was a problem and thought they should all ‘lighten up’.

Key point

Key Points

  • What are the primary concerns for Scott?
  • Where to from here?

Case study C continues in Chapter B7.

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