Bipolar Type 1

Bipolar Type 1 is considered the most severe form of this illness.

According to the DSM, Bipolar I is characterized by one or more manic episode or mixed episodes accompanied by episodes of depression.

This is the most distinguishing, defining element of Bipolar I, i.e. at least one truly manic episode.

A patient may display psychotic symptoms such as delusions of grandeur or hallucinations.

In these cases, a patient’s condition is described as bipolar I with psychotic features.

Bipolar 1 episodes of mania are so profound that some experts use the term “raging bipolar”.

A key point is “the symptoms are severe enough to disrupt the patient’s ability to work and socialize.”

The nature of raging bipolar has been captured in this Psychcentral discussion of bipolar types with a focus on how Bipolar 1 is actually experienced.

Someone suffering from bipolar I can have great difficulty functioning. You could have trouble holding down a job or dealing with your family.1

Some symptoms you might experience during a manic episode include:

1. Decreased need for sleep.

2. Racing thoughts.


Bipolar 1 is “classic” or “textbook” manic-depressive illness, with serious and damaging episodes of both mania and depression.

3. Pressured speech.

4. Excess energy. and

5. The need to engage in reckless behavior.

is this reckless behavior that makes a manic episode the most dangerous to a patient. Driving carelessly, spending excessively and engaging in unsafe and reckless sex can have serious consequences that just do not matter to you at the time.

In a severe manic episode a person can lose all touch with reality. Left untreated a manic episode can last anywhere from a few days to several years. Most of the time these symptoms will last for a few weeks or a few months.

As the key difference between Bipolar 1 and Bipolar 2 is the presence of mania versus hypomania, it is important to understand this distinction in detail. See this explanation of Bipolar 1 mania types from Brown University.

Bipolar Type 1 mania is often followed by a depressive episode. It can come within days or not pop up for several weeks or months.

During a depressive episode you may feel drained, in deep despair, guilty for no reason, worthless and irritable.


Activities you normally enjoy will hold no interest. You may experience sudden weight loss or gain and uncontrollable crying spells. At your lowest moment you may even have thoughts of suicide.

Again, possible consequences mean nothing. These depressive episodes can last for years, that is why bipolar type I is often mistaken for chronic depression.

Many people with bipolar type I disorder can enjoy longs spells without any symptoms in between episodes at all. A minority of patients have rapid-cycling symptoms between mania and depression. In extreme cases symptoms of mania and depression can even alternate in the same day.2

The exact cause of bipolar disorders is not precisely understood. It seems to be a combination of 3 things:

1. Genetics.

2. Chemical imbalances in the brain.

3. Stress and triggering events that somehow “activate” an inherited predisposition to bipolar.

Are bipolar I and bipolar II treated differently?

When you go for an assessment, just like with any other illness, you will be asked about family history. A close relative such as a parent with suspected or diagnosed bipolar disorder greatly increases the likelihood of also having the illness.

If you are concerned, take a bipolar test.

So far, there does not seem to be any way to prevent the illness, but you can prevent some episodes of mania or depression once a doctor establishes that you do in fact have Bipolar Type 1.

Bipolar Type 1 almost always requires medication for effective management. Don’t worry – stability and sanity is SO worth it!3

The key factor is stabilization. Regular therapy, steady diet and
exercise and – MOST OF ALL – mood stabilizing medications such as
lithium can greatly reduce the frequency and severity of Bipolar Type 1



2019-04-07T11:27:57+00:00February 24th, 2014|Categories: Bipolar Spectrum Disorder|15 Comments


  1. Duan February 3, 2017 at 10:00 am - Reply


    It has been very interesting to read this article and especially the symptoms of Bipolar Type 1. The symptoms that especially drew my attention was the uncontrollable crying. There was a time in my life that I experienced terrible and very overwhelming sadness and heartache. At first i used to feel the sadness and how it was hurting me, eating me from the inside. It used to feel like there was literally something living inside of me, eating away at my heart. Eventually the sadness became everything i was, i was completely empty inside. This is where the uncontrollable tears comes in… it was a strange feeling. Without being in a situation that would make you cry, the tears would just start rolling down my face, without me feeling ANY emotions. I lost my will for a lot of things, even my will to speak. I remember clearly that a whole month would pass without me speaking a single word. There was just no will left in me. I retracted myself from everyone and everything. I started scratching myself with sharp objects until it would bleed. Then also, i never sought any help because i was afraid of how my parents would react. I just kept living like that, never seeking any help. It is now nearly 9 years later and I seem normal to others again, yet i know that there is something big missing inside of me or about me. To some extent it feels like i overcame what ever it is that happened to me, but the scars remain. I don’t know how i managed to kinda build myself again, but all i know is that i realised one thing, the truth will set you free. There was a lot of things i started practising that made me emotionally very strong again, but yet i don’t know if i can call it being strong, when i can’t feel anything. At least I am not hurting myself anymore, crying anymore and i am able to communicate almost like a normal person. I have been living like this now for a few years. but can a person be completely cured from such a illness?

    • Rosy March 13, 2017 at 10:58 pm - Reply

      I love your story because I’ve been going through exact same thing.

      • Bipolar Lives Staff March 14, 2017 at 7:02 am - Reply

        Thank you Rosy! 🙂

    • Jak March 15, 2017 at 5:05 am - Reply

      Hi Duan just wanted to thank you for taking the time to share about your experience and how terrible it is that you had to go through that. I’m not sure it can be completely cured but from what Ive read it can be managed. Also it might be worth looking into alternative/complimentary therapies to help lift things (that is not to say that should replace medication you might need at times). Maybe do an internet search on what things others with bipolar have found helpful. I have found walks in nature a life saver and also the energy of crystals can be amazing and some naturally contain lithium like lepidolite. Thank you again for sharing your experience and hope that things improve. Maybe a deeper connection with nature might help heal that emptiness inside

  2. Patience Frohlich March 25, 2017 at 3:11 am - Reply

    I lived with Stage 1 bipolar my whole entire life every single day. It was really hard to function but I did. I severely abused everybody around me always. I could never have a relationship for long. The racing thoughts every single day that feeling in my gut and the rage we’re practically unbearable. I was always misdiagnosed. It’s so nice to finally be on the right medicine and be able to live or want to live.

  3. Usman Aslam April 4, 2017 at 5:25 pm - Reply

    What if you have to live and move in a society where even the most common known word is taken as just taking too much tension delibrately and people aroud you believe that jist their pieces of advice and “lectures” can bring you out of it. And when it does’nt work (obvioisly) they become angry and blame you for self destruction for no valid reason. They do not understand that depression can be a physical problem in brain like any other organ.

    Now coming to the point, after suffering from bipolar 1 for last 18 years I have just been correctly diagnosed by a neurophysician, the othe professor of psycharty treated this as Major Depression. I have been suffering from living in asociety who are unable to understand what the depresaion or Bipolar disorder is and treat me as mad, insane, unrealiable, cheater who willfully do not fulfill committments, and a person just posing drama to get relaxation from work. The recurring episodes of mania and depression have already been ruining me, and the social behavioirs have always been led to another extreme of ecstacy. How can I take care of myself when my job is stressing having no work hours flexibility, belonging to middle class having little reaources and many dependants incliding old parents, wife and 2 children under 2. Where to go ??? What to do ??? I am fed up with extreme undescribeable pains of this disorder and the insulting, mercyful behaviour of boss / colleages / subordinates / family / friends. Feeling alone / ditched and hoepless. Seriously looking for least painful way of suicide as I know life will keep going on with this order on the same pattern (depressive phases are certain to come ao as manic) despite of having proper treatment just increasing the gape.

  4. Sherry April 17, 2017 at 1:55 pm - Reply

    Hi everyone. I’m hoping someone might be able to give advice. My partner has bipolar. He is currently in a low episode, with severe depression. Although we figure he’s had this most of his life, he was just diagnosed about a year ago, but had always been treated for depression. When he gets like this, he leaves me. Moves out. It’s like one day he’s here and things are great, the next he’s gone and I’m sitting alone, head spinning, starting through tears at the empty spaces where he should be. Will he come back? Why did nothing I say matter? How could he do this when we were just talking about getting married? And then I start self loathing, as i myself have treatment resistant major depressive disorder. And serious abandonment issues.
    Any insight out suggestions would be epically appreciated.

  5. Pam April 17, 2017 at 7:39 pm - Reply

    I call mine the “Ugly Cry”….. out of nowhere, a hysterical cry that I can’t control. I’m left totally exhausted, migraine type headache & sleep for hours. I hate it!!!!

  6. Simona April 30, 2017 at 2:28 pm - Reply

    Hi. I discovered that i suffer from bipolar 1 less than one year ago. Three years ago i received the diagnose of borderline personality. At first i was so depressed. I thought my life was destroyed. I was full of shame and pain. Now i think i finally have The answers about what was happening to me, inside of me, for so many years. I started suffering of bipolar disorder when i was about 19. Now i’m 39. I’ve suffered so much in my Life. .so many periods of deep depression..i used to feel so fuckin’ lonely. Now i’m gong to the psychologist every week. I feel better. Good luck.

  7. Jamie April 30, 2017 at 4:00 pm - Reply

    My sister is type 1 i find it hard to relate to her and i have my own issues . A treatable illness but still no drug can cure it only hope to manage it.

  8. Levi May 3, 2017 at 9:56 am - Reply

    I am just now learning about bi polar and how it affects you life. I was diagnosed with it and my road is a very difficult one to travel.

  9. Michelle May 20, 2017 at 11:41 pm - Reply

    I was diagnosed with bipolar I 10 years ago and since then have made drastic changes to my life. I fall into a very small percentage of people with bipolar where meds don’t work for me (and I’ve tried). It took me some time to figure out a good regimen that would allow me to function. I also follow alternative methods of healing. Meditation has been great (sometimes a challenge), massage has had great effect, crystal therapy has been huge for me, and of course proper diet and exercise. I also realized that I need a lot of structure in my life to maintain the stability and that means having a planner and scheduling everything and keeping to at schedule. Also proper sleep is vital for me, without it I can end up in rapid cycling episodes. Nowadays I get comments like “you don’t seem like you have bipolar, you’re so normal” I simply respond with that I am high functioning because I make it a priority to be self aware of my triggers and my body. It’s been a long tough road but one that can be maintained. I also agree with Jak a deeper connection with nature can help heal the emptiness inside.

  10. M June 1, 2017 at 6:52 am - Reply

    Aww Duan I can relate

  11. Emer July 4, 2017 at 10:36 am - Reply

    I was diagnosed with Bipolar Disorder in 1979. I’ve been taking Lithium since 1992. I didn’t notice any improvement until I went for therapy sessions in 2015. During therapy it became obvious that being incarcerated in a mental institution when I was seventeen was a large cause of my instability. My symptoms subsided when I was given an opportunity to talk honestly about my experiences. I don’t believe that a chemical imbalance in the brain was the cause of my difficulties. Childhood abuse and a system that didn’t listen are far more likely culprits. Psychiatry lost its way when it lost sight of the individual.

  12. Pauline R Rentch July 20, 2017 at 10:15 am - Reply

    I have a diagnosis of bipolar 1 w a personality disorder severe w psychotic features. My mom said she knew by the time i was 6 months old that there was something wrong w me. I had what they call a hallucination for the first time that i can remember when i was 3. Yes 3. My mom remembers it quite well also. At the age of 4 thru 5 i couldn’t stop crying and ofcourse i still go through that. No matter what was said be it go play or come and eat i would cry and cry and no one knew what to do w me. I am now 43 years old and have been living w this my entire life. I still feel like theirs something or someone else inside of me trying to take me over but i have learned how to control that other being to an extent. I just dont go anywhere and socialize w only a couple of people. My children do drive me insane and their all grown. Its the worry for their future that scares me i guess. My psychiatrist retired and no one else knows me like he did. This is an issue but what can i do. Besides just deal and hide.

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