Atypical bipolar: Definition, symptoms, diagnosis, treatment

Jennifer E. Engen

“Atypical bipolar” is not a diagnosis. It refers to the fact that a person has symptoms of bipolar illness that differ in some way from the more common presentations of the condition.

Bipolar disorder is a type of mental health condition associated with extreme highs and lows. A doctor may call these “manic” and “depressive” episodes, respectively.

The combination of symptoms a person experiences helps mental health professionals classify their condition. A doctor may classify atypical presentations of bipolar disorder as “bipolar disorder not otherwise specified.”

The purpose of classification is to help the medical care team recommend the most effective combination of treatments.

Bipolar disorder causes distinct changes in activity levels, mood, and energy levels. The symptoms can often change over time, and managing the condition requires lifelong care.

This article explores:

  • what people may mean by “atypical bipolar”
  • what symptoms it can cause
  • how it differs from other bipolar types
  • how a healthcare professional arrives at a diagnosis
  • treatments
  • outlook

An atypical presentation of bipolar disorder means that a person’s symptoms do not exactly match those of the more common types of bipolar disorder.

These are:

  • Bipolar I: This typically involves having a manic episode that lasts at least 7 days and is often, but not always, followed by a depressive episode that lasts at least 2 weeks.
  • Bipolar II: This type involves a pattern of depressive episodes with a less severe manic period.
  • Cyclothymic disorder: A doctor may call this “cyclothymia,” and it involves both depressive and manic episodes that are less severe and do not fit the criteria of bipolar I or II.

Someone with an atypical presentation of bipolar disorder has symptoms of the condition that do not follow the patterns above. It may involve both manic and depressive episodes or periods.

A person with an atypical presentation of bipolar disorder may have periods of an unusually high mood and depressive episodes. They experience these in a way that does not meet the diagnostic criteria for bipolar I, II, or cyclothymic disorder.

Mania is a period of high energy and mood. It can last for several days or longer. The symptoms can vary, but mania may involve:

  • speaking quickly
  • feeling invincible
  • having lots of energy
  • being unable to sleep
  • having anxiety
  • engaging in reckless behavior
  • feeling extremely happy
  • engaging in unusual behavior that others might consider strange
  • having racing thoughts

The symptoms of depressive periods can also vary, but they can include:

  • changes in sleeping patterns
  • feeling sad or depressed
  • having an increased appetite and gaining weight
  • trouble believing in the ability to complete small tasks
  • a loss of interest in formerly enjoyed activities
  • difficulty concentrating or thinking
  • feeling slowed down
  • feeling restless
  • feeling hopeless
  • speaking slowly

Experts recognize three distinct forms of bipolar disorder:

  • bipolar I — manic episodes that each last at least 7 days, often followed by depressive episodes that each last at least 2 weeks
  • bipolar II — periods of depressive episodes with less severe manic episodes between
  • cyclothymia or cyclothymic disorder — a milder form that includes both manic and depressive episodes

An atypical presentation of bipolar disorder involves episodes of mania, depression, or both. The duration and severity of these periods do not match any of the above patterns.

It can be challenging to diagnose bipolar disorder.

According to the National Institute of Mental Health, one reason is that a person may only seek help during a depressive episode. This might be due to a feeling of enjoyment during manic periods.

If a person does not seek treatment during manic periods, a doctor may misdiagnose bipolar disorder as depression.

Also, depressive symptoms tend to present more frequently than manic symptoms, which can also lead to this misdiagnosis.

Some estimates indicate that getting a correct diagnosis can take 5–10 years from the start of symptoms.

There is no cure for bipolar disorder. But with the right treatment, a person can manage their symptoms and have a high quality of life.

A person needs to continue their treatment, even when the symptoms are not present, in order to keep them from reappearing.

The best approach varies, but a doctor may recommend one or more of the following:

  • Medications: Finding the right combination of medications may take some trial and error. The first approach often includes a mood stabilizer and a second-generation antipsychotic drug. The doctor may also prescribe other medications to help with other symptoms, such as trouble sleeping. Work closely with the doctor, and let them know which medications appear to be working, any side effects they cause, and any other changes.
  • Psychotherapy: This involves speaking with a therapist. A doctor may also recommend cognitive behavioral therapy, interpersonal and social rhythm therapy, and family-focused therapy.
  • Lifestyle changes: Getting regular exercise, having a healthy diet, avoiding alcohol, and other self-care strategies may help.
  • Other treatment options: A doctor may recommend approaches such as electroconvulsive therapy or transcranial magnetic stimulation. These help stimulate the brain to treat severe manic or depressive episodes.

Though bipolar disorder is the 12th leading cause of disability, people with the condition who receive effective treatment can maintain a high quality of life.

A person needs to continue with the treatment, even when there are no symptoms. This is to prevent them from returning.

Speak with the doctor about any worsening symptoms or unwanted side effects.

Atypical bipolar symptoms do not match those of other bipolar disorder types. A person experiences manic episodes, depressive episodes, or both. But the severity and duration of these episodes are different from those of bipolar I, bipolar II, or cyclothymia.

The approaches to treatment are similar to those of other types of bipolar disorder. They may involve medication, lifestyle changes, and psychotherapy.

It is important to continue with treatment to prevent the symptoms from recurring. Let a doctor know if any unwanted side effects arise or if the treatment does not seem to be working.

https://www.medicalnewstoday.com/articles/atypical-bipolar

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