Expert: Joanne Chang - 4/26/2008

Question
My brother was diagnosed with Bipolar-depression Disorder. What is Bipolar-depression Disorder? Is it like Bipolar i or Bipolar ii? What is the different with the depression part is it like major depression. I have 2 others in my family have Bipolar ii and 1 have major depression. I was all way been told both are two different diagnosis.


Answer
Hi Jim,

Sorry about the delay in getting back to you but this weekend has been really hectic for me.

In general, bipolar disorder has 3 diagnostic subtypes:
- Bipolar 1
- Bipolar 2
- Cyclothymia

According to the DSM-IV (a widely-used diagnostic manual), the general difference is:
- Bipolar 1: 1 or more manic episodes with or without depressive episodes
- Bipolar 2: hypomanic episodes and at least 1 major depressive episode
- Cyclothymia: hypomanic episodes and periods of depression that do not meet the criteria for major depressive episodes

Note the difference that Bipolar 1 involves manic episodes, whereas Bipolar 2 involves hypomanic episodes.  Hence, the mania feature differs in severity for Bipolar 1 (more severe) and Bipolar 2 (milder).

With your brother's diagnosis, it is best to discuss the use of the term "Bipolar-depression Disorder" with his psychiatrist.  Most of the time, when this term is used, it is used to mean bipolar disorder in general ("Bipolar Affective Disorder" is also sometimes used).

You can find a summary of the diagnostic criteria here:
http://www.mentalhealth.com/dis/p20-md02.html

Best wishes,
Joanne :-)