While each type of bipolar disorder has a somewhat different set of symptoms, all of them are characterized by fluctuations in mood, energy, and activity level, according to the National Institute of Mental Health (NIMH). These mood changes can take the form of manic episodes — feeling extraordinarily “up,” elated, irritable, or energized — and depressive episodes, in which the person feels very “down,” sad, indifferent, or hopeless. Some people with bipolar disorder experience hypomanic episodes — a milder form of mania that may not last as long.

Bipolar I Disorder

Bipolar I disorder features the following characteristics, according to NIMH:

Manic episodes lasting at least one week, or manic symptoms that are so severe you require immediate hospitalizationDepressive episodes, usually lasting at least two weeksDepressive and manic symptoms that occur at the same time (in some cases)

Bipolar II Disorder

Bipolar II disorder features a pattern of depressive episodes and hypomanic episodes, but the full-scale manic episodes of bipolar I do not occur, say NIMH experts.

Cyclothymia

Cyclothymia, also known as cyclothymic disorder, is a milder form of bipolar disorder, also featuring emotional ups and downs but with less-severe symptoms than bipolar I or II, according to the APA. Cyclothymic disorder is characterized by the following, per the APA:

Numerous periods of hypomanic and depressive symptoms have occurred for at least two years, but these symptoms don’t meet the criteria for hypomanic or depressive episodes.During the two-year period, the mood swings have lasted for at least half the time and have never gone away for more than two months.

With cyclothymia, “It may seem like you’re just going through a string of good days and a string of bad days,” says the psychiatrist Kathleen Franco, MD, of the Cleveland Clinic Lerner College of Medicine in Ohio. “But the mood shifts keep going, and there’s little neutral time in between.”

When someone has bipolar disorder symptoms that do not exactly match the categories listed above, they may receive a diagnosis of “other specified and unspecified bipolar and related disorders,” according to NIMH. When you have cyclothymia, you can typically function day to day and handle normal activities. But the mood swings are unpredictable and may significantly disrupt your life without much warning. The highs of cyclothymia, Mayo Clinic experts say, may include:

Euphoria — an excessive feeling of happiness or well-beingExcessive optimism and inflated self-esteemUnusual talkativityPoor judgment that can lead to poor choices or risky behaviorsRacing thoughtsIrritability or agitationExcessive amounts of physical activityElevated drive to reach one’s goals, whether sexual, social, or work-relatedReduced need for sleepDistractibilityLack of concentration

The lows of cyclothymia, according to the Mayo Clinic, may include:

Feelings of sadness, emptiness, or hopelessnessBeing tearfulIrritability, especially in children and teenagersLoss of interest in activities once enjoyedWeight fluctuationsFeeling worthless or guiltyTrouble sleeping or restlessnessFatigueTrouble concentratingThoughts of death or suicide — although suicidal thoughts may occur with cyclothymia, they’re more likely to occur if you have bipolar I or II disorder. If you have suicidal thoughts, call 911 or seek emergency medical care.

Only a doctor can accurately distinguish between cyclothymia and other types of bipolar disorder, or any other condition that may be causing your symptoms. Psychotherapy and medication are the first-line treatment options for bipolar I and II disorders, according to the Mayo Clinic.

Psychotherapy

Psychotherapy, also known as counseling or talk therapy, is an essential part of treatment for bipolar disorder, according to the Mayo Clinic. Several types of therapy may be recommended, including:

Cognitive behavioral therapy (CBT) This form of therapy helps you discover any unhelpful negative beliefs and behaviors you might have and replace them with helpful positive ones. It can help you identify symptom triggers and learn coping skills and stress management strategies.Interpersonal and social rhythm therapy (IPRST) This type of therapy helps you establish a consistent daily routine for meals, exercise, and sleep and wake times. These strategies can keep your mood stable.

Medication

Several kinds of medications are approved for the treatment of bipolar I and bipolar II, say Mayo Clinic experts, and can include:

Antipsychotics These medications may be prescribed to manage persistent manic or depressive symptoms.Mood stabilizers These drugs keep manic or hypomanic symptoms at bay.Antidepressants These medications are used to manage depressive episodes. They’re often prescribed alongside a mood stabilizer or antipsychotic medication, because antidepressants sometimes trigger manic episodes.

The primary treatment options for cyclothymia are similar to those for bipolar I and II disorders: psychotherapy — such as CBT and IPRST — and medication. While there are no medications specifically approved by the FDA to treat cyclothymia, your doctor may prescribe medications that are used to treat bipolar disorder in order to control and prevent symptoms, say Mayo Clinic experts. Even during periods when you’re feeling well, it’s important to continue to take your medications, because if you stop, your symptoms will likely return. Additional reporting by Deborah Shapiro and Christina Vogt.