What is Bipolar Type 1 and 2 – and what does it matter?
Bipolar Disorder is a mood disorder that consists of cycling moods that range from depression to feelings of elation. In order to find a way to provide effective treatments, Bipolar disorder was categorised into type 1 the more serious category and type 2 the milder category. To fall into the type 1 box the person must have experienced symptoms that are more severe and over a longer period of time.
I find that the type 1 and type 2 categories are more useful to psychiatry and research as the spectrum of “what is” bipolar disorder is far more complicated. I understand that medications and treatments stringently controlled in research studies need clear boundaries.
In Psychotherapy however we do not need such clear boxes as most counselling therapies involve current behaviours or thoughts. This is very useful in Bipolar because for many of those with the label there are few if any symptoms between episodes. Of the dozens of clients that I’ve seen with bipolar, few need recurring appointments once they have invested in their relationships sufficiently and have taken measures to avoid behaviours that put them at risk. Medication forms part of a toolbox that a mature adult can use effectively if supported effectively.
I’m keen to not use the “type” idea if clients are keen to avoid it. The category is likely to appear in my doctor’s letters if requested, but rarely does it alter the way I would approach counselling. I work more on a system of measuring distress. If someone has type 2 bipolar, and an unhappy workplace (e.g. bullying), unhappy relationship (e.g. partner misuses substances) and a health condition like high blood, then this person may be at risk from things going wrong in one area and finding lack of support from anywhere. This person would need a lot more professional support to make changes than someone who had a type 1 bipolar label and had 1-2 episodes in early adulthood when misusing substances and “living it up”, but has changed their lifestyle dramatically and hasn’t had a problem for years.
How does Counselling for Bipolar Work?
Counselling for Bipolar Disorder comes after a tricky assessment of factors that are likely to cause either depression or mania, and factors that are protective of relapse. I believe that too many of those with bipolar disorder that see me for counselling have identified the risks, but haven’t move to the next level and built security into their social support system. Sometimes this means ending dysfunctional relationships, or changing careers. Shift-work, demanding relatives, access to illicit drugs and poor life management skills can lead to a quick downfall.
Keen to learn more? Please see me for one appointment and let’s review your strategies and see if you have thought of most things. If not then I’m happy to be a sounding board for changes that will help make you Bipolar proof! It’s a little like fixing the house before a storm, you can also make your life more secure by working out how to prevent the condition!
Author: Vivian Jarrett, B Psych (hons), MAPS, MAICD.
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