Bipolar Disorder Is Not One Thing: Understanding the Spectrum (and Why This Matters More Than You Think)

After my last article on the topic, many people reached out.

Some shared their own stories quietly, sometimes painfully. Some simply said, “Thank you. I had no idea.”

But one message stayed with me.

It was from someone who didn’t write about themselves. They wrote about their parents.

“I’ve read your articles, and now I wonder… could this explain what I grew up with? Could this help me understand them, and finally make sense of all those years?”

There was no blame in their words. Only longing. Longing to understand the people they loved. Longing to make peace with a childhood spent walking on eggshells—between the highs, the lows, the confusion, the silence.

And this is why I write these words today. Because bipolar disorder is not one thing. It is not one shape. Not one story.

And if we only look for the dramatic versions, the screaming, the breakdowns, the hospitalizations, we will miss the truth of so many lives.

We will miss the quiet suffering. The ones who never get the right name for what’s happening to them. The ones who carry shame for something that was never their fault.

So let’s talk about what bipolar really looks like.

Let’s talk about the spectrum.

Bipolar I: The High Peaks and the Deepest Valleys

This is the version most people imagine when they hear the word bipolar.

The soaring mania. The sleepless energy. The risky decisions that feel brilliant at the time. The fall that feels unbearable.

Mania isn’t just excitement. It’s elevation beyond control where thoughts race, judgment fades, and reality can start to blur.

I once had a patient tell me: “It was the most alive I’ve ever felt. Like my mind was on fire, with ideas, with certainty, with power. I was going to fix everything. And then… everything broke.”

Bipolar I is the crash after the climb. The deep depressions that follow the high. The body that collapses under the weight of a brain that ran too fast for too long.

But not everyone with bipolar climbs that high. And that’s where so many go unseen.

Bipolar II: The Hidden Struggle Behind the Smile

There’s no full mania here. Only hypomania, a lighter, subtler version of elevation. Productive. Charismatic. Focused. Sometimes so welcome that it feels like “finally, the real me.”

But the darkness comes, too. The long stretches of depression that follow. The emptiness that feels harder to explain because, after all, “Wasn’t I just doing so well?”

One of my clients, a gifted teacher, once told me: “I thought I was just burning out. Again. But now I see… there was always a pattern. The rush, the brilliance, the crash. And I blamed myself every time.”

Bipolar II hides well. Especially behind success. Especially in people who have learned to smile while drowning.

Cyclothymia: The Soft Spectrum Few People Talk About

Cyclothymia is often missed.

The mood shifts are real, but they never reach the full criteria for mania or major depression. They’re softer. Quieter. But chronic. Ongoing.

I’ve met people who lived like this for decades. Calling themselves moody, sensitive, emotional. Apologizing again and again for being “too much” or “not stable enough.”

One woman shared with me: “I thought it was my personality. I’ve always been like this, so I assumed it was just me.”

But emotional instability is not the same as a broken personality. And cyclothymia is not a character flaw. It’s a rhythm problem in the brain. And rhythms can be regulated.

Mixed Episodes: When High and Low Collide

This is where bipolar becomes especially dangerous, and often misunderstood.

Imagine having the energy to act, but the thoughts of despair. The racing mind of hypomania… filled with hopelessness.

This is where suicide risk runs high. Because the body is restless enough to move, while the mind is trapped in darkness.

One patient once described it to me like this: “It’s like being trapped in a speeding car with the brakes cut and nowhere to go but into the wall.”

Mixed states are exhausting. Confusing. Hard to explain even to the people closest to you.

But they are real. And they are part of this spectrum.

Rapid Cycling: When the Seasons Change Too Fast

Rapid cycling means moving through four or more mood episodes in a year. For some, the cycle can shift within weeks or even days.

It’s disorienting. Just as the mind and body begin to recover from one state, the next wave hits.

One young man told me: “I feel like I’m never standing on solid ground. I never know which version of me will wake up tomorrow.”

And when this happens often enough, it’s not just the mood that suffers. It’s relationships, work, trust, even self-respect.

This Is About Patterns, Not Labels

I tell my patients this often:

“Don’t focus on the name. Focus on the pattern.”

Because the label is not the point. The point is understanding the map of your mind, so you can stop blaming yourself for being lost.

Bipolar disorder is not a sentence. It’s not your identity. It’s simply the name for a pattern that deserves care.

When we understand the pattern, we can work with it. We can stabilize it. We can build a life around what’s true, not what’s feared.

Diagnosis is not the end of the story. It’s the beginning of the right kind of help.

If This Feels Familiar…

If reading this stirs something in you, if these patterns feel uncomfortably close to home. I invite you to stay curious.

Not judgmental. Not ashamed. Just curious.

Ask the better questions.

Look at the rhythm of your life, not just the isolated moments.

And if you’re someone like the person who wrote to me about their parents, know this: Understanding isn’t about blame. It’s about healing.

Because sometimes the most powerful thing we can give ourselves, or those we love, is the right name for the struggle.

The truth. And with truth comes choice.

Florina