ASWB Practice Question: Bipolar Disorder Recall

By Heidi Tobe on June 7, 2021

This month we are continuing our series comparing recall vs. reasoning questions. Every two months, we are taking a topic that could show up on the ASWB exam and are first doing a recall (or application) question on the topic. Then the next month we come back with a reasoning question on that same topic. In February and March we covered Narcissistic Personality Disorder. In April and May we covered Antisocial Personality Disorder. Now for June and July we are delving into the differences between Bipolar 1 and Bipolar 2. This month instead of doing a straight recall question, we are going to do an application question, where you apply the knowledge of these diagnoses to a client scenario.

Bipolar 1 Disorder

For Bipolar 1 you need to have one thing: a manic episode. Bipolar 1 does not require a major depressive episode. With Bipolar 1 you will see someone with a significantly elevated mood. They could also have depressive symptoms, but these are not required for a diagnosis of Bipolar 1. Once there is a manic episode, it is Bipolar 1.

Bipolar 2 Disorder

For Bi

polar 2 Disorder, you need to have a hypomanic episode and at least one major depressive episode. There has to be a major depressive episode (along with a hypomanic episode) for a Bipolar 2 diagnosis. 

When you are distinguishing between these two, remember that as soon as they have a manic phase, it’s Bipolar 1 (even if they also have a major depressive episode). The one thing you need for Bipolar 1 is a manic episode-a major depressive episode can also occur, but you must have the manic episode. For Bipolar 2, you need a hypomanic episode and a major depressive episode.

What is the difference between mania and hypomania?

First and foremost, it is important to note that a manic episode is more severe and typically longer in duration than a hypomanic episode. A manic episode must last a week or longer and symptoms include: feelings of heightened energy, creativity, and euphoria; talking a 'mile a minute', needing very little sleep; being hyperactive; feeling all-powerful, invincible, or destined for greatness. During mania people may go days without sleeping, spend well beyond their means (even going into debt), and may neglect duties and responsibilities in their life. Mania is severe enough that it interferes with daily functioning and can require hospitalization for stabilization.

Hypomania is a milder form of mania lasting at least four days; it can still be marked by elation and hyperactivity or can even come across as intense irritability, but is not at the same level as a full manic episode where people feel invincible, can't complete tasks of daily functioning, or require hospitalization for stabilization. A simple way to think about it is that if someone were hypomanic, you may notice their behaviors seem different or off, but if someone was manic you would defin

itely know something was wrong.

ASWB Practice Question

A social worker meets with a 30 year old client who came to therapy after receiving an ultimatum from her spouse. The client reports experiencing periods of feeling ‘on top of the world’ followed by periods of severe depression. When the social worker inquires about what led to her spouse’s ultimatum that she attend therapy, the client shares that last week she quit her job and maxed out her credit cards to start a new business venture that came to her in the middle of the night. The client shares that she hasn’t slept in days, but feels like she can take on the world. What is the MOST likely diagnosis?

A. Cyclothymic Disorder

B. Bipolar 1 

C. Bipolar 2


(scroll for answer and rationale)

Bipolar Disorder

















The correct answer is B: Bipolar 1. The symptoms being described indicate the client is experiencing a manic episode. The symptom severity is beyond that of a hypomanic episode, which allows us to rule out Cyclothymic Disorder (A) and Bipolar 2 (C). Even though the client shares that she experiences periods of severe depression, remember that as soon as a manic episode is present, the diagnosis is Bipolar 1 (even when there are also depressive symptoms). The symptoms being described go beyond that of ADHD (D). 

ASWB Masters and Clinical Exam Preparation 

This topic can be a tricky one for many test takers. Do you feel confident in the differences between Bipolar 1 and Bipolar 2, or do you need additional support? One of the great things about TDC is that every customer has access to a coach they can email anytime questions come up as they go through the program. If you still have questions around this topic, be sure to reach out to your coach. And if you haven’t signed up for one of our programs yet, we encourage you to read one of the thousands of real customer testimonials. TDC has helped THOUSANDS of social workers successfully pass their social work licensing exams. Will you be next?


Commenter Name
June 11, 2021

Thank you very much for the differences between Bipolar I and II. That made it clearer for me to understand it.

Next time, can you please discuss Schizoid Personality Disorder versus Schizotypal Personality Disorder? Thank you again. Warm regards.

Commenter Name
September 13, 2021

Hi Desiree,

We're so glad it helped make things clear! While we don't have Schizoid vs. Schizotypal on the list for blogs for the rest of 2021, we will keep it in mind for 2022! Until then, be sure to reach out to your coach with any questions about the differences between the two.

Commenter Name
January 6, 2022

Thank you for this question, it definitely helps clarify. Could you go further into when we would know the difference between bipolar 2 and cyclothymic? Is it that the timeline of symptoms for 2 years that makes it cyclothymic? If so, why are more people not stating that they have cyclothymic disorder rather than bipolar since most people diagnosed with bipolar will have it for lifetime, correct?

Commenter Name
January 6, 2022

It's more than just the timeline. For Bipolar 2, we need to see a hypomanic episode AND a major depressive disorder. Once we have the major depressive disorder (along with the hypomanic episode) it is Bipolar 2.

Cyclothymic Disorder also has low periods where they feel down, but none of the highs or lows in an individual's mood can meet full criteria for a diagnosis of full mania or major depression (if it met criteria for major depression, it would be Bipolar II; if it met criteria for full mania, it would be Bipolar I). So hypomanic episodes are seen in both Bipolar II and Cyclothymic Disorder-the difference is that with Bipolar Disorder II there is also a major depressive episode.

Commenter Name
August 16, 2022

I am confused, in this case why the answer to the question is not Bipolar II but I? Can you explain more about that, and in this case, even it mentioned it's followed by severe depression it's not bipolar II, so what qualifies for II? Thank you!

Commenter Name
August 16, 2022

Anytime a manic episode is present, it's Bipolar 1 (even if there is also a depressive episode). It would only be Bipolar 2 if we had a major depressive episode and a HYPOmanic episode (not a full manic episode).

Add new comment

The content of this field is kept private and will not be shown publicly.

Plain Filter