Bipolar II Disorder

This article is part of the Depression Symptoms Guide. In this part of the series, we will examine the type of depression known as Bipolar II Disorder.

Bipolar II disorder is a part of the bipolar disorder spectrum of mood disorders, which are often also referred to as manic-depressive disorder, manic depression or bipolarism. Bipolar II disorder shares the mood cycles associated with bipolar I disorder, but sufferers of bipolar II experience mania in the form of the milder hypomania, and also have experienced at least one episode of major depressive disorder.

Depressive episodes in bipolar II are more frequent and more intense than episodes of hypomania, and in fact bipolar II may create depression or anxiety so great that the risk of suicide is higher than in those suffering from Bipolar I.^[1]

Symptoms

The symptoms of bipolar II disorder are:

• Hypomania.
• One or more episodes of major depressive disorder.

Diagnosis

Bipolar II disorder can be particularly challenging to diagnose, and the condition is generally underdiagnosed due to hypomanic behaviour being overlooked as a personality trait, or misdiagnosed as an anxiety disorder, sometimes combined with a diagnosis of some form of depression.

This can be dangerous, because if a bipolar II sufferer is prescribed an anti-depressant alone, it can elevate a hypomanic state to a manic one, or even onset periods of rapid cycling bipolar disorder.

In diagnosing bipolar II disorder, the DSM-IV-TR^[2] requires:

• At least one hypomanic episode.
• One or more major depressive episodes.
• No other disorder be responsible for the symptoms.
• The patient has not experienced either mania or dysphoric mania.
• The symptoms cause the sufferer distress, and/or impaired functioning in social, occupational, or other important areas of functioning.

Getting Help

While the hypomanic aspects of bipolar II may be attributed to an energetic personality, the presence of major depressive disorder should act as a warning sign that medical help is needed.

If you or someone you know seems to be suffering from bipolar II disorder, it is important that medical help is sought quickly. The chances of this condition worsening when left untreated are very high, escalating the risk of suicide.

As with bipolar I disorder, bipolar II disorder can be treated. Sufferers who access and maintain treatment can enjoy functional lives.

References

Goldring N, Fieve RR, (1984), Attempted suicide in manic-depressive disorder, American Journal of Psychotherapy

American Psychiatric Association, ed (June 2000), Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Fourth Edition (Text Revision) ed.), American Psychiatric Publishing, Inc