Bipolar II disorder involves periods of depression and periods of elevated mood, called hypomania. This is like mania but less extreme.
All forms of bipolar disorder involve shifts in mood and levels of energy and activity.
Bipolar II causes hypomania, a period in which mood and behavior are elevated beyond what most people experience. In a state of hypomania, a person may feel elated, energized, or even irritable.
Bipolar I causes mania, a more severely elevated mood than hypomania.
Experts introduced the term “bipolar II disorder” in 1994 to help doctors describe and treat the condition more effectively.
However, as scientists discover more about the condition, some have called for an end to the distinction between types I and II. They argue that it is more realistic to see bipolar disorder as a spectrum with a range of symptoms, patterns, and severities.
The main difference between bipolar I and II relates to the intensity of manic periods. However, the distinction is not clear-cut, according to researchers.
Below are diagnostic criteria for both types of the disorder:
Bipolar I: A person will have at least one manic episode, with or without an episode of depression. A manic episode may involve psychosis, which can include hallucinations or delusions. During mania, a person may need hospital care.
Bipolar II: A person will have at least one depressive episode and at least one episode of hypomania, which does not involve psychosis. Depression is often the dominant mood.
According to some researchers, people with bipolar II are likely to have depression more than 50% of the time, while for those with bipolar I, depression is present for around 30% of the time.
Bipolar II is characterized by periods of hypomania followed by depressive episodes. However, the duration and severity of these episodes and the range of other symptoms can vary widely from person to person.
Hypomania usually lasts a few days and can involve the following symptoms:
- having more energy and self-confidence
- feeling more creative
- being more sociable, flirtatious, or sexually active
- having faster thoughts and quicker actions
- getting distracted more easily
- talking faster and more than usual
- engaging in risky behavior, such as spending or getting into arguments
- drinking more coffee or alcohol
- smoking more or taking more drugs
A person with hypomania may feel good and function well, but others may notice that their behavior is unusual. After feeling good, there is a risk that a depressive episode will follow.
Symptoms of a depressive episode can include:
- feeling sad, empty, or hopeless
- having low motivation
- losing interest in activities
- sleeping too much or too little
- having low energy levels
- having feelings of worthlessness and guilt
- having trouble focusing
- gaining or losing weight without trying
- having suicidal thoughts or tendencies
The symptoms tend to appear in early adulthood, but the disorder can develop in children and, more often, teens.
Doctors do not know exactly what causes bipolar disorder, but the following may play a role:
- a variety of genetic factors
- environmental factors
- structural features in the brain
Bipolar disorder is more likely to develop in a person with a close relative who has it.
Also, stress and traumatic events can contribute to triggering the condition in a person with a genetic predisposition.
According to the National Institute of Mental Health, symptoms may appear for the first time during pregnancy or after childbirth.
For a diagnosis of bipolar II, a person will need to have had at least one episode of depression and at least one hypomanic episode.
People often feel good during hypomania and seek medical help when they experience depression. For this reason, doctors often misdiagnose bipolar II as depression.
When making a diagnosis, a doctor will:
- ask about symptoms
- ask about family history
- perform a physical exam
- order tests, such as blood tests, to rule out other possible causes
Then, they use criteria from the Diagnostic and Statistical Manual of Mental Disorders to make a diagnosis.
The doctor may also use a checklist to identify hypomania.
Treatment for bipolar II disorder usually involves a combination of medication and psychotherapy.
It is usually long term and continuous. If a person stops treatment, even when they feel well, symptoms can return.
These may include:
- mood stabilizers
- medications to help improve sleep quality
It can take time to find the best combination and dosage. A person may need to work with their doctor for some time before they arrive at a suitable solution.
Report any side effects to the doctor, to help them make the right adjustments. Trusted loved ones may also be able to offer helpful insight.
Psychotherapy and counseling
Talking through emotions and challenges associated with bipolar disorder can help.
The purpose of psychotherapy or counseling may be to:
- develop coping strategies for symptoms
- identify effective ways to manage stress
- identify triggers and ways of avoiding them
- educate the person about bipolar disorder
Some people have accompanying health problems, such as alcohol or drug use disorders. Treatment can help with these, too.
Various strategies can help a person achieve more stable moods and a deeper sense of well-being, including:
- Exercise: A doctor can help develop an exercise plan to support stress management and overall health.
- Diet: A healthful, varied diet provides essential nutrients and boosts overall well-being.
- Sleep: Getting enough quality sleep regularly can help, and a consistent routine is important.
- Keep a log: Noting down mood changes and life events can help identify patterns and triggers.
While there is evidence that some supplements may help with mild to moderate symptoms, it is essential for people with severe symptoms to seek professional help. People may find that supplements help manage symptoms and prevent recurrences when they use them alongside conventional treatment.
Also, it is essential to speak with a doctor first, as some supplements may interact with medications.
Symptoms of bipolar II disorder often appear in early adulthood.
The condition is lifelong, but a range of treatments can help manage it. It is essential to follow the doctor’s instructions — a person should not discontinue medication before discussing it with a healthcare provider.
Bipolar disorder is a complex condition that can affect many aspects of a person’s life. Finding a trustworthy doctor and staying in regular contact with them can help.