Understanding Bipolar II Disorder

Bipolar II disorder or bipolar 2 disorder is the less intense form of the mental health condition previously known as manic depression.

NAMI (the National Alliance on Mental Health) reports that an estimated 4% of US adults will experience bipolar at some stage.

Bipolar disorder typically presents at the age of 25, according to the Depression and Bipolar Support Alliance. Symptoms sometimes manifest earlier or later in life, though.

Most people suffering from bipolar find the symptoms disrupt daily functioning. The scope and severity of this impairment will vary from person to person.

Although bipolar can be remarkably disruptive, most people diagnosed with bipolar II can engage with a personalized array of medications and treatments, enjoying productive lives.

What is Bipolar 2?

Bipolar disorder is a mental health condition and mood disorder characterized by dramatic shifts in mood.

For some people suffering from bipolar, episodes last for just a few days. Others experience episodes of mania or depression enduring for weeks. The frequency of episodes varies considerably from person to person.

Bipolar disorder brings about all of the following:

Intense mood swings
Impaired concentration
Difficulties with focus
Pronounced changes to energy levels

The Diagnostic and Statistical Manual of Mental Disorders published by the APA (American Psychological Association) is the diagnostic tool mental health professionals use to diagnose mental health conditions and addictions.

Per DSM-5 (the latest edition of this benchmark publication), there are two types of bipolar:

Bipolar i: At least one manic or mixed episode, and either hypomanic or major depressive episodes.
Bipolar ii: At least one major depressive episode and a hypomanic episode.

Bipolar II, then, is a subset of bipolar disorder.

Those with bipolar II will experience both depressive episodes and hypomanic episodes, but they will not experience full manic episodes, meaning the condition is generally less debilitating than bipolar I.

For a diagnosis of bipolar II, the following conditions must be satisfied:

At least one hypomanic episode lasting for four days or more and presenting with three or more hypomanic symptoms.
At least one major depressive episode persists for two weeks or more and presents with five more depression symptoms that significantly impact daily functioning.
Symptoms are not better explained by other mental health of medical conditions.
Symptoms are not better explained by substance abuse.
Changes to daily functioning and mood are noticeable to others, even if they do not affect your day-to-day life.

Bipolar II Disorder Symptoms

The International Bipolar Association reports that bipolar 2 symptoms will vary from patient to patient.

For some with bipolar II, episodes persist for months, sometimes even years. Others find episodes are more fleeting and intermittent.

In the event of rapid cycling bipolar, at least four episodes will occur over one year.

The symptoms of bipolar II can be broadly cleaved into two as follows:

Manic and hypomanic symptoms
Depressive symptoms

Manic and hypomanic symptoms

Mania and hypomania are both clinical descriptors for elevated mood. Mania is more intense than hypomania.

The symptoms of mania or hypomania associated with bipolar II can include:

Underperforming at school or work
Missing school or work
Talking quickly or excessively
Engaging in dangerous behaviors
Rapidly changing topics in conversation
Elevated levels of self-importance, self-esteem, and self-confidence
Racing thoughts
Elevated levels of self-esteem, self-importance, and self-confidence
Denying that anything is wrong
Not realizing that anything is wrong
Euphoria or exhilaration
Heightened sex drive
Impaired judgment
Sleeping little but not feeling tired
Being overly sociable
Feeling bored and distracted
Edginess
Feeling capable of anything

Depressive symptoms

The symptoms of depression associated with bipolar II can include:

Physical pain not responsive to treatment
Memory issues
Problems with focus
Irritability
Feelings of hopelessness
Weight gain
Weight loss
Insomnia
Other sleep issues
Feelings of helplessness
Extreme sadness
Deep fatigue
Anxiety about trifling concerns
Sense of guilt
Inability to enjoy normal activities
Appetite changes
Oversensitivity to smells or noises
Missing work or school
Underperformance at work or school
Suicidal thoughts

Psychosis in Bipolar II

Research indicates that between 3% and 45% of those with bipolar II experience psychotic symptoms during a depressive episode. There is little data concerning the impact of psychotic symptoms in bipolar II patients since research in this area focuses on bipolar I.

Psychosis involves losing touch with reality and is often triggered by substance abuse or mental health issues such as schizophrenia.

Psychotic symptoms often involve a variety of delusions. These are false beliefs not grounded in reality, including:

Delusional jealousy
Paranoid delusions
Delusion of grandeur

Sometimes, delusions are somatic – that is, they are not clinically detectable.

Psychosis occasionally triggers hallucinations, whether visual, tactile, or auditory.

What are the most effective bipolar ii disorder treatments, then?

Bipolar 2 Treatment

Bipolar II is not as intense as bipolar I, and with the right treatment, you can expect a favorable outcome.

Most people diagnosed with bipolar II find that a proven combination of medication-assisted treatment, psychotherapy, and counseling helps to alleviate symptoms and improve functioning.

Bipolar disorder is nevertheless a lifelong condition, with episodes of mania, depression, and hypomania liable to recur. Even in the event of symptoms lingering, though, long-term treatment can help you to manage these symptoms.

In addition to MAT and psychotherapy, some people with bipolar II benefit from the following therapies:

Supplements
Acupuncture and other holistic therapies
Transcranial magnetic stimulation (TMS)
Electroconvulsive therapy (ECT)

Medications

Bipolar ii disorder medications are a core element of treatment for most people with this SMI.

If you have a dual diagnosis – bipolar with a co-occurring substance use disorder or alcohol use disorder – medication-assisted treatment can help effectively treat both conditions.

These are the most common bipolar 2 medications:

Mood stabilizers like Lithium
Benzodiazepines
Antipsychotics
Antidepressants
Anticonvulsants

You should never abruptly stop taking medication for bipolar II. This can cause a rebound effect, with the original symptoms returning in a more intense form than before.

Benzos are unsuitable for long-term use due to the speed at which tolerance builds, giving this class of medication a strong potential for abuse and addiction. Used short-term and as directed, benzodiazepines can help manage some of the symptoms of bipolar II.

Mental Health Treatment at The District Recovery

At The District, we offer an array of outpatient mental health treatment programs. This allows you to engage with personalized and highly structured therapy for bipolar II without needing residential rehab.

As well as traditional outpatient programs (OPs), we provide intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) for anyone with a more severe mental health condition.

Whatever time commitment best suits your needs, you’ll have access to the same evidence-based treatments you find in inpatient facilities at a fraction of the cost. The core programming involves: