Bipolar II Disorder

Almost everyone has at some point felt the "ups" or "downs" in their life; however, for people with bipolar disorder, these feelings of ups and downs can impair their capacity to operate in daily life and are much greater in its severity than normal highs and lows of life

What is Bipolar II disorder?

Bipolar disorder is a condition that causes unusual shifts in energy, mood, and activity levels and decreases the ability to function in every task. Bipolar disorder is divided into two types that are bipolar I and bipolar II. In bipolar II individuals do not display a full-blown Mania. Rather they experience at least one episode of hypomania and depressive episodes. It is similar to bipolar I, but the high moods never reach a full-blown Mania; they are less intense and thus called hypomanic episodes or hypomania. In a state of hypomania, an individual usually feels energized, displays elevated mood or can be irritable. In bipolar II and individuals who experience at least one episode of depression and one episode of hypomania with no involvement of psychosis, depression is often dominant and present half of the time in bipolar II, while those with bipolar I experience depression around 30% of the time only

According to DSM 5, bipolar II is no longer thought to be just a "milder" version of bipolar I, as an individual suffering from bipolar II spends a large amount of time with a depressive condition and instability of mood. Bipolar II disorder is usually accompanied by impairment in an individual's work and social life

Signs and Symptoms

Increased energy levels distinguish a hypomanic episode. These episodes are observable to others. However, they are not as severe as manic episodes. Symptoms of Hypomanic episodes include−

  • An overstated sense of euphoria or well-being

  • Increase in creativity

  • Excessive optimism

  • High self-esteem

  • Inflated self-image

  • Poor judgments and decision making

  • Risky behavior

  • Behavior that is irritable or agitated

  • Increase in physical activity

  • Increased motivation to perform

  • Reduced need for sleep

  • Racing thoughts

  • Unable to concentrate

Depressive symptoms include−

  • Feeling depressed, hopeless

  • Tearfulness

  • Loss of interest in previously enjoyable activities

  • Weight fluctuations

  • Feelings of worthlessness or guilt

  • Changes in sleep pattern

  • Restlessness

  • Tiredness

  • Concentration issues

  • Suicidal thoughts or attempts

Depressive symptoms co-occurring with a hypomanic episode or hypomanic symptoms co-occurring with depressive episodes are seen in individuals suffering from bipolar II disorder.

Diagnosis and Complications

Proper psychiatric assessment, physical examination, and recording of mood in mood chart are some criteria that are evaluated for determining and diagnosing bipolar II disorder. For the diagnosis, an individual must undergo physical and psychological evaluations, and the health physician rules out any physical conditions. In children, diagnosis includes the same criteria as used for adults

According to DSM 5 for diagnosis of bipolar II disorder includes−

  • An individual must have met at least one hypomanic episode and one major depressive episode

  • Other disorders do not better explain the experience of hypomanic and major depressive episodes in the spectrum of schizophrenia or other specified or unspecified schizophrenic and other psychotic disorders

  • There has never been a manic episode

  • The symptoms of depression and hypomanic periods cause significant impairment and distress in an individual's functioning areas of life.

  • Bipolar II disorder's onset usually begins in late adolescence and throughout adulthood within an average of 20 years. The disorder typically begins with a depressive episode and is not identified as bipolar II until a hypomanic episode occurs.


Bipolar II disorder's exact cause is unknown, but researchers believe that genetics, physiology, lifestyle, and other comorbid conditions tend to play an important role in its onset

  • Attention− Individuals with a family history of other mental disorders or bipolar disorder are predisposed to developing bipolar II disorder

  • Sensation− Differences such as changes in a person's brain and chemical imbalance may contribute to the onset of bipolar II disorder

  • Perception− It is also believed that severe prolonged periods of stress or traumatic life experience, unhealthy diet, and abuse in childhood can trigger bipolar disorder.

Living with Bipolar Disorder

Individuals with bipolar disorder tend to be dysfunctional in personal and social life areas. The symptoms of bipolar disorder make an individual, especially in their occupation, lag behind, resulting in lower socioeconomic status despite being or having the potential to reach greater heights in life. They tend to perform poorly in cognitive tests and semantic fluency and have cognitive impairments. It is critical for an individual suffering from bipolar II disorder to recognize the indicators of an upcoming manic or depressed episode. Preparing a list of the early symptoms that followed prior mood swings and assessing the triggers, and external stimuli, which previously led to depression or hypomania can be a great way to avoid the intensity and deal with the disorder better. Typical triggers include.

Treatment and Ways to Cope

Treatment for bipolar II disorder is directed at managing the symptoms depending on individual needs


Different types and doses of medication are prescribed based on individual symptoms. It may include:

  • Antidepressants− commonly prescribed to treat depression, but as they can sometimes cause hypomanic episodes, they are typically used with a mood stabilizer or antipsychotic medicine, such as escitalopram, citalopram, fluoxetine

  • Mood stabilizers− This medication helps patients regulate mood by controlling hypomanic episodes, such as lithium, valproic acid, carbamazepine, and lamotrigine

  • Antipsychotic medicines− Although psychotic episodes do not occur in bipolar II illness, these medications are occasionally recommended when hypomanic or depressive symptoms continue despite treatment options using mood stabilizers, such as quetiapine, aripiprazole, etc.

  • Anti-anxiety medicines− Benzodiazepines are used to treat acute symptoms of hypomania such as sleeplessness or agitation as a short-term contro


Psychoeducation is important as it helps understand the bipolar disorder better to help and support individuals suffering from it.

  • Cognitive behavioral therapy − CBT) is the most commonly used therapy for bipolar disorders, as it focuses on identifying negative beliefs and unhealthy patterns of behaviors and changing them with positive and healthy patterns

  • Interpersonal and social Rhythm therapy − (IPRST) aims to restore the frequent circadian rhythm abnormalities in bipolar disorder patients. These also focus on stabilizing the daily rhythms such as sleep cycle and walking.

  • Electroconvulsive therapy − (ECT) helps in treatment by changing brain Chemistry that helps by reversing the symptoms of certain mental conditions by passing an electric current through the brain and intentionally triggering a brief seizure.

  • Transcranial magnetic stimulation − (TMS) is generally used in extreme cases where antidepressants or other options have not responded well in individuals with bipolar II disorder

Lifestyle changes

Various methods can assist a person in obtaining more stable moods and a greater sense of well-being. Meditation and mindfulness can help to relax and manage stress and mood swings

  • Exercise − Aid in distress management and increase overall wellness

  • Eating a healthy diet − Helps to keep a balance in an individual's mood and also helps in balancing out any medical side effects

  • Sleep − Getting adequate quality sleep regularly can help adhere to a set pattern.

  • Keeping a record −Tracking mood swings and life events might aid in identifying trends and triggers


Bipolar II disorder is a mental illness with cycling moods between high and low over time. Diagnosis involves an individual having experienced one episode of hypomania during which they may have felt euphoric or agitated and exhibited abnormal behaviors. Psychosocial interventions help in managing acute depressive episodes and maintaining treatment progress, and preventing relapse. Psychoeducation is important for understanding the symptoms of a person going through bipolar II disorder. It is important to stay focused on the goals and find support when suffering from bipolar II disorder, as it can cause one to get demoted and isolate themselves


Simply Easy Learning

Updated on: 13-Oct-2022


Kickstart Your Career

Get certified by completing the course

Get Started