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Bipolar II Disorder (A 5 point guide)

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This article provides a detailed guide to bipolar II disorder. The article will look into the causes, symptoms, diagnosis, and treatment of the bipolar disorder. It will also discuss how bipolar II disorder is different than bipolar I disorder.

What is Bipolar II Disorder?

Bipolar II disorder is a form of mental disorder. Bipolar II is similar to bipolar I disorder, where the mood switches between high and low over time.

However, in the case of bipolar II disorder, the high moods never reach the full-blown extreme of mania. Whereas, the less-intense elevated mood in bipolar II disorder is known as hypomanic episodes or hypomania.

A person with bipolar II disorder has experienced at least one hypomanic episode in their lifetime. The majority of people with bipolar II disorder usually suffer from frequent depressive episodes. This is where the term “manic depression” stems from.

In between these episodes of depression and hypomania, most bipolar II disorder people generally lead normal lives.

Who Develops the Bipolar II Disorder?

Virtually bipolar II disorder can be developed in anyone. Almost 2.5% of the U.S population, constituting six million people,  has some form of bipolar disorder.

The symptoms of bipolar disorder initially start in teens or early 20s. Almost everyone with bipolar II disorder develops the condition before the age of 50. People with a close family member with bipolar disorder are more likely to have the condition.

Symptoms of Bipolar II Disorder

In the hypomanic episodes, a high mood can be exhibited in the form of euphoria or agitation.

Symptoms observed in a hypomanic episode may include:

  • Switching immediately between different ideas.
  • High self-confidence.
  • Fast, uninterrupted, and loud speech.
  • High and increased energy, with a low need for sleep and hyperactivity.

People with hypomanic episodes are actually fun to be around. They appear to be the life of the party–cracking jokes, taking a strong interest in other people and activities, and infecting people with their positive mood.

Now, the question may arise: what could be so bad about being the life of the party?

The answer is, hypomania can lead to intense and unhealthy behavior. Hypomanic episodes can sometimes turn to full-blown manias, which affects the person’s ability to function, i.e., bipolar I disorder.  People may spend money in mania, don’t even have, indulge in sexual activities with people they normally wouldn’t, and engage in impulsive activities that might have potentially dangerous consequences.

However, people with bipolar II disorder observe more prolonged depressive episodes than hypomanic symptoms. Depression can take over soon after hypomania goes, or much later. Some people can also transition back and forth between hypomania and depression, whereas some others have long phases of normal mood in between these episodes.

Depressive symptoms in bipolar II disorder are similar to the typical clinical depression, with low mood, low energy, loss of pleasure, feelings of worthlessness, and suicidal thoughts. Depressive symptoms of bipolar disorder can last weeks, months, or quite rarely years. 

Diagnosis of Bipolar II Disorder

Diagnosis of bipolar II disorder requires the person to have at least one episode of hypomania and at least one episode of depression.

People are typically in an elevated and jolly mood in hypomania and seek medical assistance when they experience depression symptoms. Therefore, there is a high chance that doctors usually misdiagnose bipolar II disorder as depression.

Usually, while the doctor is making a diagnosis, they will:

  • Inquire about the symptoms and their severity.
  • Take family history to rule out the genetic cause of the condition
  • Perform a physical examination.
  • Order tests, like blood tests, to rule out other potential causes.

Then, they use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM) to make the final diagnosis.

The doctor may also use a checklist to identify hypomania.

Treatments for Bipolar II Disorder

Hypomania often masks itself as happiness and extreme optimism. When hypomania is not resulting in unhealthy behavior, it is most likely to go unnoticed and untreated. This is in contrast to the complete mania, which by definition causes issues in functioning and thus requires treatment, including medications and possible hospitalization.

Treatment for bipolar II disorder typically includes a combination of medication and psychotherapy. It is a long-term and usually continuous treatment. If a person with bipolar II disorder stops the treatment, symptoms are most likely to return even when they feel well.


The medication may include the following:

  • Mood stabilizers
  • Antidepressants
  • Antipsychotics
  • Medication to improve quality of sleep

It may take some time to find the perfect combination and dosage. A person would be required to cooperate with their doctor for some period to arrive at a suitable solution.

It is also suggested to report any side effects to their doctor to make the appropriate adjustments. Trusted close ones can also offer better helpful insights.

Mood stabilizers

Lithium: It is highly effective in managing the mood swings (specifically highs) in bipolar disorder. Lithium has been used for over 60 years for bipolar disorder treatment. Lithium may take a few weeks to work completely, making it suitable for long-term treatment rather than acute hypomanic episodes. 

Carbamazepine: It is an antiseizure drug and has been used to treat mania since the 1970s. It is also known to help with bipolar depression or preventing highs and lows. Blood tests for monitoring liver functions and white blood cells are necessary.

Lamotrigine: It is an FDA approved drug used as a maintenance treatment of adult patients with bipolar disorder. It is also known to delay bouts of mood episodes of mania, hypomania, depression, and some mixed episodes in patients with standard therapy treatment. It is specifically suitable for the prevention of low episodes.

Valproate: this antiseizure drug is used for mood regulation. It has more rapid results than lithium; it can be used off label for the prevention of lows and highs. 

Some additional antiseizure medications, like oxcarbazepine, can also be prescribed sometimes for ‘experimental’ treatments for mood episodes or associated symptoms in people with bipolar disorder. 


Seroquel and Seroquel XR are the FDA approved drugs for bipolar II depression. Common antidepressants like paroxetine, fluoxetine, and sertraline are used for bipolar II depression. These drugs are likely to cause or worsen hypomania rather than bipolar I disorder.


Hypomanic episodes usually don’t include psychosis and don’t interfere with functioning. Antipsychotic drugs like asenapine, quetiapine, risperidone, olanzapine, etc., are typically used in hypomania. Some notable Seroquel is used for treating bipolar II depression symptoms.

Benzodiazepines: This drug class includes alprazolam, diazepam, and lorazepam and are known as minor tranquilizers. They are used for the short term management of acute symptoms associated with hypomania, like agitation or insomnia.

Psychotherapy and Counseling

Talking about your challenges and feelings associated with bipolar II disorder can be beneficial.

The aim of psychotherapy or counseling may include the following:

  • Identify beneficial ways for stress management
  • Establish coping strategies for the mood episodes and symptoms
  • Identify triggers and stressors and methods to avoid them.
  • Awareness of the condition to the person with bipolar disorder.

Some people may also suffer from accompanying health issues, like drugs or alcohol abuse disorders. Psychotherapy can help with these conditions, as well.

Lifestyle Changes

Numerous strategies can help people with bipolar II disorder to achieve more stable moods and a deep sense of wellness, comprising:

  • Diet: A healthy, nutritious diet will offer essential nutrients to boost overall health.
  • Exercise: A physically active lifestyle as advised by the doctor can help with stress management and the health of bipolar II disorder people.
  • Sleep: Healthy mind and body require sound sleep. Fixing a sleep schedule will help in mood stabilization and well being.
  • Keep a journal: Tracking your mood changes and life experiences can help identify patterns, stressors, and triggers.

While there is evidence, some supplements can help with mild and moderate symptoms. However, it is critical for people with extreme symptoms to consult a professional medical practitioner. Supplements can help in managing the symptoms and preventing the symptoms when used along with conventional treatment. 

Prior to any supplements, it is necessary to seek the help of your doctor.

Can Bipolar II Disorder Be Prevented?

The causes of bipolar disorder are not entirely understood and if it can be prevented altogether. It is possible to minimize the risk of developing hypomania or depression symptoms when bipolar disorder is developed. Psychotherapy and counseling sessions can help people in the identification of their warning signs and relapse symptoms.

Difference between Bipolar I and Bipolar II Disorder

In Bipolar I, a person experiences periods of extreme mood episodes ranging between mania and depression. In this form of the disorder, people experience full mania with abnormally high mood, leading to extreme disruption in life. 

Bipolar II disorder is characterized by elevated mood swings that do not reach a full-blown mania, involving milder hypomania episodes that transition with periods of extreme depression. However, the depressive phase of bipolar II disorder is usually long-lasting and more severe than bipolar I disorder. Therefore, bipolar II disorder is not just a “milder” form of bipolar disorder.


This article provided a comprehensive guide to bipolar II disorder. It also looked into the causes, symptoms, diagnosis, and treatment of the bipolar disorder. Moreover, it discussed the difference between bipolar I and bipolar II disorder.

Bipolar II disorder is different than bipolar I disorder because it has a more prolonged and severe depressive episode

Frequently Asked Questions (FAQs): Bipolar II Disorder

What is the difference between bipolar I and II?

In Bipolar I, a person experiences periods of extreme mood episodes ranging between mania and depression. Bipolar II disorder is a mild form of mood swings, involving milder episodes of hypomania that transitions with periods of extreme depression.

Is Bipolar II serious?

Bipolar II disorder is a separate diagnosis, where bipolar I disorder has severe and dangerous episodes of mania while bipolar II disorder has more severe and long periods of depression.

Does Bipolar II get worse with age?

Bipolar II may worsen with age or over time if the condition is untreated. As time goes on, an individual may observe more severe and prolonged episodes than the first time the symptoms appeared.

How does a person with Bipolar II act?

In Bipolar II disorder, a person starts to act in extremes of high and low moods. Manic episodes include increased excitement, energy, impulsive and agitated behavior. Depressive episodes include lack of energy, feelings of worthlessness, low self-esteem, and suicidal thoughts.

Is Bipolar II disorder considered a disability?

Bipolar II disorder is included in the Social Security Listings of Impairments, which implies that if the condition is diagnosed by a qualified medical practitioner and is severe enough to keep you from functioning, you can avail the disability benefits.


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