Bipolar II Disorder: What It Is and What Symptoms It Has

Bipolar II disorder is a variant of bipolar affective disorder in which depressive and hypomanic episodes occur but there is no full-blown mania. We explain how hypomania differs from mania and how the depressive phase manifests.

What bipolar II disorder is

Bipolar disorder is an endogenous mental disorder in which affective phases alternate, and between them there are lucid intervals when the psyche and personality traits recover. In ICD-11, bipolar I and bipolar II disorder are distinguished separately. The second type is characterized by the presence of only hypomanic and depressive episodes — without manic ones. The diagnosis is made by a psychiatrist.

Symptoms of bipolar II disorder: hypomania and depression

Hypomania is a less pronounced version of mania. A person may feel that everything is great and that they are getting a lot done, while those close to them notice an unusual change in mood and activity. Hypomania is often followed by severe depression. Symptoms of a depressive episode: low mood, loss of interest in usual activities, lack of energy, too much or too little sleep and food, difficulty concentrating, avoiding people, thoughts of death or self-harm. Episodes last a week or two or longer, and symptoms are present almost all day.

• elevated mood, irritability, lots of energy, need for less sleep
• racing thoughts, rapid speech, excessive confidence, impulsive spending
• low mood, fatigue, feelings of worthlessness and hopelessness
• changes in sleep and appetite, problems with concentration, self-isolation

How type 2 differs from type 1

In type I, manic episodes occur: they last at least 7 days or are so severe that immediate inpatient care is needed. Depressive episodes are also common there and usually last at least two weeks. In type II there is no mania — only hypomania and depression. If four or more episodes of mania or depression occur within a year, this is called rapid cycling.

Causes and risk factors

The exact cause is unknown. Genetics, brain structure and function, and environment play a role. The risk is higher if a close relative has bipolar disorder. The list of factors that increase the likelihood includes trauma and stressful events in childhood, severe life situations, use of cannabis or cocaine, and also the parasite toxoplasma gondii.

How the diagnosis is made

A doctor may refer you to a psychiatrist. The specialist asks about mood, behavior, health, and family history. The diagnosis is not made right away: the disorder manifests differently in each person, and the symptoms resemble other mental conditions. Additionally, an examination and tests are performed to rule out other causes.

Risks and when to see a doctor

You should see a doctor if mood swings last a long time or interfere with daily life. If a diagnosis has already been made and treatment is not helping, tell your specialist about it. About 75% of people with bipolar disorder also have other comorbid mental disorders, such as anxiety.

Bipolar disorder by itself is not a reason to call an ambulance; 103 or 112 — if there are thoughts of suicide or self-harm or a risk of harming another person.

This material is for reference and does not replace a doctor's consultation: decisions about diagnosis and care are made by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer