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As one of my personal DSM-5 diagnoses, I’m all too familiar with bipolar 2. I’ll give my vantage point later on living with this illness. However, let’s first look at the disorder’s formal definition and hallmarks while discovering the things to know about bipolar 2.

Mayo Clinic describes bipolar 2 as a type of bipolar disorder characterized by depressive and hypomanic episodes. Its main criterion for diagnosis states a patient must have at least one depressive episode for a minimal two-week duration. In addition, the patient must also experience one hypomanic episode lasting at least four days.

While bipolar II’s hypomanic episodes are far less severe than the traditional mania endured by bipolar I sufferers, BP II depression is the disorder’s defining trait. Many bipolar II sufferers describe debilitating low moods that confine them to bed for several days at a time. Some of these individuals also describe feeling irritable, unable to sleep well, and impulsive during hypomania.

Though hypomania might be a milder form of mania, its impact can still cripple daily life. The OED defines hypomania as a lesser mania, marked by elation and hyperactivity. While some bipolar II patients enjoy the increased energy of this state. many more feel hypomania is a nuisance. As with any other mental diagnosis, no two patients experience identical symptoms.

Moreso, hard data shows the condition is rare and found in just one percent of the US population. Bipolar II is most commonly diagnosed in a person’s late teens or early 20s. 

To fully understand bipolar II, you must first understand the symptoms and severity of the three additional bipolar disorders. Let’s examine them.

With some excellent insight from Medical News Today, here are the other three BP types

The Big Three

Bipolar 1 is the illness’s most common form. BP I involves manic episodes that last for at least one week. These manic cycles often create destructive consequences. During mania, several BP I sufferers engage in risky sexual, financial, and social behaviors that they later regret. As mentioned, mania is defined as an extremely elevated and excitable mood. Another of its debilitating hallmarks is a prolonged lack of sleep, which often leads to psychotic breaks from reality.

BP I’s polar end is depression. Unlike other forms of illness, bipolar I sufferers are more likely to commit self-harm or suicide when depressed. For these reasons, BP 1 is the most debilitating among the disorder’s spectrum.

CYCLOTHYMIA: A bipolar disorder hybrid, Cyclothymia is even rarer than bipolar II. Some call this condition bipolar lite as its sufferers can often function at a considerably higher level than those with bipolar I or II. Cyclothymic disorder is defined simply as cycling from elevated to depressed moods, though with far fewer complications than traditional bipolar.

Clinicians urge cyclothymic patients to seek talk and medication treatment to prevent the generally manageable disorder from progressing into either of the more serious bipolar iterations. 

Finally, UNSPECIFIED BIPOLAR, or bipolar NOS, is diagnosed when the patient exhibits short hypomanic episodes (far shorter than BP II) and then quickly alternates to a depressed mood. The condition mimics a lesser form of BP II as NOS highs remain confined to hypomanic bursts and the accompanying depression only lasts a brief time.

With each bipolar diagnosis now explained, these mood disorders are treated by talk therapy, anti-psychotics and mood stabilizers.

Common Bipolar 2 Symptoms

Switching back to bipolar II, the following symptoms are common among its patients.

Hypomania side effects include:

• Mild euphoria

• Racing thoughts

• Distractibility

• Rapid speech

• Hyperactivity

• Aggression

• Irritability

• Trouble sleeping

• Impulsivity

Bipolar II depression symptoms include:

• Persistent sadness

• Hopelessness

• Fatigue

• Anxiety

• Sleep issues

• Unexplained chronic pain

• Difficulty concentrating

• Suicidal thoughts

Factoring the destructive outcomes of hypomania and mania, combined with the accompanying lows of depression, 25 to 60 percent of bipolar patients attempt suicide. Fortunately, BP II sufferers can enjoy prolonged mood stability and normal lives with continued psychotherapy and medication treatment.

Bipolar 2 Treatment Options

Along with clinically supervised psychotherapy, WebMD lists the following as top pharmaceutical treatment routes for Bipolar 2.

Mood Stabilizers

Lithium (Eskalith, Lithobid): This metal in pill form is highly effective at controlling mood swings (particularly highs) in bipolar disorder.

Carbamazepine (Tegretol): This antiseizure drug has been used to effectively treat mania since the 1970s.

Lamotrigine (Lamictal): This drug is approved by the FDA for the maintenance treatment of adults with bipolar disorder.

Valproate (Depakote): This antiseizure drug also works to level moods.

Antipsychotics

Hypomanic episodes do not involve psychosis. However, antipsychotic drugs, such as aripiprazole (Abilify), asenapine (Saphris), cariprazine (Vraylar), lumateperone (Caplyta), quetiapine (Seroquel), olanzapine (Zyprexa), risperidone (Risperdal), and ziprasidone (Geodon) are sometimes used to treat hypomania.

Benzodiazepines

This class of drugs includes alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), and clonazepam (Klopnopin). These relaxants are effective for short-term control of acute symptoms associated with hypomania such as insomnia or agitation. Personally, Klonopin has worked wonders to alleviate my Bipolar 2 symptoms.

Antidepressants

Seroquel and Seroquel XR are the only medications FDA-approved specifically for bipolar II depression. The antidepressants fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) are also occasionally used in bipolar II depression.

Summary

While Bipolar 2 cannot be cured, its symptoms can be controlled with the use of proper medication, therapy, sleep hygiene, exercise, and a healthy diet. As someone who has suffered from the disease for decades, I can attest to the power of maintaining a daily self-care routine for optimal living. Comment below if you have any thoughts or insight regarding this article. And as always, be great to yourself! Also, check out episode one of the Stigma Battle Podcast here.

ROME Los Angeles