Bipolar II disorder (BP-II) is a mood disorder on the bipolar spectrum, characterized by at least one episode of hypomania and at least one episode of major depression.[1][2][3][4] Diagnosis for BP-II requires that the individual must never have experienced a full manic episode.[5] Otherwise, one manic episode meets the criteria for bipolar I disorder (BP-I).[2]
Hypomania is a sustained state of elevated or irritable mood that is less severe than mania yet may still significantly affect the quality of life and result in permanent consequences including reckless spending, damaged relationships and poor judgment.[6]: 1651 Unlike mania, hypomania cannot include psychosis.[1][7] The hypomanic episodes associated with BP-II must last for at least four days.[2][8]
Commonly, depressive episodes are more frequent and more intense than hypomanic episodes.[2] Additionally, when compared to BP-I, type II presents more frequent depressive episodes and shorter intervals of well-being.[1][2] The course of BP-II is more chronic and consists of more frequent cycling than the course of BP-I.[1][9] Finally, BP-II is associated with a greater risk of suicidal thoughts and behaviors than BP-I or unipolar depression.[1][9] BP-II is no less severe than BP-I, and types I and II present equally severe burdens.[1][10]
BP-II is notoriously difficult to diagnose. Patients usually seek help when they are in a depressed state, or when their hypomanic symptoms manifest themselves in unwanted effects, such as high levels of anxiety, or the seeming inability to focus on tasks. Because many of the symptoms of hypomania are often mistaken for high-functioning behavior or simply attributed to personality, patients are typically not aware of their hypomanic symptoms. In addition, many people with BP-II have periods of normal affect. As a result, when patients seek help, they are very often unable to provide their doctor with all the information needed for an accurate assessment; these individuals are often misdiagnosed with unipolar depression.[1][2][9] BP-II is more common than BP-I, while BP-II and major depressive disorder have about the same rate of diagnosis.[11] Of all individuals initially diagnosed with major depressive disorder, between 40% and 50% will later be diagnosed with either BP-I or BP-II.[1] Substance use disorders (which have high co-morbidity with BP-II) and periods of mixed depression may also make it more difficult to accurately identify BP-II.[2] Despite the difficulties, it is important that BP-II individuals be correctly assessed so that they can receive the proper treatment.[2] Antidepressant use, in the absence of mood stabilizers, is correlated with worsening BP-II symptoms.[1]
^ abcdefghiBenazzi F (2007). "Bipolar II disorder: Epidemiology, Diagnosis and Management". CNS Drugs (Therapy in Practice). 21 (9): 727–40. doi:10.2165/00023210-200721090-00003. PMID 17696573. S2CID 28078494.
^ abcdefghBerk M, Dodd S (February 2005). "Bipolar II disorder: a review". Bipolar Disorders. 7 (1): 11–21. doi:10.1111/j.1399-5618.2004.00152.x. PMID 15654928.
^Hurley K (24 November 2020). "Bipolar Disorder and Depression: Understanding the Difference". Psycom. Archived from the original on 2018-09-07. Retrieved 29 January 2021.
^"Bipolar Diagnosis". WebMD. Atlanta, Georgia. 29 January 2021. p. 1. Archived from the original on 2007-03-03. Retrieved 30 January 2021.
^American Psychiatric Association. American Psychiatric Association. DSM-5 Task Force. (2017) [2013]. Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, D.C.: American Psychiatric Association. p. 139. ISBN 9780890425541. OCLC 1042815534 – via Internet Archive.{{cite book}}: CS1 maint: numeric names: authors list (link)
^Sadock, Benjamin J.; Sadock, Virginia A.; Ruiz, Pedro (2017). Kaplan & Sadock's comprehensive textbook of psychiatry (10th ed.). Philadelphia: Wolters Kluwer. ISBN 978-1-4963-8915-2. OCLC 988106757.
^Goodwin, Guy (August 2002). "Hypomania: What's in a name?". The British Journal of Psychiatry. 181 (2): 94–95. doi:10.1192/bjp.181.2.94. ISSN 0007-1250. S2CID 41536783.
^Buskist W, Davis SF, eds. (2008). 21st Century Psychology: A Reference Handbook. Thousand Oaks, California: Sage Publications. pp. 290. ISBN 978-1-4129-4968-2 – via Internet Archive.
^ abcMak AD (2007). "A short review on the diagnostic issues of bipolar spectrum disorders in clinically depressed patients – Bipolar II disorder". Hong Kong Journal of Psychiatry. 17: 139–144. Archived from the original on 2020-08-13. Retrieved 2018-09-21 – via Gale.
^Merikangas KR, Lamers F (January 2012). "The 'true' prevalence of bipolar II disorder". Current Opinion in Psychiatry. 25 (1): 19–23. doi:10.1097/YCO.0b013e32834de3de. PMID 22156934. S2CID 10768397.
^Benazzi, Franco (March 2004). "How to treat bipolar II depression and bipolar II mixed depression?". The International Journal of Neuropsychopharmacology. 7 (1): 105–106. doi:10.1017/S146114570300395X. ISSN 1461-1457. PMID 14731315. S2CID 43388979.
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