Bipolar II Disorder: Signs, Symptoms and Treatment

Bipolar Disorder Statistics

If you or a loved one is living with signs or symptoms of bipolar II disorder, it can be helpful to know that you are not alone. According to the National Institute of Mental Health data, 2.8 percent of adults in the United States experience bipolar disorder in a given year, and 4.4 percent will experience the condition during their lifetimes. Prevalence is nearly equal in men and women. Consider these additional bipolar disorder statistics:

• The prevalence of bipolar disorder is highest among young adults aged 18-29, of whom 4.7 percent experience bipolar disorder in a given year. 
• Around 83 percent of people with bipolar disorder experience serious impairment in daily functioning. 
• By the time they reach their teenage years, 2.9 percent of adolescents will have had bipolar disorder at some point during their lives.
• The lifetime prevalence rate of bipolar disorder is higher in teen girls (3.3 percent) when compared to teen boys (2.6 percent).

What are the signs and symptoms of bipolar II disorder?

Significant changes in mood and behavior characterize bipolar disorder. The different subsets of the condition will manifest different symptoms and exhibit varying timeframes for mood changes. In bipolar II disorder, a patient will cycle between hypomania and depression.

Hypomania in bipolar patients can present as either euphoria or feeling “high,” or agitation and irritability. Hypomania symptoms can manifest as the following:

If it is a person’s first hypomanic episode, family and friends typically don’t know what’s going on with their loved one. The bipolar II individual may be entertaining, lively, and charismatic. Their positive mood may be infectious. Unfortunately, untreated hypomanic episodes will lead to impulsive, erratic behavior that can be incredibly disruptive to a person’s life. In some cases, hypomania can be downright dangerous.

A person with hypomania may spend beyond their means and go into debt. They may engage in risky sexual behavior, or damage their relationships at work, school, or at home. In some cases, an untreated hypomania episode can turn into full-blown mania, complete with delusions, hallucinations, and paranoia.

A hypomanic episode can last for weeks or months. If left untreated, a person can then go on to develop a depressive episode. Depression in bipolar patients exhibits the same symptoms as major clinical depression. Patients can become withdrawn and suicidal. Sometimes, the erratic behavior that a bipolar patient showed during a hypomanic episode can worsen their depression. They may feel ashamed, guilty, and overwhelmed with the consequences of the hypomanic episode.

People with bipolar II disorder tend to have more depressive episodes than hypomanic episodes. In bipolar I disorder, patients are more likely to suffer from manic episodes than with depression.

Bipolar II Diagnostic Criteria

While the above signs can be indicative of bipolar II disorder, it is important to keep in mind that this is a clinical mental health condition. To be diagnosed, they must meet the diagnostic criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). 

In order to meet bipolar II diagnostic criteria, a person has to experience at least one depressive episode and one hypomanic episode, but no manic episodes, and symptoms must cause distress or difficulty with daily functioning. 

To meet diagnostic criteria for hypomania, a person must experience an elevated or irritable mood, as well as increased energy or activity, for at least four days, and the mood must never become severe enough to cause psychosis or require hospitalization, or it is a clinical case of mania, which is a different version of bipolar disorder. Beyond this, a person must show three or more of the following symptoms to be in a hypomanic episode:

• High self-esteem or grandiose thoughts
• Functioning well on reduced sleep
• Constant talking 
• Racing thoughts 
• Distraction
• Increased activity aimed at achieving goals, or constant movement due to restlessness (called psychomotor agitation)
• Indulging in pleasurable but risky activities, such as unprotected sex or shopping sprees

On the contrary, a depressive episode during bipolar II disorder involves the following diagnostic criteria, and symptoms must be present most of the day for two weeks in a row:

• Depressed mood
• Loss of interest in usual activities, or experiencing no pleasure with enjoyable activities
• Change in weight or appetite
• Inability to sleep, or sleeping more than usual
• Changes in psychomotor functioning, in the form of either constant movement or lack of movement
• Fatigue and low energy levels
• Guilt or feelings of worthlessness
• Difficulty with thinking, concentrating, or making decisions
• Thoughts of death or suicide attempts

What are the treatment options for bipolar II?

Bipolar disorder, no matter the subset, is a lifelong, chronic illness that requires patients to take medication and participant in therapy over their lifetime. When a patient presents with a severe hypomanic or depressive episode, they will need intense treatment regimens for an acute event of the disease. Patients are often given mood stabilizers, antipsychotics, benzodiazepines, or antidepressants when hospitalized.

Once the patient has stabilized, they will need continued therapy to gain insight into their specific triggers and how to prevent future episodes from starting.

Bipolar disorder episodes cannot entirely be prevented, but there are some things patients can do to lower the risk. Ongoing talk therapy and maintenance treatment plans are recommended and are effective for managing the symptoms of the disease. Transcranial magnetic stimulation (TMS) has also been found to help prevent future depressive episodes in bipolar II patients.