Bipolar 2 might be more common than you realize.
It is also known as bipolar ii disorder. Bipolar II is diagnosed when hypomania and depression occur. Since the “highs” are not manic it is also referred to as “soft bipolar”, though this is a little misleading.
The term was coined because the symptoms in bipolar 2 are usually perceived as being less severe, especially regarding the “highs” or manic episodes.
A good example of this is that psychosis does not appear in Bipolar 2 mania.
Bipolar ii is still a troubling mood disorder and sufferers may be subject to classic bipolar symptoms such as serious and recurring depression, as well as subtler ones. Confusing periods of irritability, impulsiveness and agitation are a few.
On the other hand, the milder “highs” can be enjoyable and energizing and are less likely to lead to the terrible repercussions of full-blown mania.
Bipolar Type 2 is more common than you may realize.
What is Bipolar Disorder ll
What differentiates bipolar 2 from other types of this disorder is the mania. This is why it is referred to as “hypomania”. It is a less intense form of the mania bipolar 1 suffers feel.
When it comes to the depressive episodes, these can be more intense and even longer lasting. While it is might be considered the “milder form of bipolar”, if you’ve been through one these “lows” then you know that there is nothing “less intense” about them.
This is also part of the difference between cyclothymia and Bipolar 2. Cyclothymia is a rare disorder, though it is similar to bipolar. While the highs and lows might be milder, just like bipolar ii, the episodes are more frequent. This mood disorder is not to be confused with bipolar, however it can be a precursor.
Many people read about Bipolar 2 in the mass media and self-diagnose, when they should just take a bipolar disorder test with an experienced psychiatrist. Only then will they understand if they truly experience bipolar symptoms and what the appropriate treatments may be.
What is the difference between Bipolar 1 and Bipolar Type 2? Let’s look at some definitions:
Bipolar 1: Where the individual has experienced episode(s) of mania, with or without a history of depressive disorders.
Bipolar 2: Where the individual has experienced episode(s) of both hypomania and depression (and has never experienced an episode of mania or had psychotic episodes).
This is why Bipolar II disorder is sometimes known as “soft” bipolar. Depression is present, but instead of mania, the person suffers from hypomania – a milder form of mania.
So, one way of understanding the differences between hard and soft bipolar, or Type I Bipolar and Type II Bipolar, is to understand the differences between MANIA and HYPOMANIA.
“Mania” is a high mood that is of distinct severity and where the individual is often psychotic in the sense of having delusions and/or hallucinations.
“Hypomania” comes from Greek and means “less than mania”. It describes a high that is less severe than a manic episode and without any psychotic features such as misinterpretation of events.
Bipolar Disorder I is more severe, and the longer and more serious “highs”, which may involve psychosis, are far more likely to lead to hospitalization.
Bipolar Type I is quite different from the much shorter and less dramatic highs in Bipolar Type II disorder. Most importantly, Bipolar 2 does NOT involve any psychotic experiences.
Bipolar 2 Symptoms
The symptoms for bipolar ii are similar to those for type 1, only without the intense mania. During hypomania you might feel,
- Overly self-confident
- Flying from one idea to another
- Loud or rapid speech
- Boost in energy
The depression is the same, regardless if you have type one or two. Low energy, feeling sad all the time and losing pleasure in things that you used to love are all symptoms of bipolar depression. Sometimes these feelings can last for weeks and even months.
Since mania isn’t present, diagnosing bipolar 2 is even more difficult. Often it is mistaken for unipolar depression. This means that you are only being treated for depression and not the hypomania.
See here for a complete list of bipolar symptoms.
Bipolar 2 and Women
Another interesting difference is that while women and men develop Bipolar I Disorder at equal rates, those for Bipolar Disorder Type II are higher for women. Also, men and women experience Bipolar II in different ways.
When men are affected by it they tend to have roughly equal numbers of hypomanic and depressive episodes.
However, for women, depression tends to dominate. Unfortunately, this often leads to misdiagnoses that can have lasting effects on their lives. As mentioned earlier, unipolar is the most common diagnosis, NOT bipolar disorder. This means that it could take several visits to various doctors before you are properly diagnosed.
Rapid cycling, your moods swing from mania to depression frequently, is something that you should discuss with your psychiatrist. It is thought that it can occur with both types of the disorder.
Who’s at Risk for Bipolar II?
So, scientists are looking at what could cause bipolar disorder and they’ve agreed that there isn’t one single underlying factor. Instead there are several that when combined could increase your chances for getting the disorder.
If these apply to you it doesn’t necessarily mean that you will end up being diagnosed as bipolar, and if you have been this might help explain how you ended up with this mental health disorder.
Some of the risk factors that have been identified are,
- Genetics can play a role, but just because there is someone in your family with the disorder it doesn’t mean that you are destined to be bipolar. There are studies with twins, where one was diagnosed with it and the other was not.
- Brian function and structure are currently being studied, and the results will hopefully help to identify the disorder. These studies are also geared towards seeing which medications work best. Identifying which part of the brain is affected is a major step, but it will take years before any concrete results are published.
- Family history does play a role, though it is not yet understood. The study on twins emphasizes this. The disorder does tend to run in families, but just because a close relative is bipolar doesn’t mean that you will be too.
Basically, if you want to know your risk factors. Look at your family’s mental health history. There are no real guidelines, so even if you don’t fall into these risk categories always speak to a counselor or mental health advisor if you feel like something is wrong.
Treatment for Bipolar II
If you were lucky, treatment was easy. You got the correct diagnosis and the right meds. For most of us, it doesn’t work this way. It is a combination of trial and error before anything makes us feel “right”.
Unfortunately, Bipolar Disorder ii can be much harder to diagnose. This is a problem as the disorder may worsen overtime, and this could lead to negative behaviors and consequences that could include suicidal thoughts.
Bipolar 2 may be up to 3-4 times more common than Bipolar 1, and for reasons that are still being studied, the disorder seems to be coming more prevalent. This could indicate that mental health professionals are more adept now at diagnosing the disorder, but more research is needed.
Before you take any medication ensure that you are aware of all the mood risks and potential benefits. Sometimes the side effects can outweigh the “supposed” advantages so always stay in touch with your doctor or pharmacist. The most commonly prescribed are mood stabilizers and anti-depressants. Atypical antipsychotics should not be included, unless you are displaying psychotic signs, and if so Bipolar 2 no longer applies.
Bipolar 2 is NOT classified with psychotic tendencies.
This is a list of all possible medications. Some may not apply to you, remember to always talk to your health care advisor before taking any new medications.
- Mood stabilizers can control hypomania. These include Lithium, Depakenen, Depakote, Lamictal, Equestro, Tegretol, among others. These are only designed to stabilize moods, not treat the entire disorder.
- Antidepressants can help to treat depression, just be careful that it does not have an anti-psychotic bent. Symbyax may be approved for you, it is a commonly prescribed medication, but it is more geared for Bipolar 1. Remember that you do not have psychotic tendencies, and this is something that you will have to restate with bipolar 2.
This makes it even more difficult to get the right combination of meds. You need to treat the depression, and the hypomania.
Medication is not the only way to cope with bipolar 2. Therapy is also recommended, and for me it was a must. Sometimes talking is the best remedy.
Support groups, one-on-one therapy sessions and online counselors are excellent resources. They can help you get through the rough patches and point out noticeable signs that an episode might be coming on.
If you are new to the disorder or think you are bipolar 2 and can’t get the right diagnoses, try keeping a journal. Write down your moods, feelings and possible triggers. Showing it to a mental health professional could help them correctly diagnose you as bipolar II.
Treatment can also involve taking part in a study, but DON’T sign up for just any one. NIMH/NIH has additional information on their website that will ensure the study is safe. This is important since it could involve clinical trials.
Are There Benefits to Bipolar Disorder II?
At least one expert has gone so far as to suggest hypomania can be an asset.
Psychologist John Gartner believes part of the reason America is so rich and powerful is the presence of so many hypomanic individuals:
“Hypomania, a genetically based form of mild mania, endows many of us with energy, creativity, enthusiasm, and a propensity for taking risks. America has an extraordinarily high number of hypomanics—grandiose types who leap on every wacky idea that occurs to them, utterly convinced it will change the world. Market bubbles and ill-considered messianic crusades can be the downside. But there is an enormous upside as well, in spectacular entrepreneurial zeal, drive for innovation and material success. Americans may have a lot of crazy ideas, but some of them prove to be brilliant inventions.” – John Gartner, Ph.D., The Hypomanic Edge
He is referring to the milder nature of hypomania that can make it a curse and a blessing.
Some people might agree with this but remember with hypomania there will also be depression. You might get more accomplished when you are running day and night, never feeling tired but what about when you “come down”? Chances are not a lot will be started or finished then. Even if you only have mild depression that lasts for a brief time, there is no guarantee that it won’t get worse over time.
Don’t ignore the depressive side simply because you like the hypomania, it could have disastrous consequences.
Key Points to Remember
- Bipolar Type 2 has its own distinct bipolar symptoms.
- You need a bipolar disorder test from a competent professional to diagnose it. Do Not self-diagnose.
- Treatments are slightly different for bipolar 2 vs bipolar 1.
- Hypomania is not a blessing.
If you think that you are bipolar 2 make an appointment to discuss this with a licensed psychiatrist. Don’t just concentrate on describing your depressive symptoms, also discuss the hypomania. Leaving out those episodes is one reason misdiagnoses could occur. If they still won’t listen, don’t give up. For many people it took years.
Rihmer, Z., & Pestality, P. (1999). BIPOLAR II DISORDER AND SUICIDAL BEHAVIOR. Psychiatric Clinics of North America, 22(3), 667-673. Retrieved 12 26, 2018, from https://sciencedirect.com/science/article/pii/s0193953x05701015
Pålsson, E., Figueras, C., Johansson, A., Ekman, C. J., Hultman, B., Östlind, J., . . . Landén, M. (2013). Neurocognitive function in bipolar disorder: a comparison between bipolar I and II disorder and matched controls. BMC Psychiatry, 13(1), 165-165. Retrieved 12 26, 2018, from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244x-13-165