Bipolar II Disorder

What Is Bipolar II Disorder?

Bipolar II disorder (pronounced "bipolar two") is a form of mental illness. Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time.

However, in bipolar II disorder, the "up" moods never reach full-on mania. The less-intense elevated moods in bipolar II disorder are called hypomanic episodes, or hypomania.

A person affected by bipolar II disorder has had at least one hypomanic episode in life. Most people with bipolar II disorder also suffer from episodes of depression. This is where the term "manic depression" comes from.

In between episodes of hypomania and depression, many people with bipolar II disorder live normal lives.

Who Is at Risk for Bipolar II Disorder?

Virtually anyone can develop bipolar II disorder. About 2.5% of the U.S. population suffers from some form of bipolar disorder -- almost six million people.

Most people are in their teens or early 20s when symptoms of bipolar disorder first start. Nearly everyone with bipolar II disorder develops it before age 50. People with an immediate family member with bipolar are at higher risk.

What Are the Symptoms of Bipolar II Disorder?

During a hypomanic episode, elevated mood can manifest itself as either euphoria (feeling "high") or as irritability.

Symptoms during hypomanic episodes include:

Flying suddenly from one idea to the next
Rapid, "pressured," and loud speech
Increased energy, with hyperactivity and a decreased need for sleep
People experiencing hypomanic episodes are often quite pleasant to be around. They can often seem like the "life of the party" -- making jokes, taking an intense interest in other people and activities, and infecting others with their positive mood.

What's so bad about that, you might ask? Hypomania can also lead to erratic and unhealthy behavior. People in hypomanic episodes might spend money they don't have, seek out sex with people they normally wouldn't, and engage in other impulsive or risky behaviors.

Also, the vast majority of people with bipolar II disorder experience significant depressive episodes. These can occur soon after hypomania subsides, or much later. Some people cycle back and forth between hypomania and depression, while others have long periods of normal mood in between episodes.

Untreated, an episode of hypomania can last anywhere from a few days to several years. Most commonly, symptoms continue for a few weeks to a few months.

Depressive episodes in bipolar II disorder are similar to "regular" clinical depression, with depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness, and thoughts of suicide. Depressive symptoms of bipolar disorder can last weeks, months, or rarely years.

What Are the Treatments for Bipolar II Disorder?

Hypomania often masquerades as happiness and relentless optimism. When hypomania is not causing unhealthy behavior, it generally goes untreated. This is in contrast to true mania, which nearly always requires treatment with medications.


What Are the Treatments for Bipolar II Disorder?

People with bipolar II disorder can benefit from preventive drugs that level out moods over the long term. These prevent the negative consequences of hypomania, and also help to prevent episodes of depression.

Mood stabilizers

Lithium: This simple metal in pill form is highly effective at controlling mood swings in bipolar disorder. Lithium has been used for more than a century to treat bipolar disorder. Lithium can take weeks to work fully, making it better for long-term treatment than for sudden hypomanic episodes. Blood levels of lithium must be monitored to avoid side effects.

Depakote: This antiseizure drug also works to level out moods. It has a more rapid onset of action than lithium, and it can also be used for prevention.

Lamictal: This drug is approved by the FDA for the maintenance treatment of adults with bipolar disorder. It has been found to help delay bouts of mood episodes of depression, mania, hypomania (a milder form of mania), and mixed episodes in people being treated with standard therapy.

Some other antiseizure medications, such as Gabitril, Neurontin, Tegretol, Topamax, and Trileptal may also sometimes be prescribed.

Antipsychotics

For severe manic episodes, newer antipsychotic drugs -- also called atypical neuroleptics -- may be necessary. Abilify, Risperdal, Seroquel, and Zyprexa and  are often used, and many other drugs are available. Antipsychotic medicines are also used for preventive treatment.

Benzodiazepines

This class of drugs includes Xanax, Ativan, and Valium and is commonly referred to as tranquilizers. They are used for short-term control of acute symptoms of mania.

Antidepressants

Common antidepressants like Prozac, Zoloft, and Paxil can set off a manic episode in a person with bipolar disorder. For this reason, the first treatment for depression in bipolar disorder should be lithium, Depakote, or an antipsychotic. If these fail, after a few weeks an antidepressant can be safely started. Psychotherapy, such as cognitive-behavioral therapy, may also help.

People with severe or frequent symptoms of bipolar II disorder (mania or depression) should take medicines on a continuous basis for prevention.

Can Bipolar II Disorder Be Prevented?

The causes of bipolar disorder are not well understood. It's not known if bipolar II disorder can be prevented entirely.

It is possible to prevent some episodes of hypomania or depression, once bipolar disorder has developed. Regular therapy sessions with a psychologist or social worker can stabilize mood, leading to fewer hospitalizations and feeling better overall. Taking medicine on a regular basis also leads to fewer hypomanic or depressive episodes.

How Is Bipolar II Disorder Different From Other Types of Bipolar Disorder?

People with bipolar I disorder experience true mania -- a severe, abnormally elevated mood with erratic behavior. Manic symptoms lead to serious disruptions in life, causing legal or major personal problems.

In bipolar II disorder, the symptoms of elevate mood never reach full-on mania. Bipolar II can be thought of as a milder form of bipolar disorder.

click here to Visual Guide to Understanding Bipolar Disorder


source : Bipolar Disorder