Bipolar 2 disorder (also seen as bipolar II disorder) is a mental illness and one of four types of bipolar disorder. These disorders are characterized by uncontrollable mood swings, from elevated to depressed moods. Bipolar II is slightly more common than bipolar I, and is more common in women than in men. As with bipolar 1, bipolar 2 symptoms begin to appear, on average, at age 21.1 (More on what is bipolar disorder.)
A person with bipolar type II symptoms experiences depressed episodes, just as is seen in bipolar I, but also experiences hypomanic episodes rather than manic episodes. Hypomanic episodes can be thought of as milder forms of manic episodes.
Bipolar 2 Symptoms of Hypomania
Hypomania, appearing in bipolar type II, is less drastic than mania and has a lesser impact on functioning. Hypomania does not include symptoms of psychosis and some people with bipolar 2 find it to be pleasurable or productive.
Because hypomania has less of a negative impact on a person's life, treatment for bipolar 2 is typically sought during depressive episodes and not periods of hypomania.
The current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) defines a hypomanic episode as an expansive, elevated or irritable mood lasting four days or more. Three of the following symptoms must also be present:
- Grandiosity or inflated self-esteem
- Diminished need for sleep
- Pressured speech
- Racing thoughts or flight of ideas
- Clear evidence of distractibility
- Psychomotor (movement) agitation at home, at work, or sexually
- Engaging in activities with a high potential for painful consequences
As with all bipolar type 2 episodes, hypomania must be observable by others and must not be present due to drug use or any other underlying condition.
Major depressive episodes appear in type 2 bipolar and have the same diagnostic criteria as those found in bipolar disorder I. Bipolar 2 symptoms of depression must include a substantially low (depressed) mood or a loss of pleasure in most things for two weeks or more.
Four or more of the following bipolar 2 symptoms of depression must be present in a depressed episode:
- Depressed mood
- Lack of pleasure or interest in all or nearly all activities
- Sleeping too little or too much
- Significant weight loss/gain or significant appetite increase/decrease
- Overly slow (lethargic) or agitated movements
- Loss of energy or fatigue
- Feelings of guilt or a lack of self-esteem
- Lack of concentration and difficulty making decisions
- Constant thoughts of death or suicide; patient has a plan or has attempted suicide
Symptoms of a major depressive episode in bipolar II must be visible by others and not be explained by drug use or any other underlying illness. Depressive episodes vary in severity but must markedly diminish daily functioning and may also contain psychosis.