Bipolar II Disorder

Bipolar II disorder (BP-II; pronounced "type two bipolar disorder") is a bipolar spectrum disorder (see also Bipolar disorder) characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for bipolar II disorder requires that the individual must never have experienced a full manic episode (unless it was caused by an antidepressant medication; otherwise one manic episode meets the criteria for bipolar I disorder). Symptoms of mania and hypomania are similar, though mania is more severe and may precipitate psychosis. The hypomanic episodes associated with bipolar II disorder must last for at least four days. Commonly, depressive episodes are more frequent and more intense than hypomanic episodes. Additionally, when compared to bipolar I disorder, type II presents more frequent depressive episodes and shorter intervals of well-being. The course of bipolar II disorder is more chronic and consists of more frequent cycling than the course of bipolar I disorder. Finally, bipolar II is associated with a greater risk of suicidal thoughts and behaviors than bipolar I or unipolar depression. Although bipolar II is commonly perceived to be a milder form of Type I, this is not the case. Types I and II present equally severe burdens.

Bipolar II is difficult to diagnose. Patients usually seek help when they are in a depressed state. Because 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. As a result, they are unable to provide their doctor with all the information needed for an accurate assessment; these individuals are often misdiagnosed with unipolar depression. Of all individuals initially diagnosed with major depressive disorder, between 40% and 50% will later be diagnosed with either BP-I or BP-II. Substance abuse disorders (which have high comorbidity with BP-II) and periods of mixed depression may also make it more difficult to accurately identify BP-II. Despite the difficulties, it is important that BP-II individuals are correctly assessed so that they can receive the proper treatment. Antidepressant use, in the absence of mood stabilizers, is correlated with worsening BP-II symptoms.

Bipolar Disorder

Bipolar disorder, also known as bipolar affective disorder, manic-depressive illness, or affective psychosis, is a mental illness characterized by periods of elevated mood and periods of depression.The elevated mood is significant and is known asmania or hypomania depending on the severity. During mania an individual feels or acts abnormally happy, energetic, or irritable.They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. During periods of depression there may be crying, poor eye contact with others, and a negative outlook on life. The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self harm occurs in 30–40%.Other mental health issues such as anxiety disorder and drug misuse are commonly associated.

The cause is not clearly understood, but both genetic and environmental factors play a role. Typically many genes are involved. Environmental factors include long term stress and a history of childhood abuse. It is divided into bipolar I disorder if there is at least one manic episode and bipolar II disorder if there are at least one hypomanic episode and one major depressive episode. In those with less severe symptoms of a prolonged duration the condition cyclothymic disorder may be present. If due to drugs or medical problems it is classified separately.Other conditions that may present in a similar manner include: drug misuse, personality disorders, attention deficit hyperactivity disorder, and schizophrenia as well as a number of medical conditions.

Treatment commonly includes psychotherapy and medications such as mood stabilizers or antipsychotics. Examples of mood stabilizers that are commonly used include: lithium and anticonvulsants. Treatment in hospital against a person's wishes may be required at times as people may be at risk to themselves or others yet refuse treatment. Severe behavioural problems may be managed with short term benzodiazepines or antipsychotics. In periods of mania it is recommended that antidepressants be stopped. If antidepressants are used for periods of depression they should be used with a mood stabilizer. Electroconvulsive therapy may be helpful in those who do not respond to other treatments. If treatments is stopped it is recommended that this be done slowly. Most people have social, financial or work related problem due to the disorder. These difficulties occur a quarter to a third of the time on average. The risk of death from natural causes such as heart disease is twice that of the general population. This is due to poor lifestyle choices and the side effects from medications.