Bipolar II Disorder

In bipolar II disorder, depressive episodes are more intense than in the euphoric phase; controlling them in time is important because they can trigger dangerous behavior.
Bipolar II Disorder

Last update: 30 May, 2022

Bipolar II disorder is a mental illness. It’s characterized by major depressive episodes alternating with hypomanic episodes. In contrast to bipolar disorder type I, the depressive phase is more intense than the euphoric phase.

In most cases, symptoms begin to manifest from the age of 21. However, they’re also common among adolescents.

The risk increases when a close family member has a disease in the category of bipolar disorder and related disorders.

Read this recommended article: Bipolar I Disorder

Symptoms of bipolar II disorder

Bipolar II disorder.

Bipolar II disorder isn’t a milder form than bipolar I disorder. While the manic episodes of bipolar I disorder are dangerous, people with bipolar II disorder have severe and prolonged depressions.

Patients with this mental illness also have at least one hypomanic episode. This doesn’t include episodes of psychosis and is assumed by some to be a pleasant and productive period.

Symptoms of hypomania

During an episode of hypomania, patients with bipolar II disorder are in a positive mood. It’s characterized by a visible and persistent increase in energy. For diagnosis, this period must have lasted at least four days in a row.

Often, the increased energy causes noticeable changes in usual behavior. However, it doesn’t interfere with the fulfillment of daily responsibilities or tasks. It’s often accompanied by other symptoms that can cause problems.

  • Little need for sleep
  • Fluctuations of mood and euphoria
  • Facility to be distracted
  • Psychomotor agitation
  • Reckless behavior
  • A greater need to speak and to maintain a conversation
  • Self-esteem and feeling of greatness
  • Hypersexuality or risky sexual behaviors
  • Poor or excessive appetite
Bipolar disorder.

Symptoms of major depression

The episodes of major depression that occur in bipolar II disorder have the same diagnostic criteria as in bipolar I disorder. However, in this case, they tend to be more repetitive and longer-lasting.

Symptoms include:

  • A notoriously depressed mood
  • Decreased interest and lack of pleasure in almost all activities
  • A lack of emotional expressiveness
  • Too little or too much sleep
  • Noticeable weight loss (without dieting) and weight gain due to anxiety
  • Insomnia almost every day
  • Chronic fatigue or weakness.
  • Feelings of guilt and low self-esteem.
  • A lack of concentration and the inability to make decisions.
  • Thinking about death and suicide attempts.

What disorders are associated with bipolar II disorder?

Out of all the patients diagnosed with bipolar II disorder, about 60% have another disorder. Therefore, it isn’t uncommon for bipolar behaviors to be accompanied by other symptoms.

This illness is related to other disorders such as:

  • Anxiety disorder
  • Eating disorders, such as bulimia and anorexia
  • Personality disorders
  • Attention deficit
  • Obsessive-compulsive disorder


Treatment of bipolar II disorder

After the diagnosis is confirmed, the professional proceeds to design a management plan that includes:


About 75% of patients respond positively to treatment with lithium. However, this drug should be used with caution, as it causes significant side effects.

Other medications used are:

  • Anticonvulsants, anticonvulsants or antiepileptics
  • Valproic acid (sodium valproate)
  • Clonazepam (a derivative of benzodiazepines)
  • Calcium channel blockers such as verapamil
  • Atypical antipsychotics (olanzapine as first-line treatment)


Currently, 3 types of psychotherapeutic procedures are used to treat bipolar II disorder:

  • Behavioral psychotherapy
  • Cognitive psychotherapy
  • Interpersonal psychotherapy

Some of their goals are:

  • To improve adherence to treatment
  • To identify symptoms and reduce the risk of relapse
  • To recognize the factors that affect depressive or hypomanic crises
  • To provide strategies to face stressful stimuli
  • To recover the social rhythm and improve the quality of life

Read also: What Should You Do if You Have a Bipolar Partner?


To regulate the behavioral cycles that affect bipolar II disorder type, lifestyle changes are necessary. In addition, a healthy diet and the practice of relaxation techniques will help you cope with the disease.

It’s also advisable to avoid the consumption of alcoholic beverages and drugs. It’s also advisable to sleep at least 8 hours a day and to follow a regular physical exercise routine.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.