Bipolar 2 Disorder is diagnosed after one or more major depressive episodes and at least one episode of hypomania—and possible periods of level mood between these episodes. The highs in Bipolar 2 Disorder are called hypomanias. They are not as high as those found in Bipolar 1 Disorder. Sometimes, Bipolar 2 Disorder is misdiagnosed as major depression if hypomanic episodes are unrecognized.
A type of mania that shows elation and hyperactivity, hypomania may alter the way a person performs activities and all aspects of everyday life for people with Bipolar 2 Disorder, but it isn’t as serious as the delusions and/or hallucinations that bring about manic episodes that may call for hospitalization.
The periods of serious feelings of euphoria or despair occur for certain amounts of time. The change to Diagnostic and Statistical Manual (DSM)-5* is that it includes the extent of activity, energy and emotions. With DSM-5, hopelessness has been added to the mood criteria. The DSM-5 pinpoints a hypomania episode as the existence of a single or greater number of depressive events (see list below) and a minimum of one hypomania episode, which has continued for a greater part of the day for a minimum of 96 hours. At least three symptoms below will exist:
- Abnormally upbeat, jumpy or wired.
- Increased activity, energy or agitation.
- Less desire to sleep.
- Unusual talkativeness.
- Exaggerated sense of well-being and self-confidence (euphoria).
- Thinking is rushed/scattered.
- Increase in activity toward goals.
- Psychomotor agitation, which is an increase in purposeless physical activity. Symptoms are restlessness, pacing, tapping fingers or feet, abruptly starting and stopping tasks, rapidly talking and moving items around without meaning.
- Poor decision-making, such as taking risks sexually or making unwise investments.
- Individuals won’t have had a manic episode or a combination of episodes.
*The DSM is published by the American Psychiatric Association, which lists all classifications of mental disorders.
Major Depressive Episode Symptoms
A major depressive episode involves symptoms that are severe enough to cause noticeable difficulty in daily tasks like work, school and activities, as well as in relationships. An episode consists of five or more of the following symptoms.
- Depressed mood—feeling sad, empty, hopeless or teary. In children and adolescents, this can be shown as irritability.
- Significant loss of interest or feeling of no pleasure in all or most activities.
- Weight loss when not dieting, weight gain, or increase/decrease in appetite.
- Insomnia or oversleeping.
- Restlessness or slowed behavior.
- Loss of energy.
- Feeling worthless.
- Feeling inappropriate guilt.
- Decreased ability to think or concentrate.
- Thinking about, planning or attempting suicide.
What is the Difference Between Bipolar Disorder 1 and 2?
The most prevalent contrast with Bipolar 1 and Bipolar 2 is complete mania (great excitement, euphoria, delusions and overactivity) that lasts a week compared to hypomania that lasts four days. When a person experiences this, he is given a Bipolar 1 diagnosis.
Bipolar 1 (with manic episode) is separated in half a dozen sub-diagnoses. They are described by the kind of episode the individual is in at the time or the episode he just previously was in, as well as the kinds of episodes he may have had previously. (A couple out of the half-dozen diagnoses don’t have to include any major depressive episodes.)
How Bipolar Disorder 2 Impacts Individuals Every Day
People with Bipolar Disorder may have serious problems in many features of their lives. The various episodes may dominate everyday life. One of the problems is functioning in the workplace, where they can experience trouble concentrating and socializing. As a result, securing and keeping a job is low for this group. Because of hypomania episodes, people may not have job security, have absences due to sickness, can face a “black mark” on their work records and feel ashamed. As a consequence of not being able to keep a job, people with Bipolar Disorder sometimes are in a poor income bracket.
Treatments for Bipolar Disorder 2 DSM-5
- Adaption strategies can include regulating daily routines and sleep patterns. Behavioral changes may help an individual with moods and with balance.
- Therapists can help individuals learn to find the triggers for mood episodes. Poor sleep and little physical activity can cause a disruption in emotions.
- Early intervention is critical.
- Therapy that includes family members and Cognitive Behavioral Therapy are the most productive in the treatment of Bipolar Disorder. They helped improve mood and hypomania.
- Behavioral therapy can help people manage and control their responses when dealing with emotional incidents.
- Some types of therapy are used to treat the interruption of circadian rhythms related to Bipolar Disorder and has had excellent results in the improvement of job functioning. A particular approach centers on working and building relationships.
- Group therapy can help with the relationship between substance use/abuse and Bipolar Disorder. One study of group therapy reported that individuals who participated had a decreased level of dependency and stopped drug use for longer periods of time.
- A comprehensive review more than 100 examples showed that therapy has a greater success rate than medicine in Bipolar Disorder, as well as other disorders.