Bipolar disorder is a mental health condition characterized by drastic changes in a person’s mood that can last from days to weeks. Bipolar 2 involves a pattern of hypomania, often with depressive episodes. Understanding the symptoms and cause of bipolar 2 can help connect people with needed treatments.
What is bipolar 2?
Bipolar 2 disorder is a type of bipolar disorder, a mental health condition characterized by drastic changes in mood. While there are several types of bipolar disorder, there are three main subtypes:
- Bipolar 1 disorder: Characterized by at least one manic episode that lasts at least seven days or involve manic symptoms so severe that they require hospital care. These often alternated with episodes of depression.
- Bipolar 2 disorder: Characterized by at least one hypomanic episode that lasts for at least four days, often alternated with episodes of depression.
- Cyclothymic disorder: Characterized by emotional highs and lows that are not as severe as those experienced with bipolar 1 and 2. Cyclothymia is much rarer than bipolar 1 or 2.
Check out this article for a more in-depth overview of the bipolar disorder spectrum.
What causes bipolar disorder?
While no one thing causes bipolar disorder, certain environmental and genetic factors may make a person more likely to develop bipolar disorder. Bipolar disorder tends to run in families, though no single gene is responsible for it (Kato, 2019). Bipolar disorder may also be linked to chemical imbalances in the brain, specifically imbalanced levels of neurotransmitters such as noradrenaline, serotonin, and dopamine.
Certain environmental factors may trigger bipolar disorder, such as the death of a loved one, abuse, physical illness, or overwhelming life problems. Periods of high stress, a traumatic head injury, and alcohol or drug misuse can trigger bipolar disorder in those who are already susceptible (Kerner, 2014).
People with bipolar 2 often experience other co-occurring mental health conditions, such as anxiety disorders, attention-deficit/hyperactivity disorder, eating disorders, or substance-use disorder.
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Symptoms of bipolar 2
Bipolar 2 typically involves periods of hypomania and depression. It is normal to feel sad, energetic, or anxious at certain times. However, for people with bipolar 2, these emotions can be heightened and overwhelming, causing difficulties in everyday life.
Hypomania is a less-intense form of mania. It is an indicator of bipolar 2 when symptoms last for at least four days. Some common symptoms of hypomania include:
- Increased activity, energy, or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Risky behavior
It is common to experience depressive episodes with bipolar 2. It is also possible to have bipolar 2 without symptoms of depression or major depressive episodes. Often, bipolar 2 disorder is misdiagnosed as depression because hypomania, which is subtler than mania, can go unnoticed.
Some common symptoms of depression include:
- Feelings of hopelessness, powerlessness, and worthlessness
- Decreased ability to think or concentrate
- Fatigue or low energy
- Increased need for sleep or insomnia
- Lack of interest or joy in daily activities
- Decreased appetite
- Isolation and withdrawal
- Thoughts of death
- Suicidal thoughts
Patients with bipolar 2 disorder often experience other symptoms, like misuse of drugs and alcohol. Other mental health conditions related to bipolar 2 include: such as:
- Anxiety disorders
- Eating disorders
- Personality disorders
- Impulsive control disorders
What’s the difference between bipolar 2 and bipolar 1?
Bipolar 1 and bipolar 2 can look similar. However, bipolar 1 is characterized by one or more manic episodes, which are more severe than hypomania. Manic episodes may also involve psychosis and delusions. Symptoms of hypomania do not significantly impact a person’s ability to work or socialize and typically do not require hospitalization.
How is bipolar 2 diagnosed?
To diagnose bipolar 2, a licensed clinician may perform a physical examination and medical tests to rule out other possible health conditions. They may also conduct a mental health evaluation.
Clinicians typically use the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria to diagnose bipolar disorder subtypes. They may assess a patient’s symptom pattern. This can include how impaired the patient is during their most severe episodes, lifetime history, experiences, and family history.
Treatments for bipolar 2
Bipolar 2 disorder is a lifelong diagnosis with no cure. However, there are ways to manage its symptoms. Generally, treatments involve a combination of therapy and medication specific to each person’s symptoms. For this reason, finding the best combination of therapy and medication for each patient may take time.
Several types of therapy can help with bipolar 2, including cognitive behavioral therapy and interpersonal and social rhythm therapy. Therapy for bipolar 2 disorder generally involves learning to recognize when a hypomanic or depressive episode is about to begin and developing strategies to prepare for and manage them.
In addition to therapy, medication is usually used to treat bipolar 2. Patients with bipolar 2 are often prescribed mood stabilizers to help balance fluctuations.
When to seek emergency help
If you are having a psychiatric or medical emergency, please call 911 or go to the nearest emergency department. To reach the Suicide and Crisis Lifeline, please call or text 988.
- Kato, T. (2019). Current understanding of bipolar disorder: Toward integration of biological basis and treatment strategies. Psychiatry and Clinical Neurosciences, 73(9), 526–540. https://doi.org/10.1111/pcn.12852
Kerner, B. (2014). Genetics of bipolar disorder. The Application of Clinical Genetics, 33. https://doi.org/10.2147/tacg.s39297
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