Bipolar II disorder is a mental health condition that involves at least one depressive episode and at least one period of elevated mood, called hypomania.

Bipolar II disorder causes intense emotional states that affect a person’s mood, ability to function, and energy levels. Treatment can help with managing these symptoms.

There are three main forms of bipolar disorder — bipolar I, bipolar II, and cyclothymic disorder.

All forms of bipolar disorder cause episodes that involve significant shifts in mood and levels of energy and activity.

According to the current diagnostic criteria, a doctor may diagnose bipolar II if a person experiences at least one major depressive episode and at least one episode of hypomania, in which a person may feel elated, energized, or irritable beyond what is typical for them.

To receive a diagnosis of bipolar I, a person must have experienced an episode of mania, which involves a more extreme increase in energy and mood changes than hypomania. They may also experience depressive or hypomanic episodes.

Bipolar II disorder first appeared in the Diagnostic and Statistical Manual of Mental Disorders in 1994. However, some researchers have since called for an end to the distinction between types I and II, arguing that it is more realistic to see bipolar disorder as a spectrum with a range of symptoms, patterns, and severities.

The main difference between bipolar I and II relates to the whether or not the person experiences a manic episode. However, the distinction is not clear-cut.

Bipolar I

To receive a bipolar I diagnosis, a person will have experienced at least one manic episode, with or without an episode of depression.

Healthcare professionals define a manic episode as a period of persistently elevated or irritable mood with increased energy or activity levels that lasts at least 7 daysTrusted Source. During a manic episode, a person may need hospital care.

Bipolar II

With bipolar II, a person will have at least one depressive episode and at least one episode of hypomania, which does not involve psychosis. A hypomanic episode is a period of persistently elevated or irritable mood with increased energy or activity levels that lasts for at least 4 daysTrusted Source.

Depression is often the dominant mood. A recent article about bipolar disorder refers to a famous study from 2003, which suggested that people with bipolar II were likely to have depression more than 50% of the time, while depression was present around 30% of the time with bipolar I.

Bipolar II involves at least one major depressive episode and at least one hypomanic episode.

The duration and severity of these episodes and the range of symptoms involved vary widely from person to person.

Hypomania can involve the following symptoms:

  • feeling more creative
  • having faster thoughts and quicker actions
  • getting distracted more easily
  • irritability
  • talking faster and more than usual
  • engaging in impulsive behavior, such as spending excessive amounts of money

After a hypomanic period, a depressive episode can follow.

Symptoms of a depressive episode can include:

  • low motivation and energy levels
  • reduced interest in activities
  • sleeping more or less than usual
  • gaining or losing weight without trying
  • trouble focusing
  • feelings of:
    • sadness
    • emptiness
    • hopelessness
    • worthlessness
    • guilt
  • suicidal thoughts or tendencies

Find out more about the symptoms of bipolar disorder.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Doctors do not know exactly what causes bipolar disorder. However, the following may playTrusted Source a role:

  • genetic factors
  • environmental factors
  • structural features in the brain

Bipolar disorder is more likely to develop in a person with a close relative who has the condition.

Stress and traumatic events can also contribute to triggering the condition in a person with a genetic predisposition.

When making a diagnosis, a doctor may:

  • ask about symptoms
  • ask about family history
  • perform a physical exam
  • order tests, such as blood tests, to rule out other possible causes

For a diagnosis of bipolar II, a person will needTrusted Source to have had at least one episode of depression and at least one hypomanic episode. If they are experiencing an irritable mood, they must present with at least four of the following symptoms:

  • increased self esteem
  • needing to sleep less
  • being more talkative than usual
  • racing thoughts
  • being easily distracted
  • increased goal-related activity
  • increased state of anxiety and restlessness
  • engaging in high risk behavior

The doctor may also use a checklist to identify hypomania.

Treatment for bipolar II disorder usually involvesTrusted Source a combination of medication and psychotherapy.

This treatment approach is usually long term and continuous. If a person stops treatment, even when they feel well, symptoms can return.

Medication

These may include:

  • mood stabilizers, such as lithium
  • antipsychotics, such as:
  • medications to help improve sleep quality

It can take time to find the best medication combination and dosage.

It is important for people to report any side effects they experience to the doctor, who can make adjustments. Trusted loved ones may also be able to offer helpful insight.

Side effects can vary on these medications. However, they may include:

  • nausea
  • diarrhea
  • dry mouth
  • metalic taste
  • mild tremor
  • fatigue or sleepiness

Psychotherapy and counseling

Talking through emotions and challenges associated with bipolar disorder may help.

The purpose of psychotherapy or counseling may be to:

  • develop coping strategies for symptoms
  • learn about effective ways to manage stress
  • identify triggers and ways of avoiding them
  • learn more about bipolar disorder

Some people may have cooccurring health problems, such as alcohol or drug use disorders. Treatment can help with these, too.

Lifestyle changes

Various strategies may help a person maintain more stable moods and a deeper sense of well-being, including:

  • Exercise: A doctor can help develop an exercise plan to support stress management and overall health.
  • Diet: A healthy, varied diet provides essential nutrients and boosts overall well-being.
  • Sleep: Getting enough quality sleep regularly can help, and a consistent routine is important.
  • Keep a log: Noting down mood changes and life events can help people identify patterns and triggers.

There is no guaranteed way to prevent bipolar II disorder. However, a person can work with a doctor to help manage symptoms and preventTrusted Source mood episodes.

Bipolar disorder is a lifelong condition, but a range of treatments can help people manage it.

It is essential to follow a doctor’s instructions regarding treatment. People should not discontinue a medication before discussing stopping with a healthcare professional.

Bipolar disorder is a complex condition that can affect many aspects of a person’s life. Finding a trustworthy doctor and staying in regular contact with them can help.

Bipolar disorder resources

Visit our dedicated hub for more research-backed information and in-depth resources on bipolar disorder.

Bipolar II disorder is a mental health condition that involves extreme mood changes.

There are three main diagnoses of bipolar disorder, which includes bipolar I, II, and cyclothymic disorder. To receive a diagnosis of bipolar II disorder, a person must experience at least one depressive episode and at least one episode of hypomania (elevated mood). A hypomanic episode lasts at least 4 days.

Treatment typically includes medications, psychotherapy, and lifestyle modifications. A person can speak with a doctor about the best treatment plan for them.