Bipolar disorder type 2: features, symptoms and treatments

Bipolar disorder is characterized by the intermittent presence of manic episodes and episodes of depression. This is why it is called “bipolar” disorder and is also known as manic-depressive disorder (as the manifestations vary from pole to pole).

In this broad spectrum, manic episodes may be more intense than depressive episodes, or vice versa. For this reason, they are currently recognized two types of bipolar disorder: bipolar I disorder and bipolar II disorder.

    What is type 2 bipolar disorder?

    Bipolar disorder type II, also written with Roman numerals (bipolar disorder type II), is a mood pattern characterized by major depressive episodes, alternating with hypomanic episodes. In other words, that is to say depression manifests itself more intensely than mania.

    Currently, type 2 bipolar disorder is one of the clinical subcategories that fall under the category “Bipolar Disorder and Related Disorders” in the Fifth Version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). In English).

      Diagnostic criteria for bipolar disorder type II (according to the DSM-V)

      As we have said, bipolar disorder type 2 can be diagnosed in the presence of two large and complex phenomena: a hypomanic episode and a major depressive episode. In turn, these phenomena must have a number of specific characteristics (in order to differentiate bipolar disorder type I from type II).

      In addition, when diagnosed, it is necessary to specify which of the episodes was the most recent and how it was, for example, whether it has occurred in rapid cycles, whether psychotic characteristics exist, If it is accompanied by other elements such as anxiety, if there is a seasonal pattern and if the severity is mild, moderate or severe.

      The hypomanic episode

      This is a period of too high mood, for example more expansive or more irritable than normal, characterized by a visible and persistent increase in energy. For diagnosis, this period should have lasted at least four days in a row and should present for most of the day.

      Is visible and persistent increase in energy it must have caused a significant change in normal behavior, but it must not seriously interfere with the fulfillment of responsibilities considered socially appropriate for age, sex, social position, etc. of the person.

      This increase in energy is characterized by the presence of at least three of the following phenomena, provided that they cannot be explained by the physiological effects of any substance or treatment:

      • there is increased self-esteem and a sense of greatness.
      • Even if there is fatigue, there is little or no need to sleep.
      • There is a greater need to speak or to have a conversation.
      • Feel that thoughts are going at a great speed or that there is some kind of brain drain
      • There is a special facility for bathing.
      • The activity is exacerbated, which can be seen in psychomotor agitation.
      • Excessive interest in activities that may cause discomfort (eg, shopping suddenly, recklessly, and unbridled)

      If all of this is accompanied by psychotic characteristics, then the episode is not hypomanic, but manic, which requires a different intervention. Likewise, all of the above should be sufficiently noticeable and visible to your loved ones.

      Major Depression Episode

      As the name suggests, major depression episode is the presence of a depressed mood that is experienced most of the day and almost every day, which greatly influences a person’s daily activity.

      Clinically, this episode can be diagnosed when the mood exhibits at least five of the following characteristics, and in addition produced clinically significant discomfortIn other words, it has rendered the person incapable of fulfilling responsibilities that are considered socially accepted for their age, gender, social status, etc. (for example with work, education, family):

      • The mood lasted almost every day, Which can be known through what the person expresses, in addition it can corroborate what other people have seen.
      • Significant decrease in interest and feeling of pleasure in virtually all daily activities.
      • Significant and rapid weight loss or gain (without diet).
      • Insomnia almost every day.

      • Sensation of restlessness and psychomotor agitation constant and observable by others.
      • Fatigue and constant loss of energy.
      • Excessive or inappropriate guilt can even be delusional.
      • Lack of concentration and decision making.
      • Idea of ​​death and constant suicide.

      None of the above phenomena can be explained by the effects of a substance or medical treatment. For its diagnosis, it is important not only to consider the list, but the clinical criterion of the specialist based on the medical history and cultural norms of the person which makes it a significant discomfort.

      Therapies and treatments

      Type 2 bipolar disorder is not so much a disease as it is a lifelong condition, however, there are several options for help the person to better control their emotions and on the oscillations of his mood.

      The most effective options are those that combine appropriate drug therapy with long-term psychotherapy. As for drugsThose that are most often included are mood stabilizers, antipsychotics, and antidepressants. For their part, the most common psychotherapies are cognitive behavioral therapy, systemic therapy and psychoeducation.

      A lot of studies and research (and even civil associations and critical models) are currently underway to better understand type 2 bipolar disorder, so more and more options are being developed for people who have had it. diagnosis, and their families, can have good living conditions.

      Bibliographical references:

      • National Institute of Mental Health (2018). Bipolar disorder. Accessed May 2, 2018. Available at
      • American Psychiatric Association (2014). DSM-5 Diagnostic Criteria Reference Guide. Washington, DC: United States.

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